Harish Rana: Passive euthanasia still ensures medical care and is no abandonment; here's how

'Passive euthanasia,' which allows a patient to die naturally by withholding or withdrawing medical treatment that sustains their life, has been legal in India since 2018. However, it is today that, for the first time, a 32-year-old man got the Supreme Court's approval for passive euthanasia in India. Harish Rana from Gaziabad, who has been in a vegetative state for the past 13 years following a fall, will be allowed the withdrawwal of the life support due to the permanent, irreversible damage to his health. However, 'passive euthanasia' is quite different from 'active euthanasia (it is still illegal),' in which a drug is administered to cause a patient's death. How does passive euthanasia work in the Indian context?

How it works
According to expert doctors, once passive euthanasia is permitted by the court, the patient is admitted to a palliative care unit. Here, the focus would be on ensuring dignified care for the patient, instead of trying to cure them or abandoning them medically. Here's how it works:
1) At the palliative unit, the patient will still receive hydration, nutrition and care for pain relief.
2) Medical care will be given for symptoms like shortness of breath, anxiety or other kinds of discomfort.
3)Family members will receive counselling to understand how the process works.
4)Treatment methods like invasive ventilation, intravenous antibiotics or interventions and high-end ICU treatments, which are generally undertaken to prolong a person's life, will be stopped.

The right to die with dignity
1) Though legal in India, passive euthanasia always requires court approval.
2) In 2018, the Indian Supreme Court said that the 'Right to Die with Dignity' comes under Article 21. People can write their medical wishes in their living wills in advance, to ensure that their decisions are carried out if they become unable to care for themselves.
3) A judge will watch over the process of passive euthanasia, following the medical board's recommendations.

4) While in India the process is strict, requires medical and legal scrutiny and court approvals, the passive euthanasia procedures are a lot more lenient in many countries like the Netherlands and Belgium, where doctors are allowed to perform it as long as they comply with legal terms.
The health condition of 'Harish Rana' has sparked widespread concern, with it generating over 5K search volume on Google Trends in the past one hour.

Frequently Asked Questions
1. Who is Harish Rana?
Harish Rana is a 32-year-old native of Uttar Pradesh from Ghaziabad. In 2013, while he was a student at the Punjab University, he fell from the fourth floor of his PG accommodation, resulting in a 100% disability and quadriplegia. Ever since, he has been in a comatose condition. He has been bedridden and relies on a gastroejunostomy tube for feeding and a tracheostomy tube to breathe.  He experiences a wake-sleep cycle, but there has been no improvement in the past 13 years. 

2. What is passive euthanasia?
It is the legal process that allows a patient to die naturally by withdrawing medical treatment that sustains their life. This generally means removing their feeding tubes, CPR or ventilator support.

3. Is passive euthanasia legal in India?
In India, passive euthanasia has been legal since 2018. However, it is only allowed after approval by a court, a medical board, a patient's living will, or any other advance directive. It also needs family consent. 

4. What is the difference between passive and active euthanasia?
Active euthanasia refers to an action that causes a person's death. It can be done through administering a lethal injection, like in many European countries, intravenous infusion or oral medication. It is illegal in India. As opposed to this, passive euthanasia allows a patient to die naturally and only removes the equipment or medical procedure that is sustaining the life of the patient. 

5. Why was passive euthanasia allowed in Harish Rana's case?
The Supreme Court ruled that Harish Rana's condition has shown no improvement, and there has not been a meaningful interaction for years. He is also fully dependent on others for all self-care activities. The court said that prolonging the treatment is not in his best interest. The judgment was passed in a miscellaneous application filed by Harish Rana's father.