New Delhi, March 11 Authorities at AIIMS, Delhi, announced Wednesday that a committee will be formed to implement the Supreme Court's order, which allows the withdrawal of artificial life support for a 32-year-old man who has been in a coma for more than 13 years.
In a landmark judgment, the Supreme Court on Wednesday allowed passive euthanasia for Ghaziabad's Harish Rana, a BTech student at Panjab University and a sporty young man who loved football.
Rana suffered head injuries after falling from the fourth floor of his accommodation in 2013 and has been in a coma since.
In the top court's first-ever order on this sensitive issue, a bench of Justices J B Pardiwala and K V Viswanathan directed AIIMS, Delhi, to ensure that life support is withdrawn with a tailored plan to maintain dignity.
Passive euthanasia is the intentional act of allowing a patient to die by withholding or withdrawing life support or the treatment necessary to keep him alive.
"We will follow the court's order. AIIMS will also set up a committee which will decide on how to implement this," said Dr. Rima Dada, spokesperson for AIIMS, who is also a Professor in the Anatomy Department at AIIMS, Delhi.
"In the facts and circumstances of this case, we record our satisfaction that the two legal requirements for withdrawing and withholding medical treatment have been unequivocally met. First, it is established that the clinically assisted nutrition and hydration currently being administered to the applicant constitutes 'medical treatment'.
"Secondly, it has been conclusively determined that the continued administration of the same is no longer in the 'best interests' of the applicant. In light of the unanimous consensus arrived at by the parents/next of kin and the constituted medical boards respectively, we are of the opinion that the medical treatment ought not to be prolonged any further," the bench said in a 338-page judgment.
"The right to die with dignity is inseparable from the right to receive quality palliative and end-of-life care. It is imperative to ensure that the withdrawal process is not marred by pain, agony or suffering," it added.
The top court noted that Rana survived only through clinically administered nutrition via percutaneous endoscopic gastrostomy tubes, and medical boards had unanimously concluded that continuation of treatment merely prolonged biological existence without any possibility of recovery.
When primary and secondary boards had certified withdrawal of life support, there was no need for judicial intervention, the apex court said.
The court made a special mention of Rana's parents, expressing its appreciation for showing immense love and care for their son. "His family never left his side," it said.
The issues in this matter have once again brought to the fore the fragility and transient nature of life, and how swiftly things can turn for the worse, the court said, adding that for the past 13 years, the applicant has lived a life defined by pain and suffering.
"This suffering has been made all the more cruel by the fact that, unlike most of us, he was stripped of the ability to even give voice to his anguish. However, while this case highlights how unforgiving life can be, it is easy to lose sight of another vital fact."
"We note with immense respect that the applicant's parents and siblings have stood as unyielding pillars of support. They have exhausted every effort to care for him and continue to do so with unwavering dedication. We can only place on record our deepest appreciation for their boundless love, endurance, and kindness in the face of such adversity," the bench said.
Rana's family had said that allowing withdrawal of artificial life support would restore his dignity after years of irreversible suffering. Shortly after the Supreme Court pronounced its judgment, a crowd gathered outside the Brahm Raj Empire society in Ghaziabad, where the family now lives.
Rashmi Nandakumar, the lawyer who represented the Ranas in the Supreme Court, told
Local residents spoke about how the family had gone out of their way to get their son treated. Ashok Rana and his wife Nirmala Rana had sold their house in Delhi to meet the medical expenses of their son, neighbours told the media.
The order allowing passive euthanasia is in line with the court's 2018 Common Cause judgment, which was modified in 2023 and recognized the fundamental right to die with dignity.
In the 2018 judgment, a constitution bench had recognized passive euthanasia and the right to die with dignity as a fundamental right under Article 21. The court had held that passive euthanasia could be carried out using "Advance Medical Directives".
On January 24, 2023, a five-judge Constitution bench modified the 2018 guidelines to ease the process of granting passive euthanasia to terminally ill patients. A primary and a secondary medical board must be formed for an expert opinion on the withdrawal of artificial life support for a patient in a vegetative state, the guidelines stated.
Hearing the Rana family's writ petition, the top court had earlier expressed its desire to meet the parents. It examined a report on Rana's medical history filed by a secondary medical board of doctors from AIIMS, Delhi and remarked that it was a "sad" report.
The primary medical board, upon examining the patient's condition, had stressed that there was a negligible chance of his recovery.
"What they tried to convey, in their own way, was that the medical treatment imparted over a period of almost two years be discontinued and nature be allowed to take its own course," it said.