The Supreme Court on Wednesday permitted the withdrawal of life-sustaining treatment for 32-year-old Harish Rana, who has remained in a permanent vegetative state since a fall from a fourth-floor building in August 2013. The case marks the first practical application of passive euthanasia in the country.
The apex court allowed the withdrawal of medical support for Rana, granting him the right to die with “dignity”.
A Bench of Justices J B Pardiwala and K V Viswanathan directed that all medical treatment being administered to Rana, including Clinically Assisted Nutrition and Hydration (CANH), “shall be withdrawn/ withheld”. The court emphasised that the process must be implemented in a “humane” and dignified manner.
Taking note of the specific circumstances of the case, the Bench dispensed with the usual 30-day reconsideration period, observing that all stakeholders were unanimous that continuing medical intervention was not warranted. The court further directed the All India Institute of Medical Sciences (Aiims), Delhi, to admit Rana to its palliative care department so that the withdrawal of treatment could be carried out under medical supervision.
“Aiims must ensure that such withdrawal or withholding is carried out through a robust palliative and end-of-life care plan which is specifically tailored to manage symptoms without causing any discomfort to the applicant and ensuring that his dignity is preserved to the highest degree,” the Bench said.
Rana, a Ghaziabad native, was pursuing a B Tech degree at Panjab University in 2013 when he fell from the fourth floor of his paying guest accommodation and sustained a brain injury leading to comatose state.
During the hearing, the Bench observed that India lacks a comprehensive statutory framework governing end-of-life care and urged the Union government to consider enacting legislation in this area.
Rana’s family had approached the apex court seeking permission to withdraw life-sustaining treatment in line with the Supreme Court’s 2018 Constitution Bench judgment recognising the legality of passive euthanasia for terminally ill patients. That ruling established guidelines allowing withdrawal of life support in cases where a patient had issued an advance directive or living will, as well as in situations where no such directive existed.
In 2023, another Constitution Bench revised parts of the 2018 guidelines to simplify the process, introducing timelines for medical boards to make decisions and reducing the role of judicial magistrates.
“Harish Rana, presently aged 32 years, was once a young, bright boy… His brain injury left him in a condition of persistent vegetative state (PVS) with 100 per cent quadriplegia… Medical reports show that his medical condition has not improved in the past 13 years,” the Bench said.
Justice Pardiwala, who authored the main opinion, also acknowledged the devotion of the patient’s parents. “Among the manyfold truths about human existence that this case reveals, the most enduring is the resilience of love. In our considered opinion, the greatest tragedy in life is not death but abandonment. Despite the catastrophic tragedy that struck the appellant, his family never left his side. He has been cared for, protected and cherished every moment. To us, this unwavering vigilance is a testament to the true meaning of love,” he said in the judgment.
The judgment does not fall within the domain of logic and reason alone but lies at the intersection of love, loss, medicine and mercy, Justice Pardiwala said.
Earlier, the Delhi High Court had rejected the family’s request on the ground that Rana was not dependent on mechanical life support and could survive without external assistance. The family subsequently approached the Supreme Court in 2024 but did not obtain relief at that stage. The court had, however, permitted them to return if circumstances warranted, following which the present application was filed last year.
Law experts say the ruling marks an important moment in the practical implementation of the court’s earlier jurisprudence. “Passive euthanasia has been permitted in India for over a decade, but courts have remained cautious due to the lack of clear precedents on its implementation. The Supreme Court’s decision in Harish Rana vs Union of India marks the first practical application of the framework developed in Aruna Shanbaug (2011) and refined in Common Cause (2018), which recognised the right to die with dignity,” said Biplab Lenin, partner at Cyril Amarchand Mangaldas, adding that the judgment does not alter the existing legal position but clarifies how the framework should operate in practice.
“The ruling may encourage more families of patients in irreversible conditions to seek similar relief. At the same time, the Court has emphasised that such decisions must continue to involve careful medical evaluation and procedural safeguards,” Lenin said, noting that the case also highlights the need for clearer legislation governing end-of-life decisions.
According to Supriya Majumdar, partner at Elarra Law Offices, the decision gives formal recognition to passive euthanasia in legitimate cases involving terminally ill patients. However, she cautioned that the absence of a statutory framework could create risks of coercion in some cases, particularly where families may be burdened by medical costs.
“While the court has emphasised strict adherence to the two-tier medical board system, a clear statutory framework is still urgently required,” Majumdar said.
Shiv Sapra, partner at Kochhar & Co, described the ruling as a key development in India’s constitutional jurisprudence on dignity and personal liberty. “This is a landmark moment in India’s end-of-life jurisprudence. The court has reaffirmed that dignity under Article 21 extends to the final stage of life, and that in rare and medically hopeless cases, the law will permit a humane exit rather than prolonging biological existence,” he said.
He added that the decision is likely to revive discussions on a comprehensive legal framework for end-of-life care in India.
Elsewhere, in best interest
US: Courts have recognised withdrawal of life-sustaining treatment based on patient's autonomy and best interests
UK: Withdrawal decisions for incapacitated patients follow the best-interests doctrine
Australia: Courts have allowed discontinuation of artificial nutrition and hydration when treatment serves no therapeutic purpose
New Zealand: The high court has permitted withdrawal when treatment no longer benefits the patient
EU: The European Court of Human Rights in Lambert v France upheld withdrawal of life-sustaining treatment within a regulated legal framework
 "Death with 'dignity': In a first, Supreme Court allows passive euthanasia")
