The fundamental right to life and dignity also encompasses the right to die with dignity. The Supreme Court rightly upheld this principle by allowing passive euthanasia for 32-year-old Harish Rana, who has remained in a vegetative state for nearly 13 years after suffering head injuries in a fall. The judgement is a milestone in the legal and ethical debate surrounding end-of-life care in India, marking a noticeable shift from the sanctity of life to the quality of life. Though the top court had earlier legalised passive euthanasia and established a legal framework, this is the first instance of it being applied in practice, providing a concrete precedent. Rana will now be shifted to AIIMS Delhi for the withdrawal of life support, including clinically assisted nutrition and hydration.
It was in Aruna Shanbaug (2011) that the Supreme Court first recognised passive euthanasia as distinct from active euthanasia, which involves administering lethal substances to end a patient’s life. Passive euthanasia, by contrast, involves withholding or withdrawing life support or treatment necessary to keep a person alive. Later, in 2018, the court reaffirmed the right to die with dignity, formally legalised passive euthanasia and called for legislative support. It issued guidelines and introduced the concept of advance medical directives (living wills), which allow individuals to record their end-of-life wishes in advance. In 2023, the court simplified these guidelines and laid down clear procedures for the withdrawal of life-sustaining treatment including reviews by medical boards.
While the judiciary has repeatedly intervened in matters concerning the right to life with dignity, concrete legislative action has been sorely lacking. The court pointed to the absence of a law governing end-of-life concerns as an example of how legislative inaction can speak louder than legislative action. Despite judicial reminders and the constitutional, ethical, and medical dimensions involved, India’s lawmakers have sadly chosen to ignore the urgency of framing a law in this regard. What matters in situations like Rana’s is the best interest of the patient. The focus should be on relieving pain, suffering and indignity, and the decision should be rooted in good medical practice and the intrinsic purpose of medicine. The ruling must serve as a timely prompt to enact a comprehensive and coherent statutory framework for passive euthanasia, living wills and the right to refuse treatment.