Key Points
The Supreme Court permitted withdrawal of life support for Harish Rana, a 32-year-old man who has remained in a persistent vegetative state since a traumatic accident in 2013.
The ruling marks the first judicial application of the Supreme Court’s 2018 guidelines recognising passive euthanasia and the right to die with dignity.
The bench directed that life support be withdrawn in a humane and dignified manner and urged the Union government to enact comprehensive legislation on end-of-life care.
The Supreme Court, on 11 March 2026, permitted the withdrawal of life sustaining medical treatment for Harish Rana, who has remained in a persistent vegetative state for over a decade following a severe brain injury in 2013. The decision represents the first judicial application of the court’s landmark 2018 judgment recognising passive euthanasia and the constitutional right to die with dignity.
A bench of Justices JB Pardiwala and KV Viswanathan passed the order while hearing a plea filed by Rana’s family seeking permission to discontinue life sustaining treatment. The court held that continuing the treatment would only prolong the patient’s biological existence without any therapeutic improvement.
Rana, now 32, suffered a severe traumatic brain injury on 20 August 2013 after falling from the fourth-floor balcony of his paying guest accommodation in Chandigarh while celebrating Raksha Bandhan. At the time, he was a 20-year-old B.Tech student at Panjab University.
The fall left him with a persistent vegetative state and 100% quadriplegia. For more than thirteen years he has remained bedridden and unresponsive, dependent on medical support including a tracheostomy tube for breathing and a Percutaneous Endoscopic Gastrostomy (PEG) tube for feeding. A PEG tube is a device inserted through the abdominal wall directly into the stomach to deliver nutrition, fluids and medication. In Rana’s case, Clinically Administered Nutrition (CAN) and hydration were the primary means sustaining his life.
While delivering its order, the Supreme Court held that CAN and hydration constitute medical treatment and can be withdrawn if it is deemed not to be in the best interest of the patient. The court also noted that both the primary and secondary medical boards had examined Rana and concluded that withdrawal of treatment would be appropriate. The boards found that his chances of recovery were negligible.
The bench observed that when both medical boards reach a unanimous decision that life sustaining treatment should be discontinued, there is ordinarily no need for judicial intervention. However, the court decided to examine the matter because it was the first case seeking implementation of the 2018 guidelines.
Rana’s family had pursued legal relief for several years. In July 2024 the Delhi High Court dismissed their plea for passive euthanasia, observing that he was not on mechanical life support such as a ventilator. Later that year, the Supreme Court upheld the High Court’s decision but directed the Uttar Pradesh government to bear Rana’s medical expenses. The family approached the apex court again in 2025, stating that his condition had deteriorated and there was no prospect of recovery.
The judges directed that the withdrawal of treatment must be carried out in a humane and dignified manner. They also waived the usual reconsideration period of thirty days, noting that all stakeholders including the patient’s parents and the medical boards were unanimous in their opinion.
The bench recorded appreciation for Rana’s parents for their long years of care and support. “His family never left his side...to love someone is to care for them even in the darkest times,” Justice Pardiwala noted.
The court further directed that Rana be admitted to the palliative care department at the All India Institute of Medical Sciences (AIIMS) in New Delhi. AIIMS has been instructed to facilitate his transfer and to prepare a structured end of life care plan. The court emphasised that the patient’s dignity must be preserved to the highest degree during the process.
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The bench issued broader directions to ensure proper implementation of passive euthanasia guidelines across the country. It directed High Courts to instruct judicial magistrates to receive intimations from hospitals when primary and secondary medical boards decide to withdraw life support in accordance with the 2018 guidelines.
The court also highlighted the absence of a comprehensive legal framework governing end of life care in India. It urged the Centre to enact legislation addressing passive euthanasia and related medical procedures. In addition, the Centre has been asked to ensure that chief medical officers in all districts maintain panels of registered medical practitioners who can serve on secondary medical boards when such cases arise.
India’s legal framework on passive euthanasia was established in 2018 when a five judge Constitution bench ruled that the right to life under Article 21 of the Constitution includes the right to live with dignity. The judgment held that this principle extends to the process of dying, allowing withdrawal of life sustaining treatment for terminally ill patients or those in a persistent vegetative state with no hope of recovery.
The ruling also recognised living wills or advance directives through which individuals can specify that life support should be withdrawn if they become terminally ill or permanently incapacitated. In January 2023, another Constitution bench modified the 2018 guidelines to make the process less stringent and more workable. The changes included setting timelines for decisions by medical boards and reducing the role of judicial magistrates in approving withdrawal of treatment.
The most recent ruling is expected to become an important reference point for future cases involving passive euthanasia and end-of-life care in India.
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