SC allows first passive euthanasia, Harish Rana's life support to be withdrawn after 13 years

New Delhi: The Supreme Court on Wednesday passed its first order allowing passive euthanasia under the guidelines laid down in its 2018 Common Cause judgment, recognising the fundamental right to die with dignity.

A bench of Justice JB Pardiwala and Justice KV Viswanathan permitted the withdrawal of life support for a 32-year-old man who has remained in an irreversible permanent vegetative state for 13 years after falling from a building. The order came on a miscellaneous application filed by the man’s father seeking the removal of all life-sustaining treatment.

The court noted that Harish Rana, now 32, had suffered severe brain injuries after falling from the fourth floor of his paying guest accommodation. The injuries left him in a persistent vegetative state with 100 per cent quadriplegia.

Medical reports showed that his condition had not improved in the past 13 years and that he was surviving only on clinically administered nutrition (CAN) through surgically inserted PEG tubes.

The bench observed that CAN constitutes medical treatment and can be withdrawn based on the assessment of primary and secondary medical boards. It said the continuation of treatment in the present case only prolonged biological existence without any therapeutic improvement.

The court noted that both the patient’s parents and the medical boards were of the view that the feeding support should be discontinued as it was not in the patient’s best interest.

The bench clarified that once the primary and secondary medical boards certify the withdrawal of life support, court intervention is not necessary. However, since this was the first case of its kind, the matter was placed before the court. The judges emphasised that the withdrawal of life support must be carried out in a dignified manner.

Court directions
The court issued several directions while allowing the plea:

• The medical treatment, including clinically administered nutrition, may be withdrawn or withheld.
• The All India Institute of Medical Sciences (AIIMS) must admit the patient to its palliative care centre and facilitate shifting him from his residence.
• Life support must be withdrawn through a carefully planned process ensuring dignity.
• High Courts must direct judicial magistrates to receive intimation from medical boards regarding decisions to withdraw treatment.
• The Union government must ensure that chief medical officers in all districts maintain panels of registered medical practitioners to serve on secondary medical boards.

The court also recommended that the Union government enact comprehensive legislation governing passive euthanasia.

Justice Pardiwala authored the main judgment, while Justice Viswanathan wrote a concurring opinion. The bench also recorded its appreciation for the parents of Harish Rana, noting their dedication in caring for their son over the years.

“His family never left his side… to love someone is to care for them even in the darkest times,” Justice Pardiwala observed.

In its landmark 2018 judgment in the Common Cause case, a Constitution Bench of the Supreme Court recognised the right to die with dignity and laid down a procedure for passive euthanasia. The guidelines were later modified in January 2023.

Under these guidelines, the withdrawal of life support is permitted only after approval by primary and secondary medical boards.

This case marks the first time the Supreme Court’s directions in the Common Cause judgment have been applied in practice.

Earlier, a primary medical board had found that the patient’s chances of recovery were negligible. He had been bedridden with a tracheostomy tube for breathing and a gastrostomy tube for feeding and had also developed severe bed sores.

The Supreme Court later directed the All India Institute of Medical Sciences to constitute a secondary medical board to review the case.

The court was hearing a plea filed by the man’s father, who had earlier approached the Supreme Court in 2024 after the Delhi High Court declined to order the constitution of a medical board. At that time, the apex court did not allow the request but directed the Uttar Pradesh government to provide medical care.

The father later filed the present application stating that his son’s condition had worsened and that he was not responding to treatment.

Advocate Rashmi Nandkumar appeared for the petitioner, while Additional Solicitor General Aishwarya Bhati represented the Union government.
(With LiveLaw inputs.)