India's first passive euthanasia recipient Harish Rana dies after 13 years in coma

New Delhi: Harish Rana, the first person in India to be granted passive euthanasia, passed away on Tuesday at the All India Institute of Medical Sciences after spending more than 13 years in a coma.

The 31-year-old had been in a coma since 2013, when he suffered severe head injuries after falling from a fourth-floor balcony while he was a BTech student at Punjab University.

He was shifted from his Ghaziabad residence to the palliative care unit at Dr BR Ambedkar Institute Rotary Cancer Hospital, AIIMS, on March 14. Just three days earlier, on March 11, the Supreme Court of India, in a landmark ruling, had permitted passive euthanasia for Rana.

He had since been on artificial nutrition support and intermittent oxygen support.

Passive euthanasia refers to the withdrawal or withholding of life-sustaining treatment, allowing a patient to die naturally.

Harish's nutritional support was gradually withdrawn after he was admitted to the hospital, according to PTI. 

Harish's family had said after the apex court judgment that the withdrawal of artificial life support would not bring any personal benefit to the family, but in the larger public interest, the decision could help others facing similar situations.

His father had said passive euthanasia would restore Harish's dignity after years of irreversible suffering.

The apex court had directed AIIMS-Delhi to ensure that life support is withdrawn with a tailored plan so that dignity is maintained. 

A specialised medical team headed by Dr Seema Mishra, professor and head of the department of anaesthesia and palliative medicine, was constituted to implement the process, the first ever in India. The team comprised doctors from departments of neurosurgery, onco-anaesthesia and palliative medicine, and psychiatry.

The Supreme Court, in its March 11 judgment, allowed passive euthanasia for a person for the first time in the country.

Ruling on the long-discussed emotive issue, a bench of Justices J B Pardiwala and K V Viswanathan asked the Union government to consider bringing comprehensive legislation on passive euthanasia.

The top court noted that Rana survived only through clinically administered nutrition via 'percutaneous endoscopic gastrostomy' tubes, and medical boards had unanimously concluded that continuation of treatment merely prolonged biological existence without any possibility of recovery.

When primary and secondary boards have certified withdrawal of life support, there is no need for judicial intervention, the apex court said. It also asked the Union of India to ensure that chief medical officers in all districts maintain a panel of registered medical practitioners for nomination to secondary medical boards.

The court made special mention of Rana's parents, expressing its appreciation to them for showing their immense love and care for their son. "His family never left his side," the court said.

The order allowing passive euthanasia is in line with the court's 2018 Common Cause judgment, which was modified in 2023 and recognised the fundamental right to die with dignity.

In the 2018 judgement, a constitution bench had recognised passive euthanasia and the right to die with dignity as a fundamental right under Article 21. The court had held that passive euthanasia could be carried out using "Advance Medical Directives".

On January 24, 2023, a five-judge Constitution bench modified the 2018 guidelines to ease the process of granting passive euthanasia to terminally ill patients. A primary and a secondary medical board will have to be formed for an expert opinion on the withdrawal of artificial life support for a patient in a vegetative state, the guidelines stated.