Can’t keep him in this stage: SC to meet parents seeking passive euthanasia for their son in coma for over 12 years

New Delhi: The Supreme Court on Thursday said it wished to speak directly with the parents of a 31-year-old man who has remained in a comatose state for more than twelve years, as it examined a plea from his father seeking passive euthanasia through the withdrawal of artificial life support. The man, Harish Rana, sustained critical head injuries in 2013 when he fell from the fourth floor of a building, and since then has depended entirely on medical support.

Passive euthanasia involves allowing a patient to die by withholding treatment or removing life-sustaining systems. In this case, his father, Ashok Rana, has argued that his son’s situation has not changed in more than a decade and that continuing life support no longer serves a meaningful medical interest.

A bench of Justices J B Pardiwala and K V Viswanathan reviewed a report prepared by a secondary medical board at the All India Institute of Medical Sciences in Delhi. After reviewing the findings, the judges described the document as “sad” and stated that the circumstances warranted serious consideration. “It is a very sad report. We cannot keep this boy in this stage,” the bench stated while setting a meeting with the parents for 3 pm on January 13.

The Supreme Court had earlier examined the opinion of a primary medical board, which also concluded that the chances of Rana regaining consciousness were negligible. On December 11, the court observed that the primary board described the patient as being in a “pathetic condition”. According to that assessment, Rana lay in bed with a tracheostomy tube for breathing and a gastrostomy tube for feeding. Photographs attached to the report showed severe bed sores. The medical team stated that the possibility of improvement was extremely remote and that he had appeared to be in a vegetative condition for the past 13 years.

Under guidelines issued by the apex court in 2023, cases involving the withdrawal of artificial life support for a patient in a vegetative state must be evaluated by both a primary and a secondary medical board. During the December 11 hearing, advocate Rashmi Nandakumar, representing the father, pointed out that the 2018 Supreme Court judgment established the procedure of referring such cases to a secondary medical board formed by the chief medical officer after the primary board’s evaluation.

The Supreme Court recorded that the chief medical officer examined the patient along with four medical experts. They later wrote to the principal of LLRM Medical College in Meerut, Uttar Pradesh, detailing their observations. The bench stated, “In such circumstances, we should now proceed to the next step in the process. We should now order that a secondary medical board be constituted for the purpose of the examination of the patient. We request the AIIMS to constitute the secondary board and give us a report by next Wednesday.” The judges also directed that all relevant documents and excerpts be forwarded to the AIIMS director without delay.

Before this stage, on November 26, the Supreme Court had instructed the district hospital in Sector 39, Noida to create a primary medical board to assess the feasibility of passive euthanasia. The judges noted then that the patient’s health had deteriorated as the years passed. The district hospital was asked to submit its report within two weeks. At that time, the bench said, “We want the primary board to give us a report that the life-sustaining treatment can be withheld. Let the primary board place its report at the earliest and once it is before us, we shall proceed to pass further orders. Let this exercise be done within two weeks.”

This is the second consecutive year in which Rana’s parents have approached the Supreme Court seeking passive euthanasia. On November 8 last year, the court considered a report from the Union health ministry advising that the patient be placed in home care with assistance from the Uttar Pradesh government, including regular visits from doctors and a physiotherapist. The court added that if home care was not possible, Rana should be moved to the district hospital in Noida to ensure access to consistent medical supervision.

The long legal struggle began after earlier hearings in the Delhi High Court. Rana had been studying at Punjab University at the time of the 2013 accident at his paying guest accommodation. Since that incident, he has remained bedridden and dependent on artificial support. The Supreme Court had previously agreed with the Delhi High Court’s view that passive euthanasia was not justified because the patient was not on a ventilator or other mechanical device, though he was being fed through a tube. Nevertheless, the court noted that he had been in a vegetative state for more than a decade and that his parents, who had even sold their house, were struggling to continue his care.

In July last year, the Delhi High Court had again declined to refer the case to a medical board, stating that the man was not being kept alive mechanically and could continue without additional external support.