SC moves closer to first passive euthanasia nod

THe sublime margaret court on th directed the physical composition of a secondary medical room at the All India Institute of Medical Sciences (AIIMS), New Delhi, to examine whether life support and treatment may be withdrawn from a 31-year-old man who has remained in a vegetative state for over a decade, in what may become India’s first judicially sanctioned case of passive euthanasia.A bench of justices JB Pardiwala and KV Viswanathan said it was “very, very unfortunate” that the man, who suffers from 100% disability quadriplegia, is surviving in a condition so “pathetic” that he has now developed severe bedsores, an indicator of prolonged neglect and irreversible deterioration.“The boy seems to be in a pathetic condition. The bedsores are extremely painful…When a patient in a vegetative state suffers from bedsores, it means he is not being looked after well. His hygiene is poor. Bedsores are the end of everything,” the bench remarked during the hearing.“Doctors have said in so many words that there is no question of recovery. So, he is to remain like this till he is destined to leave…We will have to do something now. We can’t allow him to live like this. That’s for sure,” it further remarked.The direction came after a primary medical board, constituted pursuant to the court’s November 26 order, visited the man’s home and submitted a grim assessment. The chief medical officer (CMO) of Ghaziabad, accompanied by four medical experts, examined the patient and wrote to the principal of LLRM Medical College, Meerut, stating that his chances of recovery were “negligible”. Photographs annexed to the report showed extensive, deep bedsores.Taking note of this material and submissions by petitioner’s counsel, advocate Rashmi Nandakumar, the bench said it was time to proceed to the next step laid down in the Supreme Court’s Common Cause judgment (2018) -- obtaining the opinion of a secondary medical board.The court ordered AIIMS to constitute the secondary board and submit its report by December 17, and listed the case on Thursday next. Documents, including the primary board’s letter and photographs, will be forwarded immediately to the AIIMS director.Once the AIIMS secondary board submits its opinion, the court will decide whether life support, including feeding tubes and clinically assisted hydration, may legally be withdrawn.On November 26, the court had directed the Noida District Hospital (Sector 39) to constitute a primary board to determine whether life-sustaining treatment could be withheld. This was the second time in as many years that the parents of Harish Rana -- a former Punjab University student who suffered catastrophic head injuries after falling from the fourth floor of his paying guest accommodation in 2013, approached the Supreme Court seeking passive euthanasia for their son.Passive euthanasia, legal in India since the Common Cause decision of 2018 (later modified in 2023), permits withdrawal of life support or medical treatment when a patient is terminally ill or in an irreversible vegetative state, subject to a multilayered medical and judicial process.Harish has been bedridden and dependent on clinically assisted nutrition and hydration for nearly 13 years. Though he is not on mechanical ventilation, he survives through feeding tubes and remains entirely unresponsive. His parents, now elderly and financially drained -- they have sold their house to sustain his care -- told the court through counsel that “everything was tried” under earlier directions, including home care, physiotherapy, dietician visits and free medication with assistance from Uttar Pradesh authorities.The family’s plea had been rejected by the Delhi High Court in 2024, which held that since Harish was not being kept alive by mechanical ventilation, he did not qualify for passive euthanasia.The Supreme Court, while sympathetic, initially accepted the Union health ministry’s recommendation for home-based care. In its November 8, 2024 order disposing of an earlier petition filed by the parents, it allowed them to return if circumstances worsened.The present proceedings stem from that liberty. In the fresh application, the parents sought a declaration that clinically assisted nutrition and hydration constituted “life-sustaining treatment”, thereby bringing the son within the passive euthanasia framework. They also sought directions for proper constitution of primary and secondary medical boards across states, as mandated by the modified Common Cause guidelines.In its last order on November 26, the bench observed that the man’s condition had deteriorated sharply since last year, underscoring the futility of continued artificial life support. Emphasising the need for an expert determination on withdrawal of treatment, the court had then ordered for the constitution of the primary medical board to submit a report “whether the life sustaining treatment can be withheld or in other words withdrawn.”