By Imperilex Legal
· Harish Rana V. Union of India (2026 INSC 222)
· Supreme Court of India
· J. K. V. VISWANATHAN
· 11th March 2026
Introduction
The Supreme Court on 11-03-2026 applied the principles laid down in earlier euthanasia jurisprudence allowing passive euthanasia for the Harish Rana (herein after referred as Applicant) a man under PVS for past 31 years. The judgment does not only deals with relief asked for but laid down a critical distinction between Active and Passive Euthanasia.
Brief Facts
Applicant was a young age person pursuing B. Tech. degree from Punjab University. On 20-08-2013, the fateful day, Applicant is stated to fell off from the fourth floor of his paying guest accommodation thereby sustaining diffuse axonal injury. Applicant was rushed to Gharwal local hospital but within few hours had to be shifted to PGI Chandigarh due to severe medical condition. Further, Applicant stayed admitted from 21-08-2013 to 27-08-2013 afterward discharged but his medical condition remained far from recovery.
The constant need of replacement of feeding tube (PEG) in every two months followed by several severe infections also had multiple seizure sessions till 2016 afterwards been receiving anti-seizure drugs. The medical reports of Applicant indicates that he is not aware of the surrounding environment, has no facial gestures, does not possess ability to interact with people or no body movements to show cause any needs. The Applicant for past thirteen years have received multiple sessions of hyperbaric oxygen therapy coupled with other treatments but as per reports no significant improvements were noted.
The Applicant have received multiple disability certificates i.e. certificate dated 21.11.2014 issued by the Janakpuri Super Speciality Hospital Society (Autonomous Institute), Government of NCT of Delhi which states :
“This is to certify that Harish Rana, Age 21 years, Sex Male, S/o ……………… Registration No-0026…. is a case of Head Injury with Diffuse Axonal Injury with Vegetative Stage, Quadriplegic. He is Physically disabled and has 100% [Hundred percent] disability in relation to his whole body and is Permanent in nature.”
Another disability certificate dated 13.04.2016, issued by Dr. Ram Manohar Lohia Hospital, New Delhi, Government of India stating :
“This is to certify that I have carefully examined Mr. Harish Rana, S/o Mr…………….. photograph is affixed above, and am satisfied that he is a case of PERSISTENT VEGETATION STAGE WITH COMPLETE SENSORIMOTOR DYSFUNCTION, HIS PERMANENT PHYSICAL IMPAIRMENT IS 100% (HUNDRED PERCENT). His extent of physical impairment/disability has been evaluated as per guidelines F. No. A13021/2010-MS/MH-II-Directorate General of Health Services (Medical Hospital Section-II), Nirman Bhawan, New Delhi dated 18.06.2010”
The Supreme Court via order dated 26-11-2025 directed constitution of primary medical board of doctors(hereinafter mentioned as primary board) to assess the situation. The primary board via letter stated observation :
“This is to say that after consulting with CMO Ghaziabad we have visited residential place of Mr. Harish Rana S/O Mr……………………………. for evaluation of his health condition. The team included a neurosurgeon, a neurologist, a plastic surgeon and a critical care expert. Attendants ………….. were present during evaluation. Harish Rana suffered injuries about 13yrs back since that time he is under medical care under many centers. At present Patient was lying in bed with tracheostomy tube for respiration and gastrostomy for feeding. Patient was opening eyes spontaneously. His breathing was spontaneous with treacheostomy tube. He was emasciated and contactures were present in both lower limb and upper limb at shoulder, elbow, wrist, fingers, knee, ankle and toes. His pupils were normal in size but sluggish in reaction with no movement restriction. No facial asymmetry present. Gag reflex present. He was having spasticity all over both upper limb and lower limb with deep tendon exaggerated at bicep, triceps, supinator, knee, ankle. Sensory and cerebellar examination could not be accurately assessed due to his state. He had intact brainstem function but due to his vegetative state he requires external support for his feeding, bladder bowel and back. He needs constant physiotherapy and tracheostomy tube care. The chances of his recovery from this state is negligible.”
Further to this submission, the Supreme Court directed the formation of secondary medical board of doctors(hereinafter mentioned as secondary board) as per guidelines of Common Cause 2018. Observations of secondary board are as under :
“Based on the history and examination findings, the medical board is of the following opinion:
a. Mr. Harish Rana has non-progressive, irreversible brain damage following severe traumatic brain injury with diffuse axonal injury. He fulfills the criteria of permanent vegetative state (PVS) and has been in this state for the past 13 years.
b. The continued administration of clinically assisted nutrition and hydration is required for the sustenance of his survival. However, it may not aid in improving his medical condition or repairing his underlying brain damage.”
The Supreme Court after evaluating the reports requested Counsels for Applicant and Additional Solicitor General to have a discussion with family and submit report. The report of this discussion indicated that parents took care of applicant for past 13 years with every possible medicine, therapies etc .. but the condition of the Applicant remained the same and afar from improvement. The main concern was about who would take care of applicant after parents or something happened due to old age of parents?
On 13-01-2026, ASG having a brief discussion with primary and secondary board’s doctors submitted that the Applicant’s prolonging life via artificial life support does not severe any meaningful purpose as Applicant showed no possible recovery signs even with every possible humane attempt. It was also stated that it is the time to let nature takes its own course.
Claim of Applicants
1. As per Common Cause guidelines 2018, the Court intervention is not required to decide whether the medical support be withheld or withdrawn, it is under jurisdiction of hospital to constitute two medical board to assess the situation. The Court’s jurisdiction can only be invoked when there is difference of opinion between medical boards and their respective findings. However, this present Applicant had to invoke Court’s jurisdiction due to absence of institutional mechanism to trigger process , Applicant approached Delhi High Court via W.P.(C) of 2024 but petition was dismissed on the ground that Applicant was not depended on any machine and can sustain life by himself.
2. The SLP was filed against the judgment of High Court in above mentioned Writ Petition but was also dismissed on the request of state government that State Government will provide home based medical care to the Applicant. A liberty to seek any further direction was also granted to the Applicant.
3. Due to degrading health of Applicant followed by hospitalization in May 2025 and the reports of both medical boards the requirement under Common Cause 2018 was satisfied.
4. The PEG tube used for feeding is a type of mechanical life-support. The CANH (term used for artificial feeding) is worldwide recognized as mechanical support/ life-sustaining treatment. This Court in Common Cause 2023 have already recognized it.
Defense of Respondent
1. The ASG submitted that passive euthanasia is already recognized by this Court in its previous judgment Common Cause,2018 whereby holding that if the life supports serve no purpose except prolonging the irreversible condition usage of passive euthanasia is allowed.
2. The CANH, as per House of Lords in Airdale (supra), recognized that administration of CANH indeed constitute medical treatment.
3. The withdrawn or withholding of artificial feeding does not constitute an offence rather it allows nature to take its course as held in Common Cause,2018.
4. As per request of parents as well as emphasis on findings of both medical boards, this Court may allow withdrawal of CANH in this particular situation.
Analysis by Supreme Court
Supreme Court clarified the difference between “Active Euthanasia” & “Passive Euthanasia” and laid down reasons why usage of “Active Euthanasia” is held unconstitutional thereby holding it illegal wherebyallowing “Passive Euthanasia” take place.
“Active Euthanasia”
It is stated to be a direct participation with advancing any specific overt act to end patient’s life thereby causing death against natural flow. The Constitution of India, under Article 21, does not allow anyone without following procedure establish by law to end one’s life against natural flow however, in the countries i.e. Canada, Netherland, Belgium …. allows active euthanasia.
The core problem in allowing this process is that ending one’s natural life without provisions of law will constitute criminal act as elements of crime being satisfied. It is a positive contribution towards cause of death also mentioned as “foreseeing the hastening of death” by Dipak Misra, CJ. If such practices would be allowed than the Article 21 of Constitution of India of patients would be in direct violation and no one can be granted permission to commit an act which is not permissible and itself by Constitution constitute a crime.
“Passive Euthanasia”
On the contrary, this type of euthanasia is allowed and permissible by the Constitution of India as per interpretations and guidelines laid down in Common Cause, 2018. It is the process where doctors would withdraw life support mechanism and allow nature to takes its course thereby not advancing death.
Passive euthanasia comes under the scope of Article 21’s wild interpretation of “Right to die with dignity” as doctors omit the duty which was legally required to be perform by them.
Difference between “Active Euthanasia” & “Passive Euthanasia”
| S.No. | “Active Euthanasia” | “Passive Euthanasia” |
| 1. | Death cause by active participation | Death caused naturally |
| 2. | Injecting lethal dose of drugs | Withdrawing artificial life support system |
| 3. | Hastening the process of death | Death occurs at its own pace |
| 4. | Not permissible in India as per Article 21 of the Constitution of India | Strictly permissible in India as per Article 21 of the Constitution of India |
| 5. | Death occurs due to lethal dose of drugs | Death occurs due to underlying condition |
Judgment
The Supreme Court allowed this MA relying on multiple facts i.e. Applicant’s inability to understand surrounding environment, no movement, multiple disability certificates, decisions of medical boards thereby concluding that the present application fit in the guidelines laid down in Common Cause 2018 & 2023 and allowing Applicant to let nature takes its course quoting:
“Between the funeral fire and the mental worry, it is the mental worry which is more devastating. While the funeral fire burns only the dead body, the mental worry burns the living one.”
Key Takeaways
1. The Article 21 of Constitution of India can be interpreted to the extent that in required circumstances a person can claim “Right to die with dignity” thereby proving Constitution of India is based on autonomy of individual.
2. The differentiation between two types of euthanasia whereby result are same but the process is the deciding factor to held one constitutionally legal whereby other one equivalent to committing a crime.
3. The process again must be fair and reasonable as per upheld by multiple judgments of Supreme Court.
Conclusion
A person living in India possesses right to life as its fundamental right as well as right to die within that right. Anything which causes death to accelerate compare to natural speed and timeline is considered as committing a heinous crime and illegal whereby same result with following nature’s clock become legal.