Supreme Court gives permission for passive euthanasia for the first time, young man is in coma for 13 years

New Delhi, March 11. The Supreme Court on Wednesday passed an unprecedented order allowing passive euthanasia for the first time. The order was given in accordance with the court’s 2018 Common Cause judgment (which was revised in 2023), which recognized the fundamental right to die with dignity.

Justice J.B. Pardiwala and Justice K.V. Vishwanathan’s bench allowed removal of life support from a 32-year-old man. The man was in a permanent and irreversible vegetative state after falling from a building 13 years ago. The court passed this order on a miscellaneous application filed by his father, seeking permission to remove all life-support treatment from his son.

What did the Supreme Court say in its decision?

The Supreme Court in its judgment said that Harish Rana, who is currently 32 years old, was once a bright and talented youth. He met with a tragic accident after falling from the fourth floor of his paying guest accommodation. He suffered severe brain injury in the accident, leaving him in a state of permanent vegetative state (PVS) and 100% quadriplegia… There has been no improvement in his condition in the last 13 years.

According to reports, he was surviving only on Clinically Administered Nutrition (CAN), which was being given through a surgically inserted PEG tube. The court said that CAN is also a medical treatment and it can be discontinued based on the best judgment of the primary and secondary medical boards.

The court also said that continuing the treatment was only enhancing his biological life processes, but not resulting in any medical improvement. The court found that the patient’s parents, the primary medical board, and the secondary medical board all came to the conclusion that CAN should be discontinued because it was not in the patient’s best interests.

The court said that when both medical boards give permission to withdraw life-saving treatment, there is generally no need for court intervention. Although this was the first case, the court considered it appropriate to pass orders on it itself. The court also said that the life support system should be removed in an honorable and dignified manner.

Supreme Court instructions

• The patient’s medical treatment, including CAN, may be discontinued or interrupted.
• AIIMS will admit the patient to its Palliative Care Center so that the process of closure of CAN can be completed there. AIIMS will make complete arrangements to take the patient from home to there.
• It should be ensured that the process of removal of life support system is done under a special plan and while maintaining dignity.
• The High Court should direct the Judicial Magistrates of their area to obtain information of the decision of the Medical Board to withdraw treatment.
• The Central Government should ensure that the Chief Medical Officers (CMOs) of all districts maintain a panel of registered physicians so that they can be nominated to the Secondary Medical Board.

The court praised the parents

The court also recommended the Central Government to make comprehensive legislation on this subject. Justice Pardiwala wrote the main judgment while Justice Vishwanathan expressed the concurring opinion. The court praised the parents of Harish Rana, saying that they showed extraordinary love and care towards their son. The court said his family never turned away from him… Loving someone means taking care of them even in the darkest times.”

According to the Constitution Bench judgment of 2018 (Common Cause case) and the amended order of January 2023, it is necessary to obtain the primary and second opinion of the medical board in cases of right to die with dignity. This is the first case in which the directions of the Supreme Court’s Common Cause decision have been practically implemented.

The judge had met the patient’s parents before the order.

The judge had also met the patient’s parents before giving the final order. This application was filed by the patient’s father. He had earlier filed a petition in the Supreme Court in 2024, when the Delhi High Court had refused to constitute a primary medical board. The father later filed a fresh petition saying that his son’s condition had worsened and he was not responding to any treatment.

Supreme Court’s 2018 decision in the euthanasia case

The Supreme Court had given an important decision on euthanasia on March 9, 2018. Describing the right to death with dignity as a fundamental right, the court had given conditional permission to people who had reached incurable coma or terminal state to adopt death by removing the life support system. In the case going on in the Supreme Court, a demand was made to recognize the living will written by a dying person for euthanasia. A will is a form of will.

These are the guidelines in passive euthanasia case

The court recognized passive euthanasia (indirect euthanasia) and advance directive (living will) and set its guidelines. Under these instructions, any conscious person can make a living will that if his chances of survival are lost, his life support system should be removed. After this, the medical board will look at the case and take a decision on it.

In the case of those who do not write such a will, information will be given to the medical board with the consent of the doctor and family members and then a decision will be taken keeping in mind what is best for the patient.

A bench of five judges led by the then Chief Justice of the Supreme Court Deepak Mishra had said in its decision that Right to Life includes the right to life with dignity, easy process of death also comes under the same ambit. Also, the court asked the central government to make a law in this matter. The Supreme Court guidelines will be effective until the law is made.

There was a strong debate regarding euthanasia in the case of Aruna Shanbaug, a nurse from Mumbai. Aruna, who was in a coma for more than 40 years after the rape, died in 2015. In the Aruna case, the Supreme Court had recognized passive euthanasia, but the Central Government had not made a law at that time.

There were some changes in the decision of 2023

Making changes in the guidelines issued in the indirect euthanasia case and making them more practical, the Supreme Court had removed the condition of the process of making a living will before the magistrate.