In a significant ruling on end-of-life medical care, the Supreme Court of India allowed the withdrawal of clinically assisted nutrition and hydration (CANH) being provided to a patient who has remained in a permanent vegetative state for over thirteen years.
The case involved Harish Rana, a 32-year-old man who suffered severe brain injuries in a fall in 2013 and has since been completely dependent on artificial feeding and medical support. The Court examined whether continuing such treatment served any meaningful purpose and whether withdrawing it would be legally permissible under the Constitution.
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Background of the Case
Harish Rana was a B.Tech student when he fell from the fourth floor of his accommodation in August 2013, suffering a diffuse axonal brain injury. He underwent treatment at several hospitals, including the Postgraduate Institute of Medical Education and Research in Chandigarh and later at AIIMS, New Delhi.
Despite years of treatment, his neurological condition did not improve. Medical records showed that he remained in a persistent vegetative state (PVS), unable to communicate, recognise people, or perform basic bodily functions independently.
Artificial nutrition and hydration were administered through a Percutaneous Endoscopic Gastrostomy (PEG) tube, which required periodic medical intervention. According to disability certificates issued in 2014 and 2016, he had 100% permanent physical disability due to severe brain injury and quadriplegia.
His parents, who had been caring for him for more than a decade, approached the Court seeking directions to assess whether continuing the feeding support was medically and legally justified.
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Medical Board Assessment
To evaluate the condition of the patient, the Supreme Court directed the constitution of two medical boards in accordance with the guidelines laid down in the Common Cause case on passive euthanasia.
Primary Medical Board
A team of specialists, including neurologists and neurosurgeons, examined Rana at his residence in Ghaziabad. The board found that he had been in a vegetative state since the accident and required constant external support for feeding and other bodily functions.
The doctors noted that the chances of recovery were negligible.
Secondary Medical Board
A second panel of experts constituted by AIIMS reviewed his condition and confirmed the earlier findings. The board concluded that:
- Rana had irreversible brain damage due to traumatic injury.
- He met the clinical criteria for permanent vegetative state for more than thirteen years.
- Artificial feeding through CANH was necessary only to sustain biological survival but would not improve his medical condition.
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Court’s Observations
The bench examined the constitutional principles laid down in the landmark Common Cause (2018) judgment, which recognised the right to die with dignity as part of the right to life under Article 21 of the Constitution.
The Court reiterated that the law distinguishes between active euthanasia and passive euthanasia.
- Active euthanasia, involving a deliberate act to end life, remains illegal.
- Passive euthanasia, involving the withdrawal or withholding of medical treatment that artificially prolongs life, may be permissible in appropriate cases.
“The right to live with dignity,” the Court observed, “extends to the right to die with dignity when medical treatment only prolongs suffering without any hope of recovery.”
The Court further clarified that removing life-supporting treatment such as artificial feeding does not amount to causing death. Instead, it allows the patient’s underlying medical condition to take its natural course.
Family’s Plea Before the Court
During interactions facilitated by the Court, the patient’s parents and siblings explained that they had cared for him continuously for thirteen years.
They told the Court that despite every possible medical effort, his condition had never improved. The family said the decision to seek withdrawal of treatment was taken only after deep deliberation and with the belief that continuing artificial support served no meaningful purpose.
They urged the Court to allow the patient to pass away peacefully rather than remain indefinitely dependent on artificial support.
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Supreme Court’s Decision
After considering the medical evidence, the family’s request, and the constitutional framework laid down in earlier judgments, the Supreme Court permitted the withdrawal of clinically assisted nutrition and hydration provided through the PEG tube.
The Court held that continuing such treatment in the present case would not serve the patient’s best interests and that its withdrawal would fall within the legally permissible scope of passive euthanasia.
It also directed that appropriate palliative care and supportive measures be provided to ensure dignity and comfort to the patient during the process.
Case Title: Harish Rana v. Union of India & Others
Case No.: Miscellaneous Application No. 2238 of 2025 in SLP (Civil) No. 18225 of 2024
Decision Date: 10 March 2026
