India's top court allows removal of life support of man in vegetative state

In a landmark ruling, India's Supreme Court has allowed the removal of life support of a 31-year-old man who has been in a vegetative state for more than a decade.

This is the first instance of court-approved passive euthanasia - the act of withdrawing or withholding life-sustaining treatment - in India. The man, Harish Rana, had not left a will specifying directives for his treatment before he had an accident.

India legalised passive euthanasia in 2018 but active euthanasia - any act that intentionally helps a person kill themselves - remains illegal.

Rana suffered serious head injuries after falling from a fourth-floor balcony in 2013. He has remained in a comatose state since then.

Over the years, his parents petitioned courts several times to allow their son's life support system to be removed.

They have said in interviews to local media that they had exhausted all their savings caring for Rana and were worried about what would happen to him after they died.

Rana's case had sparked a debate in India around the ethics of court-approved passive euthanasia, with some noting that it goes against the principle of self-determination, which is the foundation of a living will.

A living will is a legal document which allows a person over 18 years to choose the medical care they would like to receive if they develop a terminal illness or condition with no hope of recovery.

For example, they could specify that they don't want to be put on life-support machines or insist that they want to be given adequate pain-relieving medication.

In this case, Rana was not able to give his consent or expressly state that he wanted to be taken off life support as he was in a coma since the accident.

On Wednesday, the Supreme Court noted that Rana has not been responding to treatment.

"He experiences sleep-wake cycles but exhibits no meaningful interaction and has been dependent on others for all activities of self-care," the judges said, according to legal news website Bar and Bench.

Rana was an engineering student at Punjab University in Chandigarh when he fell from the fourth-flour balcony of his paying guest accommodation.

Since then, he has been breathing with the help of a tracheostomy tube and is fed through a gastrostomy tube. He cannot speak, see, hear or recognise anyone, his parents have said.

In 2024, they approached the Delhi High Court seeking passive euthanasia for their son, but their plea was rejected on the grounds that Rana hadn't been placed on life-support machines and was hence "able to sustain himself without any external aid", the court noted.

They then went to the Supreme Court, which also declined their plea.

In 2025, they approached the Supreme Court again, saying that their son's condition had deteriorated and that he was being kept alive "artificially" through life support machines.

The Supreme Court agreed to consider their case after two medical boards assessed Rana's condition.

Both boards said that Rana had a negligible chance of recovering and living a normal life, and that he required external support for feeding, bladder and bowel movements.

The boards also noted that he had permanent brain damage and had suffered huge bed sores.

According to the law governing living wills in India, two medical boards must certify that a patient meets the necessary criteria before their life support can be withdrawn.

Wednesday's order paves the way for the medical boards to "exercise [their] clinical judgement regarding the withdrawal of treatment" for Rana.