BENGALURU: On Wednesday, the Supreme Court allowed the country’s first case of passive euthanasia -- withdrawal of artificial life support -- for 32-year-old Harish Rana, who has been in a coma for more than 12 years since his fall from the fourth floor of a building in 2013, which left him with severe brain injury and in a permanent vegetative state.
He has been sustaining on Clinically Administered Nutrition (CAN) with no signs of recovery. A bench of Justices JB Pardiwala and KV Viswanathan on Wednesday permitted the withdrawal of life-sustaining treatment for Rana.
“Withdrawal of life support treatment is humane, done after a great deal of thought, consultation and guidelines laid down by the Supreme Court. It is managed by a medical team and ensures the person does not suffer,” said Dr Nagesh Simha, medical director, Karunashraya (hospice), Bengaluru and Bhubaneswar, hailing the apex court verdict on Rana.
“Over the last 15-odd years with multiple judgments -- the most recent one in 2023 -- supported also by evidence-based guidelines, there is now a well-defined process recommended for the institution of palliative care and providing dignity to the dying process after establishing ‘futility of care’,” said Dr Sunil Karanth, chairman, head of department & consultant - Critical Care Medicine, Manipal Hospitals, Old Airport Road, Bengaluru.
In India, the debate over euthanasia has been contentious, balancing the right to die with dignity against fears of potential misuse and the sanctity of life. “While the Supreme Court legalized passive euthanasia and ‘living will’ in 2018 in the Common Cause vs Union of India case (revisiting guidelines in 2023 for practical ease), active euthanasia remains a criminal offence,” said Professor, Psychiatry, National Institute of Mental Health & Neuro Sciences (Nimhans) Suresh Bada Math.
Families of terminally ill persons undergo a painful “slow-motion catastrophe leading to emotional exhaustion and systemic financial ruin. For many families, the experience is not simply watching illness, but living in a prolonged state of uncertainty, suspended grief and moral burden.
The trauma lies in the paradox: the person is still alive, yet the relationship as it existed before may already feel lost. In India, it is more of economic trauma of paying hospital bills, emotional trauma of providing care and physical exhaustion of looking after the comatose patient,” added the senior psychiatrist from Nimhans.
On the question on when and at what point families take the decision to seek medical withdrawal of sustained life support (WSLT), Bada Math said, “Following the Supreme Court judgment in Common Cause vs Union of India, withdrawal or withholding of life-sustaining treatment is permissible under defined safeguards, particularly when aligned with the patient’s wishes or best interests.
As per the court decision, two medical boards, judicial officer and finally family members need to accept passive euthanasia,” explained Bada Math, while underscoring the right to health. “Right to die with dignity should be enabled only when the right to health is made available for every citizen,” he added.