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SUPREME COURT OF INDIA
HON'BLE MR. JUSTICE J.B. PARDIWALA, HON'BLE MR. JUSTICE K.V. VISWANATHAN
HARISH RANA – Appellant
Versus
UNION OF INDIA – Respondent
MA-002238 - 2025
The fact of the case involves a young man who suffered a severe traumatic brain injury after falling from a height, resulting in a persistent vegetative state (PVS) with irreversible brain damage. The injury occurred over 12 years ago, and since then, he has been entirely dependent on artificial life support, including a PEG tube for nutrition and hydration, a tracheostomy for breathing, and urinary catheterization. Despite receiving extensive medical care and multiple hospitalizations, his neurological condition has remained static, with no signs of awareness or response to stimuli, and he exhibits no meaningful interaction with his environment (!) (!) .
His medical condition is certified as irreversible and incurable, with both primary and secondary medical boards concluding that continued administration of life-sustaining treatment, specifically Clinically Assisted Nutrition and Hydration (CANH), is no longer in his best interests and offers no therapeutic benefit (!) (!) . The family, who have been his primary caregivers, have expressed that they have done everything within their capacity over the years, and they believe that further medical intervention only prolongs his suffering and diminishes his dignity (!) (!) .
The family and medical experts agree that the patient’s condition is permanent, with no prospect of recovery or improvement, and that continued treatment is futile. They have collectively requested that the court permit the withdrawal of CANH, considering his irreversible state, the absence of any benefit, and the suffering caused by ongoing medical support. The family’s decision is based on long-standing care, medical opinions, and their assessment of the patient’s likely wishes if he were capable of expressing them (!) (!) .
The case has been brought before the court through a legal process initiated by the family, seeking judicial approval for the withdrawal of life-sustaining treatment in accordance with established guidelines. Medical boards have examined his condition and concurred that withdrawal is appropriate and in his best interests. The court’s role is to evaluate whether the treatment qualifies as medical treatment and whether its withdrawal aligns with the patient’s best interests, taking into account medical, medical-ethical, and non-medical considerations, including dignity and the family’s wishes [p_114, p_115] (!) (!) (!) .
In summary, the core fact is that the patient has been in a permanently unresponsive, non-recoverable state for over a decade, dependent on artificial life support, with medical opinions confirming that continued treatment is futile and causes unnecessary suffering. The legal proceedings are focused on obtaining judicial approval to withdraw this treatment, respecting his dignity and autonomy, and ensuring that the decision is made in his best interests (!) (!) (!) (!) .
2026 INSC 222 REPORTABLE IN THE SUPREME COURT OF INDIA EXTRA-ORDINARY APPELLATE JURISDICTION MISCELLANEOUS APPLICATION NO. 2238 OF 2025 IN SPECIAL LEAVE PETITION (CIVIL) NO. 18225 OF 2024 HARISH RANA …APPLICANT VERSUS UNION OF INDIA & ORS. …RESPONDENTS
J U D G M E N T
CHANDRESH Date: 2026.03.12 Reason:
J.B. PARDIWALA, J.:
For the convenience of exposition, this judgment is divided into the following parts:
INDEX ..................................................................
(A). FACTUAL MATRIX 6 ....................
(B). SUBMISSIONS ON BEHALF OF THE APPLICANT 15 .............
(C). SUBMISSIONS ON BEHALF OF THE UNION OF INDIA 21 (D). CORE CONCEPTS UNDERLYING THE DECISION IN COMMON .........................................................................
CAUSE 2018 24 I. The Essential Distinction: Active and Passive Euthanasia . 27 II. Permissibility of Passive Euthanasia under Article 21 of the Constitution of India .......................................................................... 38 (a) The unifying and omnipresent force of ‘dignity’ in the discourse on ‘right to die with dignity’ ........................................... 39 (b) Viewing the “right to die with dignity” through the prism of self-determination, individual autonomy and privacy. ......... 48 (c) Recognising non-voluntary passive euthanasia within the framework of Article 21 .......................................................................... 58 (i) ‘Dignity’ as the standalone basis for the recognition of non-voluntary passive euthanasia. ........................................ 60 (ii) Unconscious or incompetent patients and their right to bodily integrity. .................................................................................. 74 (iii) ‘Authorized omission’ in consonance with the duty of care of doctors .................................................................................... 79 III. Impermissibility of Active Euthanasia under Article 21 of the Constitution of India .......................................................................... 83 IV. Establishing the Permissibility of Advanced Medical Directives ................................................................................................ 87 Miscellaneous Application No. 2238 of 2025 Page 1 of 286 V. Procedural Framework for Passive Euthanasia ........................ 99 ............................................
(E). ISSUES FOR DETERMINATION 110 ...........................................................................
(F). ANALYSIS 111 (1) Whether the administration of CANH is to be regarded as “medical treatment”? ..................................................................... 111 (2) What is the meaning, scope, and contours of the principle of “best interest of the patient” in determining whether medical treatment should be withdrawn or withheld? ....................... 127 (a) Best interest of the patient in United States of America (USA)
........................................................................................................................... 131 (b) Best interest of the patient in United Kingdom (UK) .......... 156 (c) Best interest of the patient in Ireland ......................................... 197 (d) Best interest of the patient in Italy ............................................... 199 (e) Best interest of the patient in Australia ..................................... 203 (f) Best interest of the patient in New Zealand ............................. 209 (g) Best interest of the patient in European Union (EU) .......... 213 (h) Best interest of the patient in India .............................................. 214 (i) Medical considerations under the best interest principle .................................................................................................................... 221 (ii) Non-medical considerations under the best interest principle .......................................................................
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