In Landmark First, SC Allows Passive Euthanasia for 32-Year-Old Man

A bench of Justices J.B. Pardiwala and K.V. Viswanathan, while ruling on the sensitive issue, also asked the Centre to consider enacting a comprehensive law on passive euthanasia.

The court directed the All India Institute of Medical Sciences (AIIMS), Delhi, to withdraw life support under a tailored plan ensuring that the process is carried out in a humane manner and that the patient’s dignity is maintained.

Passive euthanasia refers to allowing a patient to die by withdrawing or withholding life-sustaining treatment.

The patient, Harish Rana, a resident of Ghaziabad and a former student of Panjab University, suffered severe head injuries after falling from the fourth floor of his paying guest accommodation in 2013. He has remained in a comatose condition since the accident.

The Supreme Court directed AIIMS-Delhi to admit Rana to palliative care so that life-sustaining medical treatment can be withdrawn in a controlled and dignified manner.

The court noted that Rana survived only through clinically administered nutrition via percutaneous endoscopic gastrostomy tubes, and medical boards had unanimously concluded that continued treatment merely prolonged biological existence with no possibility of recovery.

It added that when both the primary and secondary medical boards recommend withdrawal of life support, judicial intervention is ordinarily unnecessary.

Observing that the decision lies between “love, loss, medicine and mercy,” the court said its order was not about choosing death but about not artificially prolonging life.

“It is the decision to withdraw life-sustaining treatment when that treatment no longer heals, restores, or meaningfully improves life. It is allowing nature to take its course when medicine can only delay the inevitable, because survival is not always the same as living,” the court said.

The bench also acknowledged the dedication of Rana’s parents and family members.

“To Harish’s family, we acknowledge the deep emotional weight this decision carries. It may feel like surrender, but in truth it is an act of compassion and courage. You are not giving up on your son; you are allowing him to leave with dignity,” the court observed.

Allowing the plea filed by Rana’s father Ashok Rana, the court said the case had filled it with profound sadness, noting that the patient had lived a life defined by pain and suffering for more than a decade.

The court praised the unwavering support of the family, saying their care and devotion reflected the enduring strength of love.

The apex court also asked the Centre to ensure that Chief Medical Officers in all districts maintain panels of registered medical practitioners who can be nominated to secondary medical boards for such cases.

The order follows the court’s 2018 Common Cause judgment, which recognised passive euthanasia and the right to die with dignity as part of the fundamental right to life under Article 21 of the Constitution.

In January 2023, a Constitution bench modified the guidelines to simplify the process for withdrawing life support for terminally ill or permanently vegetative patients. The guidelines require the opinion of both a primary and a secondary medical board before artificial life support can be withdrawn.

Rana, a BTech student and sports enthusiast, suffered a diffuse axonal brain injury after the fall on August 20, 2013, leaving him in a permanent vegetative state.

Earlier, the Supreme Court had examined medical reports submitted by a secondary medical board from AIIMS-Delhi and observed that the patient’s condition was extremely grave, with negligible chances of recovery.

The case recalls the landmark Aruna Shanbaug case, in which the Supreme Court in 2011 rejected a plea for euthanasia for the Mumbai nurse who remained in a vegetative state for decades after a brutal assault in 1973.