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The Supreme Court, on Wednesday, March 11, allowed passive euthanasia for a 31-year-old Ghaziabad resident who has remained in a permanent vegetative state for nearly 13 years, after suffering severe head injuries in a fall from the fourth floor while he was a student.
Passive euthanasia, commonly referred to as withdrawal of life-sustaining treatment, is legally permitted in India in certain circumstances. The Supreme Court has held that medical interventions such as ventilators or feeding tubes may be withheld or withdrawn in cases where a patient is terminally ill or in a persistent vegetative state with no hope of recovery.
The court first recognised passive euthanasia in the 2011 judgment in Aruna Shanbaug vs Union of India, which distinguished it from active euthanasia — the intentional administration of lethal substances to end a patient’s life — and held that the latter remains illegal in India. Later, in the 2018 Common Cause vs Union of India ruling and subsequent clarifications in 2023, the court reaffirmed that the right to die with dignity forms part of the fundamental right to life under Article 21 of the Constitution and laid down detailed procedures, including review by medical boards, for withdrawal of life-sustaining treatment.
A Bench of Justices JB Pardiwala and KV Viswanathan permitted withdrawal of life-sustaining treatment for Harish Rana, observing that the medical Board may exercise its clinical judgment in accordance with the guidelines laid down by the apex court.
Allowing the plea filed by his family, the Justice Pardiwala-led Bench directed that Rana be admitted to the palliative care unit at the All India Institute of Medical Sciences (AIIMS), New Delhi, where the process of withdrawal of medical treatment can be carried out. “In our considered view, it would be permissible for the medical Board to exercise its clinical judgment regarding the withdrawal of treatment in accordance with the guidelines laid down in Common Cause vs. Union of India,” the apex court said.
His father Ashok Rana on Wednesday expressed deep gratitude to the judges for their decision, saying that the order not only affects his family but could also bring relief to many other families facing similar situations across the country.
He noted that both he and his wife are growing older and have struggled to cope with the situation for years. "We are getting old now. I am around 63 years old and my wife is 60. My son was declared brain dead long ago. This issue is not only about our family. In India, there must be many such cases where families are facing similar circumstances," he added.
Talking to reporters, Ashok Rana said the legal battle had been long and emotionally difficult for the family. "Four years ago, my wife had suggested that we approach the Prime Minister or the President regarding this issue. But at that time, I told her that such a step would not be possible," he said.
Rana explained that he later discussed the matter with members of the Brahma Kumari institution, with which he has been associated. "I have been connected with the Brahma Kumari institution. I shared our situation with one of the senior members there. She helped us by sending a lawyer, Manish Jain, who guided us through the legal process," he said.
He also thanked the doctors who had been caring for his son over the years.
Rana has been in a permanent vegetative state with 100% disability and quadriplegia, requiring continuous medical assistance for breathing, feeding, and daily care.
Earlier, the Supreme Court had directed the constitution of a Primary Medical Board to assess whether withdrawal of life-sustaining treatment could be considered.
A team of medical experts that examined Rana at his residence reported that he was lying in bed with a tracheostomy tube for respiration and a gastrostomy tube for feeding, and that the chances of his recovery were negligible.
Subsequently, the apex court also asked AIIMS to constitute a Secondary Medical Board to independently evaluate his condition.
The case originated from a petition filed before the Delhi High Court by Rana’s parents seeking the constitution of a medical Board to examine whether passive euthanasia could be considered. The Delhi High Court had dismissed the plea, observing that active euthanasia is impermissible under Indian law.
When the matter reached the Supreme Court in August 2024, the top court issued a notice to the Union government and explored whether a humanitarian solution could be found, noting that the parents were struggling to continue caring for their son who had remained in a vegetative state for over a decade.
In November 2024, the apex court disposed of the matter after recording the government’s proposal to provide home-based medical assistance, including physiotherapy visits, nursing care, dietician support and free medicines.
However, liberty was granted to the family to approach the court again if further directions were required. The parents later moved the Supreme Court again, stating that Rana’s condition had deteriorated and that there had been no improvement despite years of treatment. After hearing the parties and receiving written submissions, the Justice Pardiwala-led Bench had reserved its verdict on January 15 this year.
With inputs from IANS