Authored By: Khushi Tandon
Bharati Vidyapeeth, New Law College, Pune
What was once impossible has been achieved by science and medicine through advanced technology and various life support systems. Yet these advancements have given rise to profound legal and dangerous plights. Such as should a person be compelled to live even though recovery is impossible and suffering is inevitable? The case Harish Rana vs. Union of India[1] serves as the important point of discussion in the evolution of the jurisprudence of passive euthanasia in India.
This case was decided by the two judge bench of the Supreme court of India compromising justices J.B pardiwala and K.V Viswanathan. It is considered as a very important case as it has assisted in developing the term ‘right to die with dignity’ in India. Another important case is Aruna Shanbaug vs. Union of India[2] as for the very first time the use of passive euthanasia was recognised by the Supreme Court of India. The common cause vs. Union of India[3] elevated the use of passive euthanasia to a fundamental right and lastly in Hrish Rana case they executed the strict rules and regulations for PVS patients by withdrawing their life support system. This article argues that end to life protocols have been reclassified by recognising the artificial feeding tubes as a withdrawable medical treatment rather than the basic needs thus the judiciary successfully transitioned the right to a dignified death from a theoretical constitutional promise into an active, enforceable reality.
The Harish Rana Case-
Harish Rana was a 20 year old b. Tech student who suffered from catastrophic fall which resulted in traumatic brain injury and persistent vegetative state. For thirteen years he was in unconscious state and unaware of what was happening with him and his surroundings and he was totally depended on the medical interventions such as- Tracheostomy tube for airway management, urinary catheter and most importantly clinically assisted nutrition and hydration( CANH) through PEG tube -( Percutaneous endoscopic gastrostomy).
The verdict of Delhi Hight Court
The parents of Harish Rana were deeply devastated. They took all the care for thirteen years, giving all the time, emotional efforts and financial resources hoping that it would recover their son, however his conditions remained unchanged because of which he was totally left in a permanent vegetative state.
With no sign of recovery his parents decided to approach the high court asking to withdraw the life sustaining treatment and feeding tubes which he was going through for his survival however the verdict of high court was not in the favour of his parents and dismissed their plea. The High court believed that he was legally self-sustaining because he was able to breathe on his own and was not dependent on the mechanical ventilator. The removal of feeding tubes will amount to killing of the patient which is very similar to the process of active euthnasia which is illegal in India.
Harish rana’s final verdict by Supreme Court of India
Initially the Supreme Court also disposed of the matter because it believed that the union government had provided home care support despite this the condition of harish rana’s condition was unchanged and his parents were still his caregivers therefore they returned to the supreme court for seeking directions on the withdrawal of life sustaining treatment for their son.
The supreme court mandated examination by primary medical board and a secondary medical board, which examined the condition of Harish Rana . Later both medical boards confirmed that he was in an irreversible permanent vegetative state and the feeding tubes are required for his survival but at the same times these feeding tubes can not aid in improving his medical condition and brain injury
The subsequent proceedings then focused on whether the withdrawal of CANH through a PEG tube can be permitted or not and closely examined the rules laid down in the case of Common cause vs. Union of India.
The supreme court held that CANH is not merely a basic nursing care, but an invasive, surgically supervised medical treatment. After examining the common cause guidelines it ruled that just as a mechanical ventilator can be withdrawn under common cause, a feeding tube can also be legally removed. This judgement established that the removal of feeding tube is not an act of criminal starvation but an act of the patient’s best interest and constitutional right to die with dignity.
LEGAL FRAMEWORK-
Article 21 of the Indian Constitutions[4] plays an important role for the case of Harish Rana vs Union of India because it guarantees protection of life and personal liberty. This means that “right to life and personal liberty” is not only limited to mere animal existence or just biological survival; instead , it means the right to live with human dignity, choice, and self-respect. In the context of end-of-life care the clash arises between state’s interest and individual’s interest. The states wants to preserve the life of a person who is in irreversible permanent unconsciousness, on the other hand an individual wants to be free from endless suffering[5]
Doctrine of bodily autonomy[6] – the core concept of bodily autonomy is that every adult person with a sound mind has an absolute right to take decisions of their own body which may include the right to include or remove the medical interventions and treatments even if it ends the life of such person however if the person is unable to do so the family members of guardians can also take decisions for such person. The same logic was applied in the case of Harish Rana holding that the right to refuse treatment does not vanish just because the patient is in PVS state or unaware of his surroundings. It stated that the competent person such as family members and guardians of the person can take decisions on behalf of the person.
CASE LAWS-
The use of passive euthanasia was evolved by important case laws one of which is-
Aruna Ramchandra Shanbaug vs. Union of India- this case plays an important role because it has helped in legalizing the passive eathansia . In this case a nurse named Aruna suffered from permanent vegetative state for nearly four decades after a brutal sexual assault by the staff of the same hospital. She was totally unable to speak because she was in PVS state therefore a petition was filed by Pinki Virani in the year 2009 for stopping the tube feeding of Aruna so that she could die peacefully however the Supreme court of India rejected her plea.
But formally legalised passive euthanasia in India. In 2011 the court held that passive euthanasia is permitted only through strict judicial processes firstly requiring mandatory application to the high court and secondly appointing three independent medical boards compromising of a physician, neurologists and psychiatrist
Common Cause v. Union of India (2018).
The supreme court in this case held that the right to die is also a part of fundamental right under article 21 of the india constitutions and made the guidelines for the use of passive euthanasia, allowing terminally ill patients for the removal of medical treatment at any time. This judgement also legalised Advanced Medical Directives(living wills)this enabled the individuals to express their wishes regarding medical treatment in advance. In 2023 the Supreme court revisited the guidelines of common cause and made the procedure for implementing passive euthanasia and living wills more easily. The court made the framework more practical and accessible for hospitals, patients and families.
Gian Kaur vs. State of Punjab[7]–
The appellants, Gian Kaur and her husband were convicted for abetting suicide of their own daughter in law and argued that if a person has right to life then it should also include the right to die under article 21 of the Indian constitution. The court rejected this argument stating that right to die can not be included in article 21 however the it also stated that the right to die with dignity can be covered under this article, depending upon the situation of the case
Harish Rana vs Union of India–
The rules and principles of passive euthanasia evolved from the above mentioned cases and was and used for the very first time in the case of Harish Rana . A 20 year old adult person who got severe brain injuries and suffered from a permanent vegetative state in which he remained unchanged and irreversible for thirteen years. This case reinforces the idea that article 21 gives the right to live and die with dignity and also balances the individual autonomy.
Critical Evaluation-
There are some challenges in implementing such guidelines because firstly there is a massive disconnection between the theory of constitution and reality of hospitals. The biggest obstacle is widespread ignorance and fear in medical professionals. Most of the doctors are not updated about the common cause guidelines and those who do know are scared of civil or criminal lawsuits because if they are not properly trained they may hesitate in taking the decisions of ending a life of a person which may later result into legal liabilities.
Secondly the use of Passive euthanasia is legally recognized in India but the process of using it includes complex legal and medical formalities, leading the patient to suffer physical and emotional distress . Such formalities can worsen the condition of patients and defeat the objective of ensuring death in a dignified manner.
Thirdly living wills which were legalised in the common cause case gives the individual right to express their medical preferences in advance but most of the citizens are unaware of this legal right or find the procedure complicated.
Lastly there is a major parliamentary challenge because the parliament of India has failed in making codified laws on the end of life. Only the judicial guidelines are used for the use of passive euthanasia this problem creates unstable legal environment and takes a lot of time to adapt in medical technologies
Way Forward-
The doctors do not take decisions of ending the life of a person because they are scared of legal responsibilities which may arise due to unawareness of passive euthanasia and common cause guidelines but this can be solved if they get training regarding the legal and ethics aspects of end of life. Not only doctors but also the other staff such as nurses and other hospital staff should get such training. This will help them in making proper healthcare decisions complying with the legal requirements
Secondly the procedure of creating and implementing living wills should be made more accessible and user friendly such as digital signatures and simple verification procedures can be used.
Lastly, public education campaigns can help the citizens in knowing their legal rights,reducing misconceptions and social stigma associated with end to life decisions.
Conclusion-
The case Harish Rana vs. Union of India is a landmark judgement which plays an important part in the evolution of giving passive euthanasia to the person who is in permanent vegetative state depending on the feeding tubes for their survival and can not restore their health at all making them helpless. After examining the common cause case closely the apex court finally decided and reclassified the feeding tubes as a withdrawable medical treatment rather than just a basic care. This marks a historic evolution in Indian end of life jurisprudence and preserves article 21 of india constitution . However the challenges arise due to the clash between progressive orders and ground level realities in the hospitals. A legal process should not make the patients and grieving families suffer from decade long emotional and financial battles in the court thus the Indian parliament must step in and make codified laws for such people and their families who can not help themselves.
The most important things which can resolve the conditions of such people are- legal Training and educational campaigns for doctors , staff, hospital administrations etc, simplifying the verification procedures, and breaking down the social taboos surrounding end of life choices. Lastly the right should be provided to everyone without any legal hurdles for the easy and smooth functioning of a fundamental right which is article 21 “right to die with dignity”
REFERENCES AND BIBLIOGRAPHY
Table of Cases-
Aruna Ramchandra Shanbaug v Union of India (2011) 4 SCC 454
Common Cause (A Regd Society) v Union of India (2018) 5 SCC 1
Gian Kaur v State of Punjab (1996) 2 SCC 648
Harish Rana v Union of India 2026 SCC OnLine SC 358
Legislation- Constitution of India 1950, art 21
Websites and Online Legal Portals-
Advocate Tanmoy, ‘Supreme Court’s Landmark Ruling on Withdrawing Life Support: Harish Rana v. Union of India’ (Advocate Tanmoy Law Blog, 2026) advocatetanmoy.com accessed 23 June 2026
Indian Kanoon, ‘Harish Rana v Union of India – Full Judgment Database’ (Indian Kanoon, 2026) indiankanoon.org accessed 23 June 2026
Indian Kanoon, ‘Judicial Text Fragment: Chief Justice Dipak Misra on Bodily Autonomy Framework’ (Indian Kanoon) indiankanoon.org accessed 23 June 2026
Indian Kanoon, ‘Legal Database Records on Passive Euthanasia Petitions’ (Indian Kanoon) indiankanoon.org and indiankanoon.org accessed 23 June 2026
LiveLaw, ‘When Biography Ends, Biology Remains: Constitutional Right To Let Go’ (LiveLaw, 2026) livelaw.in accessed 23 June 2026
[1] Harish Rana v Union of India, 2026 SCC OnLine SC 358.
[2] Aruna Ramachandra Shanbaug v Union of India, (2011) 4 SCC 454.
[3] Common Cause (A Regd Society) v Union of India, (2018) 5 SCC 1.
[4] The Constitution of India, 1950, Art. 21.
[5] Harish Rana v. Union of India, 2026 INSC 222 (Supreme Court of India, Judgment dated March 11, 2026).
[6] Harish Rana v. Union of India, 2026 INSC 222, citing Common Cause v. Union of India, (2018) 5 SCC 1 (per Dipak Misra, C.J., clarifying that the right to privacy and self-determination protects an individual from forced medical technology).
[7] Gian Kaur v State of Punjab, (1996) 2 SCC 648.
