Author: Isha Gurung, NEF Law College
TO THE POINT
On 11 March 2026, the Supreme Court of India delivered a landmark judgement in Harish Rana vs Union of India, in which they had given permission for the withdrawal of life sustaining medical treatment in accordance with the law governing Passive Euthanasia. This case is significant because it marked the first application of the legal frameworkwhich has been laid down by the Supreme Court of India in the case of Common Cause vs Union of India.
Harish Rana (aged 32 years) on August 2013 fell from a fourth-floor building resulting in diffuse axonal injury, leaving him in permanent vegetative state with 100% quadriplegia meaning a paralysis of all the four limbs. For around 13 years he had shownno sign of improvement and was only kept alive by Clinically Assisted Nutrition and Hydration (CANH) through surgically implanted PEG tubes. His parent filed a plea in the Supreme Court which ultimately approved Passive Euthanasia after the Delhi High Court had rejected the plea in 2024.
USE OF LEGAL JARGON
In the case of Harish Rana vs Union of India, the plea was initially filed in the Delhi High Court in 2024. However, the Delhi High Court had rejectedtheir petition stating that withdrawal of CANH treatment would amount to starving the patient to death and would therefore be unconstitutional. The High Court observed that since Harish Rana was not depended on a medical ventilator, the withdrawal of CANH could not be treated as an instance of passive euthanasia.
Following the dismissal of the petition, the matter was brought before the Supreme Court in October 2025. It was taken by a bench of Justice J.B.Padiwala and Justice Viswanatham. As per the common cause guideline a two-tire medical board was constituted namely a Primary Medical Board and a Secondary Medical Board to review medical process, both the medical board stated in their report that Harish’s had suffered irreversible and non-progressive brain damage. They further added that although he exhibited sleep-wake cycles, he doesn’t show any signs of awareness or reaction to sound or pain. The boards came to the conclusion that there is very little chance in his recovery and that although he continued to receive nutrition and hydration, his underlying medical condition will not improve.
The principal issues before the court was whether CANH constituted ordinary care or medical treatment. The petitioner argued that CANH cannot be equated with ordinary feeding or basic caregiving, as it involves an invasive medical procedure requiring continuous clinical supervision. It stated that while CANH was necessary for his survival, it is not improving his condition. Relying upon Common Cause vs Union of India, the petitioner further contented that right to die with dignity is an integral part of Article 21 of the constitution and argued that compelling a patient to continue life sustaining treatment despite the absence of any realistic prospect of recovery merely prolong suffering and undermine the patient dignity.
Accepting the submission, Supreme Court held that CANH is not equivalent to ordinary feeding or basic caregiving. Instead, it is a medically administered invasive procedure requiring clinical supervision and is therefore properly classifiable as medical treatment. Balancing both the pros and cons and hearing the views made by Rana’s parents and the report given by the Medical Board, the court arrived at this conclusion that withdrawal of CANH is appropriate in accordance with the prescribe legal framework provided in the case of Common Cause vs Union of India.
The legal principles that were applied in Harish Rana vs Union of India has its origin from the landmark case of Common Cause vs Union of India. In thiscase the Supreme Court had recognised ‘Right to Die with Dignity’ as an intrinsic part of article 21. In this judgement, the Supreme Court of India had given a detailed procedural safeguards and guidelines to ensure that the withdrawal of life sustaining treatment should be carried out only in exception case.
The Common Cause litigation was first originated from a Public Interest Litigation (PIL) and was filed by a registered society Common Cause in 2005 under Article 32 of the constitution. The petitioner in their argument stated that patient who are terminally ill or who are suffering from chronic disease must not be subjected to cruel treatment and they should have a right to refuse prolonging medical treatment by recognising legality of passive euthanasia and allowing patient to execute Advance Medical Directive (living wall).
In response the Ministry of the Health and Family Welfare opposed the regulation of legalizing passiveeuthanasia arguing that ‘’right to die’’ will become ‘’right to kill’’. He argued that legalising any form of euthanasia could lead to abuse of vulnerable patients, neglect of elderly or disabled person. They feared that there can be a risk of fraud of living wall to inherit property of their hire.
After hearing both the argument, the supreme court of India came to the conclusion and acknowledged Right to Die with Dignity as a fundamental right under Article 21of the constitution broadening the interpretation of personal autonomy. The court also recognised the legality of passive euthanasia stating that in medical term it means to stop doing something that is artificially keeping the heart beat of a person who is in permanently vegetative state. At the same time the court unequivocally reaffirmed that active euthanasia remains illegal under Indian law.
The court further recognised the legal validity of Living Wall and Advance Medical Directive stating that living will are a legal document where a person can specify what kind of medical treatment they want, when they no longer are able to make decision for themselves. Before the Common Cause case such kind of document had no legal standing in India. However, such documents are valid now.
The supreme court has stated important guideline that need to be followed before permitting the withdrawal of life sustaining treatment. The key guideline before passing such orders are
1. The patient must be terminally ill in a permanent vegetative state or suffering from an irreversible condition with no reasonable chance of recovery.
2. A medical board must be constituted consisting of a Primary Medical Board of experienced doctors and Secondary Medical Board nominated by the chief medical officer to independent examine the patient condition and tomake decision in the best interest of the patient.
3. The decision of the medical board should be communicated to the patient family member or legal guardian and their view should be taken into account.
4. The medical board must record detailed reason explaining why withdrawal or withholding of life sustaining treatment is medically justified.
THE PROOF
The judgment of this case significantly strengthens dignity based constitutional interpretation under Article 21. It firmly establishes that the principle of sanctity of life cannot be invoked mechanically to justify the medically futile prolongation of biological existence. Instead, the Court places human dignity at the centre of constitutional analysis, thereby reaffirming dignity as the controlling constitutional value in end-of-life jurisprudence. The decision is likely to have far-reaching implications for future constitutional and medical law adjudication, particularly in relation to advance medical directives (living wills), substituted consent, palliative and endof-life care rights, medical negligence in treatment-withdrawal cases, and broader questions of personal autonomy and bodily integrity under Article 21 of the Constitution. More significantly, the judgment deepens the jurisprudential shift from a purely lifepreservative approach toward a dignity oriented constitutional framework, where the quality, meaning, and conditions of continued existence become legally relevant considerations.
ABSTRACT
Harish rana vs Union of India was the first landmark judgement in which the court has allowed the removal of life sustaining medical treatment. In this case the patient has been in vegetative state for more than a decade. The patient has been on life support with no chance of recovery. In this context the family sought permission to withdraw the life support. This is the first case in which the framework laid down in the Common Cause vs Union of India was applied. This case is significant as the court had acknowledged the right to die with dignity under article 21 of the constitution and held that life sustaining medical treatment can be removed in case of the patient has been in irreversible vegetative state.
CASE LAWS
There are various cases that had ultimately led to the extension of article 21 by including right to die along with right to live with dignity
1. P. RATHINAM VS UNION OF INDIA 1994
In this case, Section 309 of the Indian Penal Code, 1860, was challenged on the ground of being in violation of Article 21 of the Constitution of India. Concerning the then prevalent situation, the court bench led by Justice Banwari Lal Hansaria held that Section 309 of the Indian Penal Code, 1860 was in violation of Article 21 and hence was declared unconstitutional. Also, the Court decriminalised assisted suicide.
2. GIAN KUAR VS STATE OF PUNJABJ
In this case, the decision in the case of P. Rathinam v. Union of India (1994) was challenged before the Supreme Court. The five-judge Bench led by Justice Jagdish Sharan Verma held that the decision in the previous case was wrong. The Court upheld the constitutionality of Section 309 of the Indian Penal Code, 1860. The Court stated that, considering Article 21 of the Indian Constitution, the right to life is included in it. However, when a question arises regarding the right to die, the ambit of Article 21 is not wide enough to include the right to die.
Moreover, the Court also quashed the legitimacy of passive euthanasia as well as assisted suicide.
3. ARUNA RAMACHANDRA SHANBAUG
This case was the most significant instance that marked a breakthrough in the legislation regarding euthanasia. Passive euthanasia was legalised, and the Smt. Gian Kaur’s case rulings were entirely overruled. The fundamental distinction between this case and the common cause case, which might be seen as a complement, is that in the former, passive euthanasia was made legal, whereas, in the latter, the right to die with dignity was essentially incorporated into the right to live with dignity.
CONCLUCION
The harish rana case 2026 represent asignificant advancement in Indian Constitution concerning on end-of-life care. By recognising CANH as a medical treatment the court also clarifies that its continuation must serve the patient’s best interest not merely prolong biological existence without therapeutic benefit. The judgement balanced compassion with constitutional principle ensuring that passive euthanasia is legally permissible under strike medical supervision.
FAQ
1. Is abetment of suicide a bailable offence under the BNS?
No — Section 108 is cognizable, non-bailable, non-compoundable, and triable by the Court of Session.
2. What is the punishment for abetment of suicide under the BNS?
Section 108: up to 10 years + fine. Section 107 (child / person with mental illness): up to death or life imprisonment.
3. Is attempting suicide still a crime under the BNS?
Generally no — the BNS drops Section 309 IPC, and Section 115 of the Mental Healthcare Act, 2017 bars punishment. Only Section 226 BNS (coercing a public servant) survives.
