Supreme Court Allows First Passive Euthanasia

Source: Supreme Court

Why in News? 

A bench comprising Justice JB Pardiwala and Justice KV Viswanathan of the Supreme Court of India, in the case of Harish Rana v. Union of India (2026), passed its first-ever order allowing passive euthanasia in terms of the landmark 2018 Constitution Bench judgment in Common Cause v. Union of India (as modified in January 2023).  

• The Court permitted the withdrawal of all life-sustaining treatment, including Clinically Administered Nutrition (CAN), from a 32-year-old man who has remained in an irreversible Persistent Vegetative State (PVS) for 13 years following a fall from a building. The order marks the first judicial application of the Common Cause guidelines in a concrete case.

What was the Background of Harish Rana v. Union of India (2026) Case? 

• Harish Rana, aged 32, suffered a severe brain injury after falling from the fourth floor of his paying guest accommodation, leaving him in a Persistent Vegetative State (PVS) with 100% quadriplegia. 
• He has remained in this irreversible condition for over 13 years, sustained solely by Clinically Administered Nutrition (CAN) through surgically installed PEG tubes and a tracheostomy tube for respiration. 
• His father approached the Delhi High Court seeking constitution of a Primary Medical Board to evaluate his son's condition, but the High Court refused. 
• The father then moved the Supreme Court in 2024, which, while initially declining the plea, prompted the State of Uttar Pradesh to undertake responsibility for the patient's medical treatment. 
• The father subsequently filed a Miscellaneous Application before the Supreme Court, reporting a further deterioration in his son's condition and absence of response to any treatment, seeking withdrawal of all life-sustaining measures.

What were the Court's Observations? 

• The Court held that Clinically Administered Nutrition (CAN) constitutes medical treatment and, as such, is amenable to withdrawal in the best judgment of the Primary and Secondary Medical Boards. 
• The Court observed that continuation of treatment was merely prolonging biological existence without any therapeutic benefit or prospect of improvement. 
• The Court noted that the patient's parents, the Primary Medical Board, and the Secondary Medical Board constituted by AIIMS had unanimously reached the opinion that withdrawal of CAN was in the best interest of the patient. 
• The Court clarified that once both Primary and Secondary Boards have certified withdrawal of life support, no further court intervention is ordinarily required; however, given that this was the first instance of such an application, the reference to the Court was appropriate. 
• The Court emphasised that withdrawal of life support must be carried out in a dignified manner, with a tailored plan to preserve the patient's dignity throughout the process. 
• Justice Pardiwala authored the main judgment, while Justice Viswanathan penned a concurring opinion. 
• The bench recorded its special appreciation for the parents of Harish Rana for their sustained love, care, and devotion across 13 years of unimaginable hardship. 
• The Court recommended that the Union Government enact comprehensive legislation on passive euthanasia to provide a robust statutory framework.

What Directions Were Issued by the Court? 

• The medical treatment, including CAN administered to the patient, shall be withdrawn or withheld. 
• AIIMS shall admit the patient to its palliative care centre and facilitate his dignified shifting from residence to the centre. 
• Life support must be withdrawn pursuant to a tailored plan ensuring the maintenance of dignity throughout. 
• High Courts shall direct Judicial Magistrates to receive intimation from medical boards regarding decisions to withdraw medical treatment. 
• The Union of India shall ensure that Chief Medical Officers in all districts maintain a panel of Registered Medical Practitioners for nomination to Secondary Medical Boards. 

What is Euthanasia? 

About:  

• Euthanasia or “mercy killing” refers to deliberately hastening a person’s death to prevent further suffering from incurable or terminal illness. 
• This aims to protect the right to die with dignity and prevent prolonged, futile suffering in irreversible medical conditions.

Types of Euthanasia:  

• Active euthanasia:  
  • Directly causing a patient’s death, such as through a lethal injection. 
  • Forms of active euthanasia include: 
  • Voluntary: Patient consciously chooses death. 
  • Non-voluntary: Decision made for an incompetent patient. 
  • Involuntary: Death caused without consent. 
• Passive euthanasia:  
  • The withdrawal or withholding of life-support or medical treatment when a patient is terminally ill and has no realistic chance of recovery, allowing death to occur naturally. 

Legal Status in India:  

• Active Euthanasia: It is illegal in India. The Bharatiya Nyaya Sanhita (BNS), 2023 classifies acts committed with the intention of causing death as culpable homicide or murder under Sections 100 and 101. 
• Passive Euthanasia: In Aruna Shanbaug v. Union of India (2011), the SC recognized that life-sustaining treatment could legally be withheld or withdrawn. It applies even to persons without decision-making capacity. 
• In Common Cause v. Union of India (2018), the SC recognized the right to die with dignity as a fundamental right under Article 21 of the Constitution and legalized the use of advance medical directives or “living wills (specifying conditions under which treatment may be withdrawn)”.

Supreme Court Guidelines on Euthanasia:   

The Supreme Court in 2023 modified the 2018 Euthanasia Guidelines to ease the process of granting passive euthanasia. 

• Living Wills / Advance Directives: Adults of sound mind can create a living will. It must be signed by the executor in the presence of two witnesses. 
• Signature can be attested by a notary or gazetted officer. 
• Medical Board Approval: Hospital forms two medical boards. Medical boards must communicate their decision within 48 hours. 
• High Court Oversight: If hospital boards deny permission, the patient’s kin can approach the High Court, which forms a fresh medical board to review the case. 

Global Perspective:  

• Passive euthanasia is accepted in many countries. Countries like the Netherlands and Belgium have legalised active euthanasia under strict safeguards.