India’s law on passive euthanasia has changed slowly over the years. The change came through major court rulings and difficult human stories. Two cases stand out in this journey: Aruna Shanbaug v. Union of India and the later ruling in Harish Rana’s case. The first case created the legal framework. The second showed how courts now apply that framework in practice.
These decisions also show a wider legal shift. Over time, courts moved from discussing the right to live with dignity to recognising, in limited cases, a right to die with dignity under Article 21 of the Constitution.
Right to Die Debate Began With Gian Kaur
The legal debate on the “right to die” began with Gian Kaur v. State of Punjab (1996). In that case, a three-judge Bench of the Supreme Court upheld the constitutional validity of the offence of abetment of suicide under the Indian Penal Code. The Court also held that the right to life under Article 21 does not include a right to die.
Even so, the Supreme Court made an important observation. It said that the right to live with human dignity continues until the end of natural life. It also said that this includes a dignified process of death. The Court added that a dying person may have a right to die with dignity when life is ebbing away.
That observation later shaped euthanasia law in India. It left room for future recognition of passive euthanasia and end-of-life choice.
In 2006, the 196th Law Commission of India also addressed the issue. It said that withholding life support or medical treatment from terminally ill patients would not amount to attempt to suicide, if doctors act in the patient’s best interest.
Aruna Shanbaug Case Brought the Issue Before the Court
The issue of euthanasia directly reached the Supreme Court in Aruna Shanbaug v. Union of India. Aruna Shanbaug worked as a nurse at King Edward Memorial Hospital. In 1973, a brutal sexual assault deprived her brain of oxygen. After that, she remained in a persistent vegetative state for more than four decades.
In 2009, journalist Pinki Virani approached the Supreme Court and sought permission for euthanasia on Shanbaug’s behalf.
In 2011, the Court refused euthanasia. It largely relied on the fact that the hospital staff caring for Shanbaug opposed the withdrawal of life support. Still, the judgment became a landmark ruling.
The Supreme Court held that passive euthanasia was legal in India, but only with safeguards and High Court approval. At the same time, the Court said passive euthanasia could be made lawful “only by legislation.” Until Parliament enacted a law, the procedure set out by the Court would govern such cases.
The ruling introduced an important principle. It recognised that doctors may legally withdraw life-support treatment in some cases where recovery is medically impossible.
Common Cause Recognised Right to Die With Dignity
The law developed further in Common Cause v. Union of India (2018). A Constitution Bench of the Supreme Court decided the case. The Bench comprised Chief Justice of India Dipak Misra, Justice A.K. Sikri, Justice A.M. Khanwilkar, Justice D.Y. Chandrachud and Justice Ashok Bhushan.
The Court held that the right to die with dignity forms part of Article 21 of the Constitution. It also affirmed that passive euthanasia is legally valid.
The Supreme Court said: “Though the sanctity of life has to be kept on the high pedestal yet in cases of terminally ill persons or PVS patients where there is no hope for revival, priority shall be given to the Advance Directive and the right of self-determination”.
The judgment also introduced advance medical directives, often called “living wills.” A living will is a written document. It allows a person to record instructions in advance about medical treatment to be given when that person becomes terminally ill or can no longer give informed consent.
It also allows the person to authorise family members to withdraw life support if a medical board finds that recovery is no longer possible. This ruling gave patients greater control over end-of-life decisions.
2018 Safeguards Proved Difficult in Practice
Although the 2018 judgment was progressive, its procedure proved difficult to follow. The Court had laid down detailed safeguards on many issues. These included who could execute an advance directive, what it should contain, how it should be recorded and preserved, when it could be enforced, and when it could be revoked or treated as inapplicable.
The judgment also dealt with appeals against a hospital medical board that refused permission.
In 2019, the Indian Council of Critical Care Medicine moved the Supreme Court. It pointed out the practical problems that families and hospitals faced while trying to implement living wills.
Supreme Court Simplified the Process in 2023
In 2023, another Constitution Bench revisited the issue. The Bench comprised Justices K.M. Joseph, Ajay Rastogi, Aniruddha Bose, Hrishikesh Roy, and C.T. Ravikumar. It modified the earlier guidelines and simplified the procedure to make it “workable”.
The Court made several important changes.
Under the 2018 judgment, a Judicial Magistrate had to countersign an advance directive. The Court removed that requirement in 2023. It allowed attestation by a notary or gazetted officer instead.
Earlier, a person could name only one guardian or relative as a surrogate decision-maker. Under the revised rules, a person can name more than one guardian or close relative for that role.
The Court also simplified the medical board process. The earlier framework was more complex and involved the district collector. The revised system created primary and secondary medical boards. Both boards must give their opinions within 48 hours.
Another major change concerned the judicial magistrate. Earlier, doctors could withdraw treatment only after receiving the magistrate’s “approval.” Under the 2023 ruling, hospitals only need to “convey” the opinion of the medical board to the magistrate.
Harish Rana Case Showed the Law in Action
Harish Rana had remained on Clinically Administered Nutrition (CAN) after he fell from a building in 2012 and suffered severe brain injuries. He showed no signs of recovery.
In 2024, soon after the 2023 ruling, his family approached the Supreme Court. They sought permission to withdraw life-sustaining treatment for their 32-year-old son.
The Supreme Court allowed the withdrawal of life support after noting compliance with procedural safeguards. The Court held that prolonging Harish’s biological life was not in his best interest because his condition had not improved.
Justice Pardiwala, in his 286-page judgment, said: “For the past 13 years, the appellant has lived a life defined by pain and suffering. A suffering made more cruel, as unlike most of us, he was stripped of his ability to even give voice to his anguish,” Justice Pardiwala said in his 286-page judgment.
What the Shift in Law Means
The Harish Rana ruling completes an important legal journey. In Aruna Shanbaug, the Supreme Court recognised passive euthanasia in principle but refused it on the facts of that case. In Harish Rana’s case, the Court applied the doctrine and allowed withdrawal of treatment.
This shows a clear shift in the law.
First, passive euthanasia now rests firmly on the constitutional value of dignity under Article 21.
Second, the 2023 changes removed many procedural hurdles that had made living wills hard to use.
Third, courts now appear more willing to balance the sanctity of life with the dignity of a person at the final stage of life.
The Supreme Court has also pointed to the legal “vacuum” in this area. It has urged the government to consider a comprehensive law on passive euthanasia.
A Law That Has Moved From Principle to Practice
Aruna Shanbaug opened the legal door to passive euthanasia. The 2018 and 2023 rulings then built the constitutional and procedural structure around it. The Harish Rana case now shows that courts are using that framework in practice.
From Gian Kaur onward, the law has changed significantly. Passive euthanasia is now legal. Living wills now have legal force. And Article 21 now includes, in limited situations, the right to die with dignity.
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