In a judgment that blends constitutional principles with deep human empathy, the Supreme Court on Wednesday allowed the withdrawal of life-sustaining treatment for 32-year-old Harish Rana, who has been in a permanent vegetative state since a tragic accident in 2013.
A Bench of Justices JB Pardiwala and KV Viswanathan permitted the withdrawal of clinically assisted nutrition and hydration (CANH) being administered to Rana through a PEG tube, while directing that the process be carried out in a manner that preserves dignity.
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The court also waived the mandatory 30-day reconsideration period prescribed under earlier guidelines.
“The medical treatment, including the clinically assisted nutrition administered to the patient, shall be withdrawn or withheld,” the bench directed.
To ensure that the process is conducted with medical care and sensitivity, the Court directed the All India Institute of Medical Sciences (AIIMS) to admit Rana to its palliative care centre, where the withdrawal of treatment will take place.
The hospital has also been directed to facilitate the safe transfer of Rana from his residence to the palliative care facility.
“It must be ensured that life support is withdrawn with a tailored plan so that dignity is maintained,” the court emphasised.
A decade-long ordeal
Harish Rana was an engineering student in Chandigarh when a fall from the fourth floor of his paying guest accommodation in August 2013 caused a severe traumatic brain injury.
Since then, he has remained in a permanent vegetative state, experiencing sleep–wake cycles but showing no meaningful interaction with his surroundings.
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For over ten years, his parents have cared for him at home, watching their son remain alive but unresponsive, sustained only through artificial nutrition delivered through a feeding tube.
Doctors repeatedly indicated that his neurological condition was irreversible.
Eventually, the family approached the courts seeking permission to withdraw the life-sustaining treatment.
Their plea was initially rejected by the Delhi High Court, which held that Rana was neither terminally ill nor dependent on mechanical life support such as a ventilator. The High Court reasoned that since he could sustain basic bodily functions independently, the question of passive euthanasia did not arise.
The family challenged this decision before the Supreme Court in 2024.
Applying the Common Cause framework
The ruling marks the first judicial implementation of the Supreme Court’s landmark 2018 Constitution Bench decision in Common Cause v. Union of India, which recognised passive euthanasia and the right to die with dignity under Article 21 of the Constitution.
In that case, the Court had ruled that the right to life includes the right to live with dignity and that dignity must extend to the process of dying, particularly in cases where a patient is terminally ill or in a persistent vegetative state with no hope of recovery.
The judgment had also laid down detailed safeguards for withdrawing life support.
Under the framework, the decision must be approved by both a Primary Medical Board and a Secondary Medical Board before treatment can be withdrawn.
These procedures were further simplified by the Supreme Court in January 2023.
In Rana’s case, the court reiterated the importance of institutional mechanisms to implement these safeguards.
It directed High Courts across the country to issue instructions to Judicial Magistrates to receive intimations from hospitals whenever Primary and Secondary Medical Boards arrive at a unanimous decision to withdraw or withhold life support.
The Court also directed the Union government to ensure that Chief Medical Officers in all districts maintain a panel of registered medical practitioners who can serve on secondary medical boards.
Significantly, the bench recommended that Parliament consider enacting comprehensive legislation governing end-of-life decisions.
A deeply human moment in court
While Justice Pardiwala authored the main judgment, Justice Viswanathan wrote a concurring opinion.
The bench also recorded its special appreciation for Rana’s parents and wrote, “His family never left his side, to love someone is to care for them even in the darkest times.”
For the Rana family, the judgment marks the end of a long and painful legal battle and the beginning of what the court described as a dignified farewell.
For the law, it represents a significant step in translating the constitutional promise of the right to die with dignity into a living reality.
