In a historic first in India, the Supreme Court of India permitted the withdrawal of artificial life support for Harish Rana, a 32-year-old man who has remained in a permanent vegetative state for nearly 13 years. At the same time, the court urged the Government of India to introduce comprehensive legislation addressing passive euthanasia and end-of-life care.
A Tragic Accident and Years in a Vegetative State
Harish Rana, a resident of Ghaziabad in Uttar Pradesh, suffered severe head injuries after falling from the fourth floor of a flat in Chandigarh in August 2013. At the time, he was a student.
Following the accident, he entered a permanent vegetative state (PVS) and has remained dependent on medical support since then.
Supreme Court Bench Approves Withdrawal of Treatment
A bench of Justices J. B. Pardiwala and K. V. Viswanathan delivered two concurring judgments allowing the withdrawal of life-sustaining treatment.
As reported by The Indian Express, the court observed that the two key legal requirements for withdrawing medical treatment had been clearly fulfilled. First, it determined that Clinically Assisted Nutrition and Hydration (CANH) constitutes medical treatment. Second, medical experts concluded that continuing this treatment would no longer serve the patient’s best interests.
Furthermore, the bench noted that Rana’s parents and the medical boards involved had reached a unanimous decision that prolonged treatment was no longer appropriate. Consequently, the court directed that all medical treatment, including CANH, be withdrawn.
Waiver of the Reconsideration Period
Normally, a 30-day reconsideration period applies between the decision to withdraw life support and its implementation. This period allows any concerned party to approach a court if they oppose the decision.
However, considering the unique circumstances of this case and the unanimous agreement among all stakeholders, the court waived the reconsideration period.
AIIMS Delhi to Oversee End-of-Life Care
The court also directed AIIMS Delhi to admit Rana to its palliative care department. The hospital will oversee the withdrawal of medical treatment, including CANH, while ensuring that the patient receives compassionate end-of-life care.
Additionally, AIIMS has been asked to arrange transportation and necessary facilities to safely transfer Rana from his residence to the hospital.
Importantly, the court emphasised that the withdrawal process must follow a comprehensive palliative care plan. This plan should manage symptoms, minimise discomfort, and ensure that the patient’s dignity remains protected throughout the process.
Court Calls for Comprehensive End-of-Life Care Law
During the judgment, Justice J. B. Pardiwala highlighted the absence of a comprehensive law governing end-of-life care in India. He warned that without clear legislation, decisions about withdrawing life support could be influenced by factors unrelated to medical science or patient autonomy, such as financial distress or lack of insurance.
Therefore, the court urged the central government to enact a law that provides a structured framework for passive euthanasia and palliative care.
Justice Pardiwala further stressed that the right to die with dignity is closely linked to access to quality palliative and end-of-life care. According to him, doctors must ensure that withdrawing treatment does not lead to patient abandonment. Instead, healthcare providers must focus on managing pain and maintaining the patient’s comfort.
Recognising the Family’s Compassion
The court also acknowledged the dedication of Rana’s family, who cared for him for more than a decade. Justice Pardiwala described their decision as an act of profound compassion and courage.
He noted that the family was not giving up on their son but rather allowing him to live—and die—with dignity.
Why CANH Is Considered Medical Treatment
The bench clarified that Clinically Assisted Nutrition and Hydration (CANH) should not be viewed as basic care. Instead, it is a technologically mediated medical intervention that requires prescription, monitoring, and periodic evaluation by trained healthcare professionals.
In Rana’s case, doctors administer nutrition and hydration through a surgically implanted PEG tube. Therefore, the court concluded that CANH clearly qualifies as medical treatment, even though it is currently being provided at home.
Family’s Plea and Legal Background
Rana’s family approached the court seeking permission to withdraw life support based on the landmark 2018 ruling in Common Cause vs Union of India. In that judgment, the Supreme Court recognised the legality of passive euthanasia for terminally ill patients.
The ruling also introduced guidelines for cases where patients leave an advance directive or “living will” requesting withdrawal of life support, as well as cases where no such directive exists.
Later, in 2023, another Constitution bench simplified the process to make it more practical. These changes introduced clearer timelines for medical boards and reduced the procedural role of judicial magistrates.
Legal Journey of the Case
Rana’s family initially approached the Delhi High Court in 2024. However, the court dismissed the plea in July that year, stating that Rana was not terminally ill.
Subsequently, the family moved the Supreme Court of India, which initially dismissed the petition in August 2024 but allowed them to approach the court again if circumstances required.
The family later filed a fresh application, leading to the current ruling.
Directions to Strengthen Medical Boards
In addition to deciding the case, the Supreme Court issued broader directions to improve the implementation of passive euthanasia guidelines.
The court asked the central government, in coordination with state and union territory health departments, to ensure that district Chief Medical Officers prepare and maintain a panel of qualified medical practitioners. These doctors will serve on secondary medical boards responsible for reviewing such cases.
The court directed authorities to update these panels regularly, at least once every 12 months.
Next Hearing
Finally, the Supreme Court scheduled a follow-up hearing after one month to review whether its directions have been implemented.
This landmark decision marks a significant development in India’s evolving legal and ethical framework for end-of-life care and the right to die with dignity.