The Supreme Court (SC), in Harish Rana vs Union of India Case (2026), authorised passive euthanasia of 32-year-old Harish Rana, who has been in a persistent vegetative state (PVS) for the last 13 years. The ruling marks the first practical application of India’s passive euthanasia framework developed through earlier Supreme Court judgments.
Background of the Case
Harish Rana suffered severe head injuries after falling from a balcony in 2013 and remained in a persistent vegetative state with 100% quadriplegia for more than 13 years. His father first approached the Delhi High Court in 2024 seeking permission to withdraw treatment, but the plea was rejected.
The family later approached the Supreme Court of India. A bench comprising Justice J. B. Pardiwala and Justice K. V. Viswanathan constituted two medical boards, which concluded that the chances of recovery were negligible. Based on these findings, the Court permitted the withdrawal of life-sustaining treatment, marking the first practical application of India’s passive euthanasia framework.
Euthanasia Meaning and Types
Euthanasia refers to the deliberate act of ending the life of a person suffering from an incurable disease or irreversible condition to relieve pain and suffering. Euthanasia can only be administered by a physician and can be either “active” or “passive”.
Active euthanasia
Active euthanasia involves directly causing the death of a patient through deliberate medical intervention, such as administering a lethal injection.
Active Euthanasia is illegal in India under the Bharatiya Nyaya Sanhita (BNS), 2023 and may amount to culpable homicide or abetment to suicide under criminal law.
Passive euthanasia
Passive euthanasia involves withdrawing or withholding life-sustaining medical treatment such as ventilators, artificial nutrition or other medical support. In such cases, death occurs naturally due to the underlying illness rather than a direct medical action.
Passive euthanasia is legally permitted in India under safeguards prescribed by the Supreme Court of India in Common Cause vs Union of India, which recognised the right to die with dignity as part of the Article 21 of the Constitution of India.
Procedure for Passive Euthanasia in India
The procedure for passive euthanasia in India is strictly regulated to ensure it is not misused and the patient’s dignity is maintained. It is based on Supreme Court guidelines from Common Cause (2018) and subsequent modifications. The procedure is as follows:
- Constitution of Medical Boards: Two medical boards must be formed:
- A Primary Medical Board at the treating hospital.
- A Secondary Medical Board comprising independent external experts.
Both boards must examine the patient and confirm that the condition is irreversible and recovery is not possible.
- Consent of Family or Legal Guardians: If the patient is incapable of making decisions, consent from family members or legal guardians is required before withdrawal of life-support measures.
- Simplified Legal Procedure (2023 Modification): Earlier guidelines required High Court approval or judicial magistrate involvement. The 2023 clarification by the Supreme Court simplified the process by reducing direct judicial intervention while retaining procedural safeguards.
- Withdrawal of Life Support and Palliative Care: After approval, the patient may be shifted to palliative care, where life-support systems can be withdrawn in a humane manner ensuring dignity and minimal suffering.
- Mandatory Documentation: All decisions, medical board opinions and consent records must be properly documented to maintain transparency and prevent misuse.
Passive Euthanasia Constitutional Basis
The constitutional foundation of passive euthanasia in India lies in Article 21 of the Constitution of India,which guarantees the Right to Life and Personal Liberty. The Supreme Court has interpreted this right to include not just living, but living with dignity.
Key Supreme Court Judgements on Euthanasia
The legal framework governing euthanasia in India has evolved primarily through landmark rulings of the Supreme Court of India. Over the years, the Court has clarified the legality of passive euthanasia and recognised the right to die with dignity as part of constitutional rights.
Maruti Shripati Dubal vs State of Maharashtra
- The Bombay High Court held that the right to life under Article 21 of the Constitution of India could include a right to die, particularly for individuals suffering from terminal illness or extreme, incurable pain.
Gian Kaur vs State of Punjab
- The Supreme Court of India overturned the earlier ruling in Maruti Shripati Dubal vs State of Maharashtra, which had held that the right to die forms part of the right to life under Article 21 of the Constitution of India. The Court clarified that Article 21 protects life and does not include a right to die, reaffirming the principle of preservation of life.
Aruna Shanbaug Case (2011)
- In Aruna Ramchandra Shanbaug v. Union of India (2011), the Supreme Court recognised passive euthanasia for the first time in India.
- Aruna Shanbaug, a nurse in Mumbai, had remained in a persistent vegetative state since a brutal assault in 1973.
- While the Court rejected the plea seeking permission to end her life, it held that withdrawal of life support could be allowed in exceptional circumstances.
- The Court permitted passive euthanasia with the approval of the relevant High Court and under strict safeguards, marking the first judicial recognition of the concept in India.
Common Cause Case (2018)
The judgment laid down detailed procedural safeguards for implementing passive euthanasia.
- A five-judge Constitution Bench ruled that the right to die with dignity is an intrinsic part of the right to life under Article 21.
- The Court also recognised the concept of a living will or advance directive, allowing individuals to state in advance that life-sustaining treatment should be withdrawn if they fall into a terminal illness or a persistent vegetative state.
In 2023, another Constitution Bench of the Supreme Court modified the guidelines issued in the Common Cause judgment. The Court simplified the procedure for implementing passive euthanasia by introducing timelines for medical boards and reducing the procedural role of the judicial magistrate.
These changes were aimed at making the process more practical and accessible for hospitals and families dealing with end-of-life situations.
Rabies Patients’ Petition (2019)
- In 2019, the NGO All Creatures Great and Small filed a petition before the Supreme Court seeking recognition of rabies as an exceptional medical condition and requested guidelines allowing patients or their guardians to seek the option of death with dignity due to the severe suffering caused by the disease.
- The Supreme Court agreed to examine the issue, and the matter remains pending before the Court.
Arguments in favour of Legalisation of Passive Euthanasia
Legalisation of passive euthanasia is supported on constitutional, ethical and humanitarian grounds, particularly in cases of irreversible medical suffering.
- Right to Die with Dignity: Recognised by the Supreme Court of India in Common Cause vs Union of India as part of the Article 21 of the Constitution of India.
- Respect for Patient Autonomy: Allows individuals to exercise control over medical decisions, including refusal of life-sustaining treatment.
- Protection of Human Dignity: Prevents a person from being reduced to mere biological existence in a persistent vegetative or terminal condition.
- Recognition of Living Will: Advance directives allow individuals to state their medical preferences in advance, ensuring their wishes are respected.
Arguments Against Legalisation of Passive Euthanasia
Despite legal safeguards, the legalisation of passive euthanasia raises several ethical, social and institutional concerns in the Indian context.
- Risk of Misuse and Coercion: There is a possibility that elderly, disabled, or economically dependent patients may be pressured by families or institutions to withdraw life support.
- Weak Healthcare and Palliative Care System: In a country with limited access to quality palliative care, euthanasia may become an easier option instead of improving end-of-life care facilities.
- Diagnostic Uncertainty: Medical prognosis is not always certain, and some patients in vegetative states have shown unexpected recovery.
- Moral and Cultural Opposition: Many religious and cultural traditions in India view life as sacred, and deliberate withdrawal of life support may face strong societal resistance.
Ethical Dimensions of Passive Euthanasia
Passive euthanasia raises profound ethical questions about the balance between preserving life and alleviating suffering.
- On one hand, it respects the principle of autonomy, allowing individuals or their families to make decisions about end-of-life care when recovery is impossible.
- On the other hand, it challenges the sanctity of life, a core value in medical ethics and society.
Ethical frameworks emphasise that any decision to withdraw life support must be guided by compassion, beneficence, and non-maleficence, ensuring that the patient’s dignity and comfort are preserved. The Supreme Court’s guidelines seek to balance these ethical concerns by combining medical evaluation, legal safeguards, and family consent, thereby providing a humane approach to end-of-life care while preventing misuse.
Euthanasia in Other Countries: Global Examples
Many countries across the world have adopted different legal approaches to euthanasia and assisted dying, balancing ethical concerns with the principles of individual autonomy and dignity.
- Netherlands: Euthanasia and physician-assisted suicide have been legal since 2002 under strict conditions such as voluntary consent and unbearable suffering; in 2023, the law was expanded to allow euthanasia for terminally ill children aged 1–12 with parental approval and medical safeguards.
- Belgium: Legalised euthanasia in 2002, and in 2014 removed age restrictions, allowing minors of any age to access euthanasia provided they have a terminal illness, parental consent, and proven decision-making capacity.
- Canada: Introduced Medical Assistance in Dying (MAiD) in 2016 for adults with grievous and irremediable medical conditions; however, the proposed expansion to include mental illness as the sole condition has been postponed until March 2027.
- Switzerland: Allows assisted suicide if it is not motivated by selfish interests, although active euthanasia remains illegal; the country is known for permitting assistance even for non-residents.
- United States: Medical Aid in Dying is legal in several jurisdictions such as Oregon, California, and others under “Death with Dignity” laws, with strict eligibility criteria and medical oversight.
- Japan: There is no specific law legalising euthanasia, but courts and medical guidelines allow withholding or withdrawing life-sustaining treatment (“death with dignity”) under limited circumstances.
- Australia: Voluntary Assisted Dying (VAD) has been legalised across all six states, including Victoria and New South Wales, with strict eligibility requirements and medical safeguards.
Passive Euthanasia FAQs
Q1: What is passive euthanasia?
Ans: Passive euthanasia is the withdrawal or withholding of life-sustaining medical treatment, allowing a patient to die naturally from an underlying illness. It is legally permitted in India under strict safeguards.
Q2: How is passive euthanasia different from active euthanasia?
Ans: Active euthanasia involves directly causing death, such as through a lethal injection, and is illegal in India. Passive euthanasia lets death occur naturally by stopping or withholding treatment and is legal under certain conditions.
Q3: What is the constitutional basis for passive euthanasia in India?
Ans: The Supreme Court has derived the right to passive euthanasia from Article 21, which guarantees the right to life and personal liberty. It includes the right to live with dignity and the right to die with dignity in terminal or irreversible conditions.
Q4: What procedure must be followed for passive euthanasia in India?
Ans: Two medical boards (Primary and Secondary) must assess the patient and certify negligible chances of recovery. Family consent is required, and withdrawal of treatment is done in a palliative care facility under documented, humane procedures.
Q5: Which key Supreme Court judgments govern passive euthanasia?
Ans: The landmark cases are Aruna Shanbaug (2011), Common Cause (2018), the 2023 modification of Common Cause guidelines, and pending cases like the Rabies Patients’ Petition (2019), all of which define the legal and procedural framework.