Passive euthanasia order: AIIMS, Delhi to form committee for life support withdrawal

AIIMS, Delhi said it will form a committee to implement the Supreme Court order permitting withdrawal of artificial life support for Harish Rana, a 32-year-old in a coma for more than 13 years. The court directed a tailored plan to withdraw support while maintaining dignity, marking its first order in this case.

AIIMS, Delhi authorities said a committee will be set up to carry out a Supreme Court order. The order allowed the withdrawal of artificial life support for Harish Rana. Rana is 32 and has been in a coma for over 13 years. Officials said the plan will aim to keep dignity during the process.

The Supreme Court’s order concerned passive euthanasia, which means stopping or withholding life-sustaining care. The court said AIIMS, Delhi should follow a planned approach. The bench included Justices J B Pardiwala and K V Viswanathan. The case involved clinically assisted nutrition and hydration being used to keep Rana alive.

Passive euthanasia order and AIIMS, Delhi committee

"We will follow the courts order. AIIMS will also set up a committee which will decide on how to implement this,\" said Dr Rima Dada, AIIMS spokesperson. Dr Rima Dada is also Professor in the Anatomy Department at AIIMS, Delhi. AIIMS said the committee will decide steps for withdrawing support under the court’s direction.

In its 338-page judgment, the bench said legal conditions for stopping treatment were met. It held that clinically assisted nutrition and hydration counted as medical treatment. It also found continued administration was not in Rana’s best interests. The bench noted unanimous agreement from parents and medical boards on ending treatment.

The court also said end-of-life care must reduce suffering during withdrawal. \"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 direction required a plan that protects dignity.

Passive euthanasia and Harish Rana medical findings

The court recorded that Rana survived through nutrition given using percutaneous endoscopic gastrostomy tubes. Medical boards concluded continuing care only extended biological existence. They said there was no chance of recovery. The judgment said treatment should not continue further given the consensus and medical opinion.

The apex court also said judicial intervention was not needed once both boards approved withdrawal. It stated that when primary and secondary boards certified withdrawal, courts should not be approached. The case still reached the Supreme Court through the family’s writ petition. The court reviewed the medical material placed before it.

Rana was a BTech student at Panjab University and liked football, the court noted. Rana suffered head injuries after a fall in 2013. Rana fell from the fourth floor of paying guest accommodation. Rana has remained in a coma since the incident. The order described the case as the court’s first on the issue.

Passive euthanasia and family response in Ghaziabad

After the judgment, the court spoke about Rana’s family and their role. \"The issues in this matter have once again brought to the fore the fragility and transient nature of the life we live, and how swiftly the tide can turn for the worse,\" the court said. It added Rana lived for 13 years with pain and suffering.

The bench also praised the family’s care in strong words. \"A suffering 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 applicants 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.

The family had said ending artificial life support would return Rana’s dignity. Soon after the order, a crowd gathered outside Brahm Raj Empire society in Ghaziabad. The family now lives there. Rashmi Nandakumar, the lawyer for the Ranas, said the family could not speak to media at that time.

Residents also spoke about the family’s efforts to fund care. Neighbours told media Ashok Rana and Nirmala Rana sold their house in Delhi. The sale helped meet medical expenses, residents said. The court itself noted the family stayed by Rana for years. It recorded appreciation for their continued support.

Passive euthanasia rules under Common Cause judgment

The court said the order aligned with the 2018 Common Cause ruling, later changed in 2023. The 2018 Constitution bench recognised passive euthanasia under Article 21. It also accepted Advance Medical Directives for such decisions. On January 24, 2023, a five-judge bench eased steps for terminally ill patients.

The 2023 changes required two medical boards for patients in a vegetative state. The guidelines said a primary and secondary board should give expert views. In this case, the court examined a secondary board report from AIIMS, Delhi. The court earlier wanted to meet the parents and called the report a sad one.

The primary board said there was a negligible chance of 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,\" the court said. The Supreme Court order now directed AIIMS, Delhi to implement withdrawal through a planned process.

With inputs from PTI