Supreme Court Allows Passive Euthanasia for 32-Year-Old, Echoes Aruna Shanbaug Ruling

SC Allows Passive Euthanasia for 32-Year-Old Man: How Aruna Shanbaug Case Shaped the Law

The Supreme Court of India on Wednesday permitted passive euthanasia for a 32-year-old man who has been in a coma for more than 12 years, allowing the withdrawal of artificial life support. Passive euthanasia refers to allowing a patient to die by withholding or withdrawing life-sustaining treatment when recovery is medically impossible.

What is the Harish Rana case?

Harish Rana, a resident of Ghaziabad, suffered severe head injuries after falling from the fourth floor of a building in 2013. Since then, he has remained in a comatose state. A bench of Justices J. B. Pardiwala and K. V. Viswanathan directed the All India Institute of Medical Sciences (AIIMS), Delhi, to admit Rana to its palliative care unit, where doctors will follow a carefully designed plan to withdraw life-sustaining treatment.

The court emphasised that the process must ensure dignity and sensitivity. Earlier, the court had examined Rana’s medical records submitted by a secondary medical board of doctors from AIIMS-Delhi and described the report as “sad”. A primary medical board had already concluded that the chances of recovery were negligible.

In December, the court observed that the patient was in a “pathetic condition”.

What is passive euthanasia?

Passive euthanasia involves withholding or withdrawing medical treatments such as ventilators, feeding tubes or medications that keep a patient alive. Unlike active euthanasia — which involves a deliberate act such as administering a lethal injection — passive euthanasia allows death to occur naturally after life support is withdrawn.

Is passive euthanasia legal in India?

Passive euthanasia in India has been recognised through two landmark judgments of the Supreme Court.

Aruna Shanbaug case (2011)

In 2011, the Supreme Court first recognised passive euthanasia in exceptional circumstances in the case of Aruna Shanbaug. Although the court rejected the plea to withdraw life support in Shanbaug’s specific case, the ruling established that passive euthanasia could be allowed under strict judicial supervision.

Common Cause case (2018)

In the landmark ruling in Common Cause v. Union of India, a five-judge bench formally legalised passive euthanasia and held that the Right to Die with Dignity is part of the fundamental right to life under Article 21 of the Constitution.

The judgment also recognised Living Wills, or advance medical directives, allowing individuals to record their wishes regarding end-of-life treatment.

What is the current framework for passive euthanasia?

In 2023, the Supreme Court simplified the earlier guidelines to make the process more practical for families and hospitals.

Key requirements include:

Medical boards: Two medical boards — one at the treating hospital and another independent board — must confirm that the patient has no reasonable chance of recovery.

Attestation of living wills: Living wills can be attested by a notary or gazetted officer instead of a judicial magistrate.

Next friend: If the patient cannot give consent, a close relative or legal guardian can initiate the process as a “next friend”, subject to medical review and legal safeguards.

How the Aruna Shanbaug case opened the door

The case of Aruna Shanbaug became a turning point in India’s legal debate on euthanasia.

Shanbaug, a nurse at King Edward Memorial Hospital in Mumbai, remained in a persistent vegetative state for decades after a brutal assault in 1973.

A hospital janitor strangled her with a metal dog chain, cutting off oxygen to her brain and causing severe brain damage that left her paralysed, blind and unable to communicate.

For decades, nurses at KEM Hospital cared for her, feeding her through a tube and ensuring continuous medical attention.

The legal battle

Journalist Pinki Virani approached the Supreme Court as Shanbaug’s “next friend”, arguing that keeping her alive in such a state violated her right to die with dignity. The court rejected the plea, ruling that the hospital staff who had cared for Shanbaug for years were effectively her guardians and opposed withdrawing life support.

However, the judgment had far-reaching consequences. For the first time, the Supreme Court clearly distinguished between active euthanasia (illegal) and passive euthanasia (permissible under strict safeguards).

The court also laid down guidelines under which life support could be withdrawn in rare cases after approval from courts and medical experts. Aruna Shanbaug died of pneumonia in 2015 at the age of 66 after spending more than four decades in a vegetative state under the care of KEM Hospital.