Harish Rana case: What is euthanasia, difference between passive and active euthanasia, is it legal in India?

Harish Rana, a 31-year-old man, was granted permission to die after the Supreme Court today, in a landmark decision, allowed passive euthanasia by withdrawing his artificial life support. Harish Rana had been in a comatose condition for more than 12 years. A bench of J. B. Pardiwala and K. V. Viswanathan directed All India Institute of Medical Sciences (AIIMS) to admit Harish Rana to its palliative care unit, enabling doctors to withdraw life-sustaining treatment.

Who is Harish Rana and what happened to him?

A student of Punjab University, Harish Rana, fell from the fourth floor of a paying guest accommodation in 2013 and suffered serious injuries. Harish Rana suffered head injuries after falling from the fourth floor of a building in 2013 and has been in a coma for over a decade. He was pit on life support and since then, Harish Rana has been bedridden, relying on a tracheostomy tube for breathing and a gastrojejunostomy tube for feeding. Harish Rana had been in a vegetative state with 100 percent disability and quadriplegia, which requires continuous medical assistance for breathing, feeding and daily care.

"Harish Rana was once a bright young 20-year-old boy pursuing education at Punjab University when he had a fall from the fourth floor of a building and sustained brain injuries. Harish was discharged, but a brain injury left him in a persistent vegetative state. He experiences a sleep-wake cycle and is dependent on others. The medical report shows no improvement in 13 years," the court said. The court said that while a doctor's duty is to treat a patient, "that duty no longer sustains when the patient has no hope of recovery".


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Passive euthanasia meaning

Passive euthanasia is the intentional act of letting a patient die by withholding or withdrawing life support or the treatment necessary to keep him alive. In passive euthanasia, life-sustaining medical treatment such as ventilators, feeding tubes, or antibiotics are withdrawn to allow a terminally ill patient or someone in a persistent vegetative state (PVS) to die naturally.

Unlike active euthanasia, which involves a direct act such as administering a lethal injection, passive euthanasia refers to the withdrawal or withholding of medical treatment when recovery is no longer possible.

What type of euthanasia is legal in India

Passive euthanasia in exceptional circumstances was legalised in India through the landmark Aruna Shanbaug vs Union of India judgment in 2011. Aruna Shanbaug, a nurse, had remained in a vegetative state for more than four decades after a brutal sexual assault left her paralysed and caused severe brain damage.

The Supreme Court of India had rejected a plea seeking withdrawal of her life support, noting that medical evidence suggested she could continue living. However, the ruling marked a turning point by relaxing legal norms around passive euthanasia, allowing it under exceptional circumstances with strict safeguards.

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Is active euthanasia painful?

Active euthanasia involves intentionally ending a person’s life, usually through a lethal injection administered by a doctor in countries where it is legal. Whether it is painful depends on the drugs and medical protocol used.

Usually designed to be painless: The process typically starts with strong sedatives or anesthetics, so the person becomes unconscious quickly.

Loss of consciousness first: After sedation, medications are given that slow breathing and stop the heart, usually while the person is already unconscious.

Medical supervision: In places where active euthanasia is legal, the procedure is performed under strict medical protocols to minimise discomfort.

Possible brief discomfort: Some people may feel a small needle prick or mild burning from the injection, similar to other IV medications.

Ethical and legal debate: Active euthanasia remains illegal in many countries, including India, where only Passive euthanasia is permitted under strict conditions.

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What are the four pillars of euthanasia?

The four commonly discussed pillars (ethical principles) related to euthanasia are:

Autonomy

Respecting a patient’s right to make decisions about their own life and medical treatment, including the choice to end suffering.

Beneficence

The duty of healthcare professionals to act in the patient’s best interest and relieve suffering.

Non-maleficence

The principle of “do no harm.” In euthanasia debates, this raises the question of whether prolonging suffering may itself be harmful.

Justice

Ensuring fair and equal treatment in healthcare decisions, including ethical and legal considerations about access, safeguards, and societal impact.