SC Allows Passive Euthanasia for 32-Year-Old; Aruna Shanbaug Case Set the Legal Path

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

The Supreme Court of India on Wednesday allowed passive euthanasia for a 32-year-old man who has been in a coma for more than 12 years, permitting the withdrawal of his artificial life support.

Passive euthanasia refers to allowing a patient to die by withholding or withdrawing life-sustaining medical treatment.

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 and has remained in a comatose state for over a decade.

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 implement a carefully planned process to withdraw life-sustaining treatment.

The court emphasised that the process must be carried out with dignity and sensitivity.

Earlier, the court had examined Rana’s medical records submitted by a secondary medical board of AIIMS doctors and described the report as “sad”. A primary medical board had also 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 life-sustaining treatment such as ventilators, feeding tubes, or medication when recovery is medically impossible.

Unlike active euthanasia — where death is caused by a direct intervention such as a lethal injection — passive euthanasia allows the patient to die naturally after medical support is withdrawn.

Is passive euthanasia legal in India?

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

Aruna Shanbaug case (2011)

In 2011, the Supreme Court first recognised passive euthanasia in exceptional circumstances through the case involving Aruna Shanbaug.

Although the court rejected the plea to withdraw life support in her specific case, it laid down the legal principle that passive euthanasia could be permitted under strict judicial oversight.

Common Cause case (2018)

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

The judgment also introduced the concept of Living Wills or advance medical directives, allowing individuals to record their wishes regarding end-of-life care.

What is the current legal framework?

The Supreme Court further simplified the process in 2023 to make it easier for families and hospitals to implement passive euthanasia.

Key provisions include:

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

Living Will attestation: Living wills can now be attested by a notary or gazetted officer instead of a judicial magistrate.

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

How the Aruna Shanbaug case shaped the law

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

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

A hospital janitor strangled her with a metal dog chain, cutting off oxygen to her brain and causing irreversible brain damage.

For more than four decades, nurses at KEM Hospital cared for her, feeding her through a tube and ensuring constant medical supervision.

The legal battle

Journalist Pinki Virani approached the Supreme Court as Shanbaug’s “next friend”, arguing that keeping her alive in such a condition violated her right to die with dignity.

The court ultimately rejected the plea, ruling that the hospital staff who had cared for her for decades were her true guardians and they opposed withdrawing life support.

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

It also laid down guidelines allowing life support to be withdrawn in rare cases with approval from courts and medical experts.

Aruna Shanbaug died of pneumonia in 2015 at the age of 66, after spending 42 years in a vegetative state under the care of KEM Hospital.