The Supreme Court on Wednesday passed its first-ever order allowing passive euthanasia, in terms of its 2018 Common Cause judgment (as modified in 2023) recognising the fundamental right to die with dignity.
A bench comprising Justice JB Pardiwala and Justice KV Viswanathan allowed the withdrawal of life support for a 32-year-old man, who has remained in an irreversible permanent vegetative state for the past 13 years after falling from a building. The bench passed the order on a miscellaneous application of the father seeking to remove all life-sustaining treatment from his son.
“Harish Rana, presently aged 32 years, was once a young, bright boy. He met with a tragic life-altering accident after a fall from the fourth floor of his paying guest accommodation. His brain injury left him in a condition of Persistent Vegetative State (PSV) with 100% quadraplegia… Medical reports show that his medical condition has not improved in the past 13 years,” the bench noted. He is sustaining life only on Clinically Administered Nutrition (CAN) administered through surgically installed PEG tubes.
The Court held that CAN is a medical treatment, which can be withdrawn in the best judgment of Primary and Secondary Medical Boards.
The Court noted that the continuation of treatment merely prolonged his biological existence without any therapeutic improvement.
The Court noted that the patients’ parents, the primary and secondary medical boards, have reached the opinion that the CAN administered to the patient should be discontinued, as it was not in the best interest of the patient.
The Court stated that when primary and secondary boards have certified withdrawal of life support, there is no need for the Court’s intervention. However, since this was the first instance, the reference to the Court was felt. The Court stated that withdrawal of life support must be done in a dignified manner.
The Court passed the following directions.
1. The medical treatment, including the CAN administered to the patient, shall be withdrawn or withheld. The reconsideration period of 30 days stand waived.
2. AIIMS shall grant admission to the patient to its palliative care centre, so that the withdrawal of CAN be given effect to. AIIMS shall give all facilities for shifting the applicant from residence to the palliative care centre.
3. It must be ensured that life support is withdrawn with a tailored plan so that dignity is maintained.
3. The High Courts of all States shall issue directions to all Judicial Magistrates to receive intimations from hospitals, in accordance with the guidelines laid down in Common Cause, in the event the Primary Medical Board and Secondary Medical Board arrive at a unanimous decision to withdraw or withhold life support.
4. Union of India shall ensure that Chief Medical Officers in all districts maintain a panel of Registered Medical Practitioners for nomination to the secondary medical boards.
The Court has also recommended that the Union Government bring comprehensive legislation in this regard.
While Justice Pardiwala wrote the main judgment, Justice Viswanathan penned a concurring opinion. The bench recorded its special appreciation for the parents of Harish Rana for showing their immense love and care for their son. “His family never left his side…to love someone is to care for them even in the darkest times,” Justice Pardiwala stated.
In the 2018 judgment in Common Cause, a Constitution Bench of the Supreme Court recognised the right to die and formulated a procedure to be followed for passive euthanasia. These guidelines were further modified in January 2023. As per these guidelines, withdrawal of life support is permissible only after the approval of Primary and Secondary Medical Boards.
This becomes the first case where the directions of the Court in Common Cause have been judicially applied.
Background
The petitioner, through his father, first approached the Delhi High Court in 2024, seeking permission for
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Supreme Court Allows Withdrawal of Life Support in First Application of Passive Euthanasia Guidelines
New Delhi: In a significant development recognising the right to die with dignity, the Supreme Court on Wednesday permitted the withdrawal of life-sustaining treatment of a 32-year-old man who has remained in a permanent vegetative state for over 13 years, marking the first judicial application of its passive euthanasia guidelines laid down in the Common Cause judgment.
A Bench comprising Justices JB Pardiwala and KV Viswanathan passed the order while allowing a plea filed by the patient’s father seeking withdrawal of artificial life support.
Case background
The patient, Harish Rana, suffered severe brain injury after falling from the fourth floor of his paying guest accommodation as a teenager. Medical records placed before the Court confirmed that he has remained in a Persistent Vegetative State (PVS) with complete quadriplegia and no signs of neurological recovery.
The Court noted that his survival depended entirely on Clinically Administered Nutrition (CAN) provided through surgically inserted PEG feeding tubes.
After examining medical opinions, the Bench observed that continuation of such treatment was only prolonging biological survival without any therapeutic benefit or possibility of recovery.
Court observations
The Supreme Court held that clinically administered nutrition qualifies as medical treatment and can be withdrawn if medical boards conclude that continuation is not in the patient’s best interest.
The judgment recorded that both the Primary Medical Board and Secondary Medical Board, along with the patient’s parents, agreed that continuing life support served no medical purpose.
The Bench also clarified that once medical boards approve withdrawal of life support under the prescribed guidelines, court approval is generally not required. However, since this was the first such case, judicial oversight was considered appropriate.
The Court stressed that the withdrawal process must be conducted with sensitivity and dignity.
Key directions issued
The Court issued several important directions:
Withdrawal of all medical treatment including clinically administered nutrition
Waiver of the usual 30-day reconsideration period
Transfer of the patient to AIIMS palliative care facility for dignified withdrawal of treatment
Direction to High Courts to instruct Judicial Magistrates to receive hospital intimations regarding passive euthanasia decisions
Direction to the Union Government to ensure district-level panels of registered doctors for secondary medical boards
The Court also recommended that the Union Government consider bringing a comprehensive law on passive euthanasia.
Emotional note from the Bench
The judges also recorded appreciation for the parents, noting their dedication and care over more than a decade.
Justice Pardiwala observed that the family’s commitment reflected deep compassion, stating that true love often means standing by someone even in their darkest moments.
Legal context
In its landmark 2018 Common Cause judgment, the Supreme Court recognised passive euthanasia and the validity of living wills, laying down procedures for withdrawal of life support in terminal or irreversible conditions. These procedures were further simplified in 2023.
This case becomes the first instance where those guidelines have been practically implemented through a judicial order.
Background of litigation
The plea was initially filed before the Delhi High Court in 2024 before eventually reaching the Supreme Court for final directions.
