India has moved slowly on euthanasia. In a country of unequal awareness and diverse socio-economic conditions with different needs, and of many faiths, that is perhaps expected. But on March 11, 2026, the Supreme Court allowed the appeal to grant passive euthanasia — withdrawal and withholding of life support — to a 32-year-old man, Harish Rana, who has been in a permanent vegetative state for 13 years. This has happened for the first time in India; in the Aruna Shanbaug case in 2011, the court reportedly rejected the plea for active euthanasia for Shanbaug, who had been in a vegetative state for years. Active euthanasia is also known as assisted suicide. Instead, the Supreme Court laid down the guidelines for passive euthanasia. Two law commissions had considered the matter, the second one in 2012; it had tightened the guidelines. Finally in 2018, the Supreme Court laid down detailed guidelines for passive euthanasia when it recognised the right to die with dignity as a fundamental right under Article 21 of the Constitution. This was in response to a much earlier petition brought by the non-governmental organisation, Common Cause.
The most important aspect of this judgment is the emphasis on dignity. The hospital where the withdrawal of life support to Mr Rana will be conducted has been directed to manage symptoms in order to prevent the patient’s discomfort and preserve his dignity. A permanent vegetative state without cognition, dependent on machines and artificial means of nutrition and hydration, is a tragic destruction of the dignity of a human being. With passive euthanasia, this unbearable indignity can be corrected. This is therefore a truly welcome judgment. The Supreme Court has also instructed the high courts to let first class magistrates be informed of the 2018 guidelines, so that hospitals may let them know when primary and secondary medical boards — according to the guidelines — are unanimous in their decision about the passive euthanasia of a patient. This indicates the Supreme Court’s recognition that this need may be widespread.
It is unfortunate that many would not be able to derive the benefits of this progressive judgment, for access to courts and awareness are unequal in India. But the progress is gradual: it is noticeable that the legislature has not made a law regarding euthanasia in spite of the court repeatedly asking it to do so. A law is different from guidelines. Yet euthanasia is legal in many parts of the world — often if a patient is in an irredeemable condition of suffering and wishes to die with dignity — although only under rigorous regulatory conditions. Belgium, the Netherlands, Luxembourg, Canada or Colombia, for example, or some states in the United States of America permit euthanasia, although in each country the legal definition and the conditions governing the act may be different. It is time that the Supreme Court’s guidelines were complemented by a law permitting passive euthanasia.