Harish Rana v. Union of India

Case Title – Harish Rana v. Union of India

Court – Supreme Court of India

Bench Type – Division Bench

Bench – Justice J.B. Pardiwala and Justice K. V. Vishwanathan.

Date of Judgement – 11^th March, 2026

Parties in the Case:

Petitioner/Appellant: Harish Rana (32-year-old)

Respondent: Union of India & ORS.

INTRODUCTION

Harish Rana (aged 32 years), on August 2013, he fell from a fourth-floor building. The accident caused catastrophic brain injuries, leaving him in Permanent Vegetative State (PVS) with a 100% quadriplegia (means a paralysis of all four limbs). For around 13 years, he showed no signs of improvement and was only kept alive by Clinically Assisted Nutrition and Hydration (CANH) through surgically implanted PEG tubes. His parents petitioned the Supreme Court which was ultimately approved passive euthanasia, after the Delhi High Court rejected his parent’s plea in 2024.

Fact of the Case

• The applicant (Harish Rana aged 32 years old) was once a young man of 20 years, pursuing a B. Tech degree at Punjab University, he met with a tragic and life altering accident. On August 20,2013, at around 6 p.m., the applicant fell from a fourth-floor building and as a result he sustained a diffuse axonal injury.
• From 08.2013 to 27.08.2013, he treated at the PGI, Chandigarh and treatment in the form of conservative management including AED, analgesics, ventilating support, antibiotics, tracheostomy, and feeding through a Ryle’s tube (nasogastric tube). However, he shifted from PIG Chandigarh to AIIMS.
• After being discharged, his precarious health required frequent hospital stays and ongoing care at AIIMS for his head injury, seizures, pneumonia, and bedsores. In 2013, the petitioner’s method of receiving CANH was changed from Ryle’s tube/nasogastric tube to a PEG tube that was surgically inserted, which now needs to be replaced every two months at a hospital. Medical report the applicant’s neurological condition has remained static with no improvement also he also does not indicate by any facial gesture, if he is hungry no body movement.
• Additionally, the disabled certificate dated November 21, 2024, issued by the autonomous Janakpuri Super Speciality Hospital Society (Autonomous Institute), Government of NCT of Delhi, certified the applicant’s condition with the current MA as having a head injury with a vegetative stage and diffuse axonal damage, 100% permanent physical disability and quadriplegia in connection with the entire body. Another, disability certificate dated April 13, 2016, issued by Ram Manohar Lohia Hospital, New Delhi, Government of India, certified the applicant’s condition is in a Persistent Vegetative State (hereinafter referred to as “PVS”) with complete sensorimotor dysfunction, and 100% permanent physical impairment.
• The Court had ordered AIIMS to establish a Primary Medical Board and a Secondary Medical Board. The physicians discovered that Harish’s brain damage was irreversible and non-progressive. They stated that although he had sleep-wake cycles, he showed no signs of awareness or reaction to sound or pain. The boards came to the conclusion that there was little chance of his recovery and that although he continued to receive nutrition and hydration, his underlying medical condition did not improve.

Legal Issues

The Supreme Court had to address five major legal questions in this case:

1. Whether the administration of CANH is to be regarded as “medical treatment”?
2. What is the meaning, scope, and contours of the principle of “best interest of the patient” in determining whether medical treatment should be withdrawn or withheld?
3. Whether it is in the best interest of the applicant that his life be prolonged by continuation of medical treatment?
4. What are the further steps to be undertaken in the event that a decision to withdraw or withhold medical treatment is arrived at?

Contention of the Appellant

Citing the Common Cause vs. Union of India (2018) precedent, the applicant contended that the PEG tube is a type of medical treatment as opposed to basic care. It was stressed that whether it is in the patient’s best interest to artificially prolong life through pointless intervention should be the primary legal question, rather than whether it is in their best interest to die. The applicant emphasized that the absence of institutional channels for home-based patients to access medical boards forced the applicant’s family to petition the court. In order to allow for a humane death, it was suggested that the Court waive the 30-day of reconsideration period and link the right to dignity with the freedom from an undignified vegetative state.

Contention of the Respondent

In this case, the Additional Solicitor General (ASG) supported the legality of passive euthanasia, pointing out that stopping treatment is a legal omission rather than an illegal positive act. According to the Union of India, CANH given through medical devices is considered “medical treatment” and may be legally stopped if it is no longer used for therapeutic purposes. The government admitted that the applicant’s condition is irreversible and that further treatment is medically pointless based on the reports from the Primary and Secondary Medical Boards. The Union suggested that the government provide palliative care to ensure that the applicant’s comfort during the withdrawal process and expressed support for the family’s thoughtful decision.

Supreme Court’s Analysis and Judgement

Clinically Assisted Nutrition and Hydration (CANH) as Medical Treatment

• A wide range of clinical factors must be carefully taken into account when prescribing and administering CANH. These factors include the installation of the CANH device (whether surgically or not), accurate assessment of the patient’s nutritional needs, the patient’s underlying clinical condition, gastrointestinal tolerance, potential metabolic instability, assessment of the expected duration of CANH support, and the potential risks of CANH-related complications.
• A regular medical review of CANH’s indications, administration method, risks, advantages, and therapeutic objectives is also necessary.
• Therefore, CANH should be recognized as a technologically mediated medical intervention that is prescribed, supervised, and routinely reviewed by qualified healthcare professionals in accordance with established medical standards. This is because its clinical and procedural characteristics show that CANH cannot be viewed as merely a means of basic sustenance or primary care.
• It is inaccurate to focus solely on the aspect of nourishment when comparing CANH with regular feeding. Instead, consideration should be given to the entire artificial feeding regimen, which includes the use of enemas and catheters as well as the ongoing fight against potentially fatal infections.
• Even when given at home, CANH is still considered a medical procedure because it requires regular medical and nursing supervision and involves skills and protocols that the layperson would need to specifically acquire by using medical knowledge.
• Since CANH is considered medical treatment, the primary and secondary medical boards may use their clinical judgment to decide whether to continue, withdraw, or withhold CANH, just like they would with any other medical treatment, in compliance with Common Cause Guidelines.

Principle of Best Interest

• When considering the withdrawal or withholding of medical treatment for an incompetent patient who is unable to make an informed decision for himself, the best interest principle is applicable.
• All stakeholders and decision-makers, including the medical boards, the patient’s next of kin, next friend, or guardian, and the courts (if involved), must follow the best interest principle at every stage when deciding whether to withdraw or withhold medical treatment.
• Regarding the question of why the best interest principle is applied, the Court clarified that it is no longer required to continue medical treatment when a patient has been diagnosed with a terminal illness or is in PVS, with no chance of recovery, and the continuation of treatment only prolongs his biological existence without any therapeutic benefit. The best interest principle should be used to determine whether or not such a stage has been reached.

Harish Rana, who had been in a permanent vegetative state for more than 13 years, was granted passive euthanasia by the Hon’ble Supreme Court of India, allowing the withdrawal of life-sustaining treatment under medical supervision. The decision, which is India’s first court-approved use of passive euthanasia, applies previous guidelines recognizing the right to die with dignity under Article 21 of the Indian Constitution.

Conclusion

In conclusion, the Hon’ble Supreme Court’s ruling in the case of Harish Rana v. Union of India marks a historic affirmation of the right to die with dignity under Article 21 of the Indian Constitution. By recognizing Clinically Assisted Nutrition and Hydration (CANH) as medical treatment, the Court also clarified that its continuation must serve the patient’s best interests, not merely prolong biological existence without therapeutic benefit. The judgment balanced compassion with constitutional principles, ensuring that passive euthanasia is legally permissible under strict medical supervision. Therefore, this case sets a precedent for humane treatment of patients in irreversible vegetative states, aligning law with dignity and justice.

Reference(S):

1. Reportable, In the Supreme Court of India Extra Ordinary Appellate Jurisdiction Miscellaneous Application No. 2238 of 2025 in Special Leave Petition (Civil) No.18225 of 2024 Harish Rana vs. Union of India & Ors., Supreme Court of India,(11 March, 2026), https://api.sci.gov.in/supremecourt/2025/60980/60980_2025_7_1501_69246_Judgement_11-Mar-2026.pdf.
2. Drishti IAS, SC Allows 1st Passive Euthanasia in Harish Rana Case (13 Mar 2026), https://www.drishtiias.com/daily-updates/daily-news-analysis/sc-allows-1st-passive-euthanasia-in-harish-rana-case#:~:text=The%20Supreme%20Court%20(SC)%2C,right%20to%20die%20with%20dignity.
3. Aastha Kaushik, Competent Person Has Fundamental Right To Refuse Medical Treatment: Apex Court Clarifies While Allowing First Passive Euthanasia, Verdictum, (11 March, 2026), https://www.verdictum.in/court-updates/supreme-court/2026-insc-222-harish-rana-v-union-of-india-1609685.
4. SSC Online, Passive Euthanasia in India: Key Takeaways from Supreme Court’s Landmark Verdict, (12 March 2026), https://www.scconline.com/blog/post/2026/03/12/supreme-court-india-verdict-allows-passive-euthanasia-key-takeaways/.