In A First, SC Allows Passive Euthanasia For 32-Year-Old Man In Vegetative State For 13 Years
The apex court said patient's parents and primary and secondary medical boards have concluded that the CAN administered to the patient should be discontinued.
By Sumit Saxena
Published : March 11, 2026 at 11:31 AM IST
|Updated : March 11, 2026 at 6:06 PM IST
New Delhi: In its first such order, the Supreme Court on Wednesday allowed passive euthanasia for a 32-year-old man who has remained in a permanent vegetative state for over a decade.
A bench comprising justices J B Pardiwala and K V Viswanathan said it is the first judicial implementation of its 2018 Common Cause ruling recognising the right to die with dignity.
On January 15, the apex court reserved for judgment a plea by the family of Harish Rana, a 32-year-old man, who has been in a vegetative state for nearly 13 years, to withdraw life-support to him.
In 2013, Harish, who was a student of Punjab University, suffered head injuries after falling from the fourth floor of his paying guest accommodation. Since then, he has been completely bedridden and on an artificial support system.
The bench heard submissions made by additional solicitor general Aishwarya Bhati, representing the central government, and advocate Rashmi Nandakumar, appearing for Harish's family.
Harish is sustaining life only on Clinically Assisted Nutrition and Hydration (CANH) administered through surgically installed PEG tubes.
The apex court said the patient's parents and the primary and secondary medical boards have concluded that the CAN administered to the patient should be discontinued, as it is not in the patient's best interest.
The bench noted that Harish's brain injury left him in a persistent vegetative state (PSV) with 100% quadriplegia, and medical reports show his condition has not improved in the past 13 years.
Justice Pardiwala said the applicant has lived a life defined by pain and suffering, stripped of his ability to even voice his anguish.
"We note with immense respect that the applicant’s parents and siblings have stood as unyielding pillars of support. They have exhausted every effort to care for him and continue to do so with unwavering dedication. We can only place on record our deepest appreciation for their boundless love, endurance, and kindness in the face of such adversity…this case reveals the most enduring is the resilience of love," said the bench.
The bench said the medical treatment, including CAN being administered to the applicant, shall be withdrawn or withheld.
It stated that, given the peculiar facts and circumstances of the matter, the 30-day reconsideration period is waived because all stakeholders unanimously agree that the applicant's medical treatment should be withdrawn or withheld.
The bench said AIIMS shall grant the applicant admission to its palliative care department so that the withdrawal or withholding of the applicant’s medical treatment, including CAN, can be administered effectively.
AIIMS, it added, should ensure such withdrawal or withholding is carried out through a robust palliative and end-of-life care plan, which is specifically tailored to manage symptoms without causing any discomfort to the applicant and ensuring his dignity is preserved to the highest degree.
The apex court also lauded Harish's family for being by his side and caring for him. Justice Pardiwala said the greatest tragedy in life is not death but abandonment, and the applicant’s family never left his side, and he has been cared for, protected, and cherished every moment.
In the 338-page judgment, the bench said, "Throughout the adjudication of this matter, we have been gripped by profound sadness."
Justice Pardiwala said, "To love someone is to care for them not just in times of joy, but in their saddest and darkest hours. It is to care for them even when the horizon is devoid of hope. It is to stand by them as they prepare to cross the threshold into the beyond. Ultimately, to love is nothing but to care deeply, softly, and endlessly".
"Our decision today does not neatly fit within logic and reason alone. It sits in a space between love, loss, medicine and mercy. This decision is not about choosing death, but is rather one of not artificially prolonging life. It is the decision to withdraw life-sustaining treatment when that treatment no longer heals, restores, or meaningfully improves life. It is allowing nature to take its course when medicine can only delay the inevitable because survival is not always the same as living", said the top court.
The apex court said the right to die with dignity is inseparable from the right to receive quality palliative and end-of-life (EOL) care, and it is imperative to ensure that the withdrawal process is not marred by pain, agony, or suffering.
The bench said, "First, it is established that the CANH currently being administered to the applicant constitutes medical treatment. Secondly, it has been conclusively determined that the continued administration of the same is no longer in the best interests of the applicant. In light of the unanimous consensus arrived at by the parents/next of kin and the constituted medical boards respectively, we are of the opinion that the medical treatment ought not to be prolonged any further".
Justice Pardiwala said, "To Harish's family, we want to acknowledge the deep emotional weight this decision carries. This decision can feel like an act of surrender, but we believe it is, in truth, an act of profound compassion and courage. You are not giving up on your son. You are allowing him to leave with dignity. It reflects the depth of your selfless love and devotion towards him".
The bench said, dealing as we are with a case of an individual for whom withdrawal or refusal of medical treatment is under consideration, it is implicit that all those involved in the decision-making process act in the "best interest of the patient".
The bench said the primary medical report and the secondary medical report are unanimous that Harish is in a vegetative state and has been in that situation for over 12 years.
"As is clear from the joint report filed by the learned counsel and also the court's interaction with the parents and siblings, the parents and siblings firmly believe that the medical treatment is not making any difference and that there was no point in continuing with such treatment and making Harish suffer for no good reason. The treatment is, according to the medical board, offering no benefit to Harish. It serves no therapeutic purpose. Harish is subjected to a lot of indignity," said the bench.
The bench said the futility of the treatment, the medical, emotional and welfare aspects all point to only one direction, namely, withdrawal of medical treatment, and there is no benefit much less continuing benefit from the treatment.
"On the implementation of this order, it is not as if their agony will be entirely wiped off. However, the distress that they experience due to what Harish is undergoing will at least be over. Though the judgment is not based on this aspect and has proceeded on the applicable legal principles by keeping the best interest of Harish, it will be very naive to ignore this harsh reality," said Justice Viswanathan, citing ancient Shubashristha in Sanskrit, who wrote a separate judgment.
The apex court in the 2018 judgment in Common Cause, recognised the right to die and formulated a procedure to be followed for passive euthanasia, and these guidelines were further modified in January 2023. According to the guidelines, withdrawal of life support is permissible only after the approval of primary and secondary medical boards.
"We urge the Union Government to consider enacting comprehensive legislation on the subject in line with the vision of the Bench in Common Cause. Such legislation would provide clarity, coherence, and certainty in matters that are deeply practical and emotionally sensitive," said the bench.
In 2018, the apex court characterised active euthanasia as a positive overt act, such as the administration of a lethal injection, designed to directly cause or accelerate death. In contrast, passive euthanasia was defined by the absence of such an act, primarily encompassing the withdrawal or withholding of medical treatment(s) that serve to sustain life.
The bench said in fact, when the best interests of the patient dictate such withdrawal or withholding, such action is taken in furtherance and is a manifestation of the doctor’s duty of care.
"CANH constitutes medical treatment, it is permissible for the primary medical board and secondary medical board to exercise their clinical judgment with regard to the continuation or withdrawal or withholding of the CANH, like any other form of medical treatment, in accordance with the guidelines as laid down in Common Cause," said the bench.
The bench said the best interests principle must incorporate a strong element of the non-medical considerations under the substituted judgment standard as aforesaid, requiring the decision-maker to consider, in a patient-centric manner, what that patient would have wanted if he possessed the requisite capacity.
The bench said that if both the primary medical board and secondary medical board certify the withdrawal or withholding of medical treatment, there is no further requirement for court intervention.
"We deem it necessary to further clarify that it is legally permissible for hospitals to admit patients who are undergoing treatment in home settings, where a reassessment of the patient’s best interests is sought," said the bench.
“The respondent no.1/Union of India in coordination with the respective Secretaries of Health & Family Welfare of all States/UTs, shall ensure that the CMOs of all concerned districts across the country, forthwith prepare and maintain a panel consisting of registered medical practitioners possessing qualifications in accordance with the guidelines as laid down in Common Cause, for the purpose of nomination to the secondary medical board," said the bench.
On January 13, the apex court judges personally met Harish's parents and his younger brother. The family had communicated to the judges that they did not want him to suffer anymore.
This is the second time in as many years that his parents have approached the Supreme Court seeking passive euthanasia for Harish. In November 2025, the apex court took note of a Union Health Ministry report that suggested Harish would be in home care, with assistance from the Uttar Pradesh Government and regular visits from doctors and a physiotherapist.
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