Supreme Court Allows Withdrawal of Life Support in First Use of Passive Euthanasia Framework

In a landmark application of its passive euthanasia framework, the Supreme Court of India permitted the withdrawal of life-sustaining treatment for Harish Rana, a 32-year-old man who has remained in a persistent vegetative state for more than 13 years following severe head injuries from a fall in 2013.

A bench of the apex court directed that all medical treatment, including Clinically Assisted Nutrition, be withdrawn and withheld, allowing the underlying medical condition to take its natural course.

Application of the ‘Common Cause’ Framework

The court applied the guidelines laid down in the Common Cause v. Union of India (2018), which legalized passive euthanasia under strict safeguards. According to the framework, withdrawal of life-sustaining treatment can occur only after certification by two medical boards:

• A Primary Medical Board at the treating hospital.
• A Secondary Medical Board that includes an external medical expert.

Both boards must conclude that continuing treatment serves no meaningful medical purpose.

Distinction Between Active and Passive Euthanasia

• Active euthanasia (assisted dying): Intentionally causing death through methods such as a lethal injection. In India, this is illegal and can attract criminal liability under the Bharatiya Nyaya Sanhita, potentially amounting to culpable homicide or abetment to suicide if assisted by a doctor.
• Passive euthanasia: Involves withdrawing or withholding life-sustaining treatment, allowing the illness or injury to take its natural course.

Constitutional Basis

The distinction is grounded in Article 21 of the Constitution of India, which guarantees the right to life. The Supreme Court has interpreted this right to include the right to live with dignity, extending to patients who are terminally ill or in irreversible conditions where life is “ebbing out.”

Call for End-of-Life Care Legislation

The bench observed that India still lacks a comprehensive law on end-of-life care and urged the Union government to consider dedicated legislation to address ethical, medical, and legal issues related to such decisions.