INTRODUCTION:
Passive Euthanasia involves the withholding or withdrawing of the life-sustaining treatment, allowing the natural deaths for the patients with no recovery prospects. To release them from the never-ending suffering, it was considered as a reason to permit the die with dignity right. India’s Supreme Court has made a landmark ruling in the case of Harish Rana, a 32-year-old man, by permitting the withdrawal of life support for a patient in a persistent vegetative state, marking the first ever judicial application of the passive euthanasia framework established in the prior judgments. The decision of the court balances the right to die with dignity under article 21 of the constitution with procedural safeguards. Passive euthanasia is illegal otherwise, but due to the extreme vegetative condition of the patient, it was considered a valid reason to grant the right to die with dignity. The Supreme Court’s recent consideration in the Harish Rana case which was applied in 2018 Common Cause guidelines for the first time, emphasizing humane end-of-life care. In Harish Rana v. Union of India, Justices J.B. Pardiwala and K.V. Vishwanathan ruled that passive euthanasia is permissible under article 21’s right to die with dignity, distinguishing it from illegal active euthanasia.
BACKGROUND:
The case that formed the legal foundation of this case came from the Aruna Shanbaug v. Union of India (2011) 4 SCC 454, where the court first recognized the need for a passive euthanasia under the High Court oversight for exceptional cases. However, it was rejected by the court and the need for passive euthanasia was being denied in that case. In the Common Cause v. Union of India AIR 2018 SC 1665, a five-judge bench affirmed the right to die with dignity as a part of article 21. Harish Rana, then 20 years old pursuing B.Tech at Punjab University, suffered from a diffuse axonal injury after falling from the 4th floor paying accommodation in 2013. He received the initial treatments including the ventilatory support, tracheostomy, and nasogastric feeding been given to him. Later, his treatments were switched to PEG tubes and replaced every 2 months. He was suffering from immense pain despite the treatment given to him. His body could not recover and was bedridden since he was 20 years old. And for 12 years he has been in pain and could not react to any treatments given to him.
KEY POINTS:
The CANH is the Clinically Assisted Nutrition and Hydration should be treated as ordinary care or as medical treatment. The court clarified that CANH is form of medical intervention as it requires the invasive procedures such as the insertion of the feeding tubes, continuous clinical monitoring and periodic medical replacement to maintain a check on the patient. it is stated that as it is a medical treatment rather than a basic care and it can legally be withdrawn when it is determined to be against the best interest of the patient.
The best interest principle is followed in this scenario, where the consent from the family members is required along with the consideration of a lot of factors such as the condition of the patient, medical reports and evidence, the burdens and the benefits arising in the continuation of the treatment. In the cases involving the incapacity of expressing the wishes, the court in these cases applies the doctrine of the Substantial Judgement – which is the attempt to determine what the patient would likely have wanted if they had the capacity to decide.
To prevent the misuse, the court reaffirmed the strict procedural safeguards established under the previous judgements. The medical hospital treating, should examine the patient and assess whether withdrawals if treatment is justified or not. And later, the independent secondary medical board consisting of 3-5 experts to review the findings to ensure impartiality. The legal guardians of the family should be considered, and their consent should be obtained.
The court made it clear that if the life support is withdrawn, the patient must receive comprehensive palliative care. This aims to ensure that the patient experiences no pain, distress or suffering during the natural process of dying.
RECENT DEVELOPMENTS:
The Supreme Court of India directed the constitution of the medical boards in accordance with the guidelines laid down in the Common Cause v. Union of India. In this both the primary board and the secondary board examined the condition of Harish Rana and concluded that he was suffering from the irreversible persistent vegetative state, with not even a slight possibility of recovery and that the continuous treatment by the hospital would turn out to be futile.
On 11 March 2026, the bench permitted the withdrawal of the life support measures to let the person suffering exercise the right to die with dignity in the condition of a vegetative state. It is stated that the process be carried out with proper supervision of palliative care specialist to ensure a painless and dignified end-of-life process.
CONCLUSION:
This precedent clarifies passive euthanasia protocols, prioritize the patient’s medical condition and the centric best interests of the patient to be kept in mind. And it was also stated by the court to follow the required procedures.
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WRITTEN BY: MEENAKSHI DANGI.
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