New Delhi, Mar 11: In its first ever order allowing passive euthanasia, the Supreme Court on Wednesday permitted the withdrawal of artificial life support to a 32-year-old man who has been in a coma for more than 12 years.
Ruling on the long discussed emotive issue, a bench of Justices J B Pardiwala and K V Viswanathan asked the Union government to consider bringing comprehensive legislation on passive euthanasia. It also directed AIIMS-Delhi to ensure that life support is withdrawn with a tailored plan so dignity is maintained.
Passive euthanasia is the intentional act of letting a patient die by withholding or withdrawing life support or the treatment necessary to keep him alive.
Ghaziabad’s Harish Rana, who was a student of Panjab University, suffered head injuries after falling from the fourth floor of his paying guest accommodation in 2013 and has been in a coma since.
Directing AIIMS-Delhi to grant Rana admission in palliative care so medical treatment can be withdrawn, the bench stressed that the process be carried out in a “humane manner”.
The top court noted that Rana survived only through clinically administered nutrition via ‘percutaneous endoscopic gastrostomy’ tubes, and medical boards had unanimously concluded that continuation of treatment merely prolonged biological existence without any possibility of recovery.
When primary and secondary boards have certified withdrawal of life support, there is no need for judicial intervention, the apex court said.
It also asked the Union of India to ensure that chief medical officers in all districts maintain a panel of registered medical practitioners for nomination to secondary medical boards.
The court made special mention of Rana’s parents, expressing its appreciation to them for showing their immense love and care for their son. “His family never left his side,” he said.
The order allowing passive euthanasia is in line with the court’s 2018 Common Cause judgment, which was modified in 2023 and recognised the fundamental right to die with dignity.
In the 2018 judgement, a constitution bench had recognised passive euthanasia and the right to die with dignity as a fundamental right under Article 21. The court had held that passive euthanasia could be carried out using “Advance Medical Directives”.
On January 24, 2023, a five-judge Constitution bench modified the 2018 guidelines to ease the process of granting passive euthanasia to terminally ill patients. A primary and a secondary medical board will have to be formed for an expert opinion on the withdrawal of artificial life support for a patient in a vegetative state, the guidelines stated.
Hearing the Rana family’s writ petition, the top court had earlier expressed its desire to meet the parents. It examined a report on Rana’s medical history filed by a secondary medical board of doctors from AIIMS-Delhi and remarked that it was a “sad” report.
The primary medical board, upon examining the patient’s condition, had stressed that there was negligible chance of his recovery.
“What they tried to convey, in their own way, was that the medical treatment imparted over a period of almost two years be discontinued and nature be allowed to take its own course.
“According to them, if the medical treatment is not making any difference, there is no point in continuing with such treatment and making Harish suffer for no good reason. They believe that Harish is suffering like anything, and he should be relieved of all further pain and suffering,” the bench had noted in its order.
On December 11, the top court noted that according to the report of the primary medical board, the man is in a “pathetic condition”.
In 2011, the top court rejected a euthanasia plea on behalf of Aruna Shanbaug, bedridden in a permanent vegetative state in a Mumbai hospital for 38 years after a brutal sexual assault in November 1973. The court had also directed that passive euthanasia can be allowed in cases of permanent vegetative state.
