Passive euthanasia verdict: A delicate balance between life and dignity

IN its historic judgment on March 11, 2026, the Supreme Court of India allowed the first-ever case of passive euthanasia to end the life of Harish Rana, who has been in a vegetative state since 2013. It shows that judicial prudence ultimately rests on logic, practicability and reason beyond the temporary veil of emotion.

With this decision, the apex court has partially reviewed its own verdict in the Aruna Shanbaug case of 2018, whereby, such a request was denied. It has given the green signal to passive euthanasia under the safeguards spelled out in the same judgment.

Euthanasia refers to the practice of intentionally terminating human life to relieve the person from suffering and undignified existence. Proponents justify it as an extension of the autonomy to choose a respectful exit in order to get rid of unbearable pain and persistent trauma. For them, it is a compassionate alternative to prolonged agony.

On the other hand, opponents warn against its misuse, stating that vulnerable patients may feel pressured into choosing death. It would also erode societal and familial commitment to the care of sick persons. Disability rights groups caution that validating death for whatever reasons may signal that some lives are "less worth living."

The law esteems the lives of men as not only valuable to their own possessors, but also valuable to the State which protects them and for the protection and amelioration of which the State exists. The State is politically duty-bound to prevent persons from taking their own lives, as much as it is obliged to prevent them from taking the lives of others.

Euthanasia has two forms: passive and active. Passive euthanasia amounts to withdrawing a patient from the life-support system and clinically-assisted nutrition and hydration. Active euthanasia calls for a medical professional administering drugs with the consent of the family members of the patient to cause death.

Passive euthanasia has been accepted in many healthcare systems the world over, including India, where courts allow it under strict safeguards to relieve a terminally ill person from pains when there is no hope of recovery.

Under societal norms and practices, passive euthanasia is a part and parcel of everyday social life, when near and dear ones reconcile to the fate that the ill or aged person has no chance of survival and they take a call to stop all human interventions, allowing death to arrive naturally and peacefully.

In Jainism, Santhara, also known as Sallekhana, is a religious practice involving the voluntary, gradual cessation of food and liquid intake until death. Practitioners view this act as spiritual discipline intended to thin human passions, purify the soul and detach from the material body to destroy karma and achieve a peaceful end to life.

While passive euthanasia is mercy, active euthanasia is a crime. Active euthanasia is illegal in India and in major parts of the world. Only 10 countries, including the Netherlands, Belgium, Canada and Spain, have validated it under strict legal layers of eligibility checks, second opinion and cooling-off period.

The instant judgment of the SC in the Harish Rana case is the culmination of prolonged judicial deliberations on the subject of right to self-destruction from time to time. In State of Maharashtra vs Maruti Sripati Dubal (1986), the Bombay High Court opined in favour of the 'right to die', saying that "right to live includes right not to live." It declared Section 309 of the Indian Penal Code, 1860 (IPC), criminalising attempt to commit suicide, unconstitutional.

Contrary to that, the Andhra Pradesh High Court took the opposite view in Chenna Jagadeeshwar's case (1988) and held that Section 309, IPC, is not unconstitutional and self-effacement is a serious crime.

The controversy was settled by the apex court in P Rathinam vs Union of India (1994), upholding the views expressed by the Bombay High Court in the Maruti Sripati Dubal case. A couple of years later, the SC revised its viewpoint and established in Gian Kaur vs State of Punjab (1996) that the right to live under Article 21 does not include the "right to die" or "right to be killed." Justice JS Verma observed, "Right to life is a natural right embodied in Article 21 but suicide is an unnatural termination or extinction of life and incompatible and inconsistent with the concept of right to life."

While rejecting the petition of activist Pinki Virani seeking passive euthanasia for Aruna Shanbaug, who remained in a vegetative state for more than four decades, the SC issued guidelines in 2011 to allow the withdrawal of life support under specific circumstances and judicial supervision.

In the Common Cause vs UOI (2018), the apex court formally recognised the "right to die with dignity" as a fundamental right under Article 21. It also legalised the use of advance medical directives, allowing competent adults to issue written instructions (living wills), specifying their medical preferences should they become terminally ill or incapacitated.

Accordingly, keeping in view the popular public opinion, the lawmakers decriminalised attempt to commit suicide and omitted the offence from the Bharatiya Nyaya Sanhita, 2023. It was, perhaps, a precursor to the validation of passive euthanasia by the SC in the instant case.

In 2023, a Constitution Bench modified and further simplified the procedural requirements established in the Common Cause case of 2018, introducing specific timelines for medical boards and reducing the role of the judicial magistrate to improve accessibility.

The decision on passive euthanasia revolves around balancing respect for personal choice and the protection of the vulnerable. The prudent approach should focus on safeguards in the form of transparent and clear medical diagnosis, repeated informed consent of the patient and his family members, robust palliative care and mental health assessment to ensure that euthanasia is not chosen simply because no other alternative of pain relief is available.