An man from India whose life support was removed after the Supreme Court accepted his parents' plea to do so has died.
Harish Rana's case constitutes the pioneering case of court-approved the withdrawal of life support – the act of ceasing or not providing life-sustaining treatment – in India.
Rana, thirty-one, passed away this Tuesday at the All India Institute of Medical Sciences (Aiims) in the capital, where he had been under palliative care after his life support was withdrawn.
The Circumstances of the Case
Rana had been in a comatose state since 2013 since that year, when he incurred grave injuries to his head after falling from a fourth-floor balcony. He was an engineering student during that period.
Prior to the tragic incident, Rana did not have a legal directive outlining directives for his treatment if he lost his ability to make choices for himself.
Often referred to as a 'advance medical directive', this legal document allows anyone over 18 years to choose the medical care they would like to receive if they develop a terminal illness or condition with no hope of improvement.
The Legal Journey
In that year, the apex court legalised the withdrawal of life-sustaining treatment by enabling people to draw up advance directives. Any act that intentionally ends a life – any action that deliberately assists a person end their own life – is illegal in India.
But as Rana didn't have a advance directive and could not consent to the removal of life support due to being in a coma, his family approached to allow their son's medical support to be discontinued.
They have previously said in media interviews that they had depleted all their financial resources looking after their son and were also concerned about what would become of him following their own passing.
Rana's parents initially petitioned the Delhi High Court in that year, requesting withdrawal of treatment for their son, but their petition was rejected because Rana was not then reliant on external life support at the time and was, as the court noted, "surviving without any assistance from machines".
They then approached the higher court, which similarly rejected their plea.
In the following year, they petitioned the Supreme Court once more, saying that their son's condition had worsened and that he was being kept alive "artificially" through medical equipment.
Medical Assessments and the Ultimate Ruling
The Supreme Court consented to review their case after two medical boards assessed Rana's condition.
According to the law governing living wills in India, two medical boards must certify that a individual meets the criteria for their life support to be ceased.
Both boards said that Rana had a virtually non-existent probability of recovering and leading a normal life, and that he needed external support for feeding, bodily functions. The boards further observed that he had irreversible neurological injury and had developed huge pressure ulcers.
On 11 March, the court observed that Rana was not showing improvement from treatment and asked the clinical panels to "exercise [their] clinical judgement" in the case.
He was then moved from his house to the palliative care unit at Aiims, where he later passed away.
Setting a Benchmark
After Rana's death, the legal representative for the family informed a newspaper that the legal battle would establish a benchmark in India.
"It is estimated there are many such patients across the country," the lawyer stated.
The case underscores the complex ethical and legal questions surrounding end-of-life care, personal autonomy, and dignity in contemporary healthcare.
