Supreme Court's Consideration of Harish Rana's Case

The Supreme Court of India is addressing the case of Harish Rana, a 31-year-old who has been in a vegetative state for 13 years following an accident. His condition, described as "pathetic," involves reliance on a tracheostomy tube for respiration and gastrostomy for feeding. The court is evaluating whether life-sustaining treatment should be withheld, aligning with ongoing legal discussions on euthanasia and patient rights under Article 21 of the Constitution.

Legal Framework on Assisted Dying and Life Support Withdrawal

• Assisted Dying:
  • Considered illegal in India, pegged as murder or culpable homicide under the Bharatiya Nyaya Sanhita (BNS).
  • Involves criminal liability for both performing and abetting suicide, despite the Supreme Court's stance that those attempting suicide require care, not punishment.
• Life-Sustaining Treatment:
  • Withdrawing or withholding life support is legally distinct as it involves omission rather than action, without intent to cause death.
  • The Supreme Court has interpreted the "right to life" to include the right to die with dignity, especially for terminally ill patients or those in persistent vegetative states.

Evolution of Supreme Court's Framework

The judicial approach to life-sustaining treatment withdrawal began with the Aruna Ramchandra Shanbaug v. Union of India case in 2011. The court acknowledged the potential for a dignified death but deemed assisted dying illegal. The decision to withdraw life support required approval from family, a "next friend," doctors, and the High Court.

• Common Cause (2018):
  • Recognized the right to die with dignity as part of Article 21.
  • Upheld withdrawal of life-sustaining treatment as a natural conclusion of an ongoing dying process.
  • Introduced Advance Medical Directives, although the initial framework proved cumbersome.
• Supreme Court Revisions (2023):
  • Streamlined the process for Advance Directives, which can now be attested by a notary or Gazetted Officer.
  • Removed the need for Collector’s verification and mandatory Magistrate visits.
  • Hospitals now inform the Judicial Magistrate First Class (JMFC) before implementing withdrawal, simplifying procedural hurdles.

The Supreme Court, by hearing directly from Rana's parents, appears to be assessing the practical application of these legal frameworks, balancing the right to life with the choice of a dignified death.