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

The order marks the first judicial application of the top court’s 2018 Common Cause judgment, as modified in 2023, which recognised the fundamental right to die with dignity and laid down guidelines for passive euthanasia.

A bench comprising Justices JB Pardiwala and KV Viswanathan passed the order on an application filed by the father of Harish Rana, who sought the withdrawal of life-sustaining treatment for his son.

"Harish Rana, presently aged 32 years, was once a young, bright boy. He met with a tragic life-altering accident after a fall from the fourth floor of his paying guest accommodation. His brain injury left him in a condition of Persistent Vegetative State (PSV) with 100 per cent quadraplegia. Medical reports show that his medical condition has not improved in the past 13 years," the bench noted. He is sustaining life only on clinically administered nutrition (CAN) administered through surgically installed tubes.

The bench held that clinically administered nutrition qualifies as a form of medical treatment and can be withdrawn in the best judgment of the primary and secondary medical boards. The court noted that the continuation of treatment in Rana’s case merely prolonged his biological existence without any therapeutic improvement.

It observed that the patient’s parents, along with the primary and secondary medical boards, had reached the view that the CAN administered to him should be discontinued as it was not in the best interest of the patient.

The bench also stated that once both the primary and secondary medical boards certify the withdrawal of life support, court intervention is not required.

However, it noted that since this was the first instance of the guidelines being applied, the matter had been placed before the Supreme Court. The top court further stated that the withdrawal of life support must be carried out in a dignified manner.

The medical treatment, including clinically administered nutrition being provided to the patient, shall be withdrawn or withheld.

The All India Institute of Medical Sciences (Aiims) shall grant admission to the patient at its palliative care centre so that the withdrawal of CAN can be implemented.

Aiims will also provide all facilities to shift the patient from his residence to the palliative care centre while ensuring that his dignity is preserved.

High Courts must direct judicial magistrates to receive intimation from medical boards regarding decisions to withdraw medical treatment.

The Union government shall ensure that chief medical officers in all districts maintain a panel of registered medical practitioners who can be nominated to the secondary medical boards.

Harish Rana has been in a vegetative state since 2013 after falling from the fourth floor of his house while he was a student.

His father had earlier approached the top court in 2024 seeking the constitution of a primary medical board for his son after the Delhi High Court refused the request.

At that stage, the Supreme Court declined to allow the plea. However, following the court’s intervention, the Uttar Pradesh government agreed to take care of the patient’s medical treatment.

The father later filed the present application stating that his son’s condition had worsened and that he was no longer responding to treatment.