A First-Hand Report by Dr Savita Butola for the Advance Care Planning- India (ACP-I) Team – A Peaceful PassingP: Finally, Mr Harish Rana passed away peacefully, surrounded by his loving family members, at the Palliative Care Department, All India Institute of Medical Sciences (AIIMS), New Delhi, at 4:10 p.m. on 24th March 2026, marking the first case of implementation of India’s landmark judgement on withdrawal of life support to ensure dignity in death.
Mr Rana had been in a vegetative state for more than 13 years. AIIMS confirmed his peaceful passing in a press release issued by Dr (Prof.) Rima Dada on behalf of the Medical Cell, extending heartfelt condolences to the family and loved ones of Mr Rana.
The ACP India Journey Behind the Case
Behind the scenes, it was also a moment of quiet closure in a long journey for the Advance Care Planning (ACP) Group, India. The ACP team members, including Dr Savita Butola, Dr Roop Gursahani, Dr Rajani S. Bhat, Ms Smriti Rana, and Adv. Dr Dhvani Mehta, were actively involved in coordinating palliative care and supporting the legal battle of the ageing parents of Mr Rana to ensure a peaceful passing for their son with dignity. The team also provided continued support to address the medical and psychosocial needs of Mr Rana and his family.
The Story So Far (as narrated by Dr Savita Butola, Member, ACP India)
During my visit, I gathered information about Mr Rana’s treatment and the family’s living situation. The Advance Care Planning Team (ACP-India) became involved in Mr Rana’s case after learning about it from a Delhi High Court verdict in 2024. The group contacted the family after obtaining their details through their advocate.
Understanding the Family’s Story
I personally visited the family’s home a number of times to understand the situation. The family shared how Mr Rana had fallen from a building while studying engineering. He had been in a permanent vegetative state for 12 years by then, with a medical history that included ventilator support at PGI Chandigarh and later care at the AIIMS Trauma Centre.
Living with Long-Term Critical Illness
During my visit, I gathered information about their treatment and living situation. The family had recently moved to a new house with an elevator to facilitate stretcher access. The father, is a retired employee from TajSats and the family had been caring for their son for over 12 years despite emotional and financial challenges. While all possible medical treatment options had been exhausted, he continued to require intensive nursing care, with a neurologist confirming the permanence of his condition.
Mr Rana was on a tracheostomy and required continuous care and support. The family with their strong spiritual grounding-maintained hope and faith throughout their care journey. The development of bedsores and medical complications such as recurrent seizures and pneumonia made their journey even more difficult.
Exploring Meaning and Possibilities
During this time, Mr Rana’s mother learned about the 2018 judgement of the Supreme Court on right to die with dignity, and felt that if there were a possibility of withdrawing Life Sustaining Treatment (LST), allowing natural death and then proceeding with organ donation, it could give meaning to her son’s suffering and he could continue to live through the recipients.
Exploring Legal Pathways for Dignity in Death
In 2018, the family sought legal assistance through the Brahma Kumaris organisation and approached an advocate to explore the possibility of withdrawing treatment and donating their son’s organs. However, in 2024, the Delhi High Court ruled that artificial nutrition and hydration, on which Mr Rana was dependent, did not qualify as life support, thereby preventing withdrawal. In August 2024, the Supreme Court observed that it was prima facie in agreement with the High Court’s view but issued notice to the government to explore the possibility of shifting Mr Rana to a facility where his care needs could be adequately met, given the financial strain on his ageing parents. In November 2024, on the final day of then Chief Justice D.Y. Chandrachud’s tenure, the Bench further suggested that the Government of Uttar Pradesh provide financial assistance to support his medical expenses. The medical team from Noida Government District Hospital was given the charge.
Financial and Social Support Along the Way
When a group of retired Taj employees learned about the family’s situation, they voluntarily created a fund to support them. The family initially declined but later accepted after counselling on the importance of financial assistance for the future, especially as some medical equipment and supplies still had to be arranged by the family
However, Mr Rana’s condition continued to deteriorate, with repeated hospital admissions for pneumonia and need for PEG tube changes.
Continuity of Care and ACP Team Involvement
I continued my interactions with the family and extended all possible support. Over multiple visits, I developed a close bond with them. Drs Roop, Dr Rajani and Adv. Dr Dhvani also interacted with and guided the family via Zoom for medical as well as legal concerns.
The family eventually decided to file another application in court, with Adv Dr Dhvani Mehta leading the legal process. Her experience in the legal battle for End-of-Life Care Policy and Advance Care Planning proved invaluable. As surrogate decision makers, the family petitioned that Mr Rana was an avid footballer and body-builder and would not have wished to continue in this condition if he had been able to decide speak for himself.
Supreme Court Ruling on Withdrawal of Life Support
On 11th March, 2025, The Supreme Court of India finally ruled that clinically assisted nutrition and hydration qualify as medical procedures that can be withdrawn, classifying this under “withdrawal of life support” rather than passive euthanasia. Following a four-month decision-making process involving two medical boards, as per guidelines laid down in the 2023 judgement, the Supreme Court ordered that treatment should be withdrawn at the Palliative Care Unit, AIIMS, New Delhi. Mr Rana passed away peacefully 10 days later.
End-of-Life Care and Final Days at AIIMS, New Delhi
The family was supported throughout the process, and organ donation was successfully coordinated, although only non-vascular tissues (Cornea and heart valves) could be donated due to the nature of death.
Dr Sushma Bhatnagar, whom the family had consulted earlier, visited Mr Rana and his family multiple times and provided essential support. In what could only be a divine intervention, I along with Dr Rajani and the Taj employees’ coordinator, happened to be present in Delhi on the day of Mr Rana’s admission, and could help the family with their transition to AIIMS. All of us and Adv. Dr Dhvani could hand-hold the family at AIIMS so as to prepare them for the emotional challenge of finally having the Artificial nutrition withdrawn. In spite of the prolonged legal battle for it, actually going through the process would be very difficult for them.
We regularly interacted with them several times during the final 10 days. The Palliative Care Team at AIIMS, New Delhi, provided the much-needed end-of-life care to Mr Rana and his family, ensuring a peaceful passing. Dr Sushma Bhatnagar herself regularly visited the family and personally coordinated the arrangements for the funeral, including the police escort, preparations at the crematorium, a place to stay for the family, and a priest for the last rites and transportation to the funeral site. The father’s dream of giving a beautiful farewell with rose petals was fulfilled.
Organ Donation: A Meaningful Legacy
This has become a historical landmark case in India, where life support was withdrawn for the first time under a living will framework, with the family donating corneas and cardiac valves after the heart stopped.
A First-of-Its-kind case in India
I, along with other ACP team members, including Dr Rajani, Dr Roop, Dr Sushma, Adv. Dr Dhvani Mehta, and others, provided continuous support and counselling to the family over the past one and a half years during their challenging journey and legal battle. The whole team including the Taj Employees group are grateful for this chance to have helped the family.
Implications for Future Practice and Policy
The suffering of Mr Rana and his family shall not go in vain as this outcome will help thousands of others in a similar predicament through establishment of clear legal and clinical guidelines for similar situations in India. The Supreme Court of India has clearly mentioned that:
- A competent individual has an unconditional right to refuse medical treatment, grounded in the fundamental right to autonomy and privacy. Advance medical directives are an expression of this right.
- Where a patient lacks decision-making capacity, their right to bodily integrity and dignity requires a decision to be made in their best interests. March 12, 2026
- Best interests is a holistic evaluation of medical considerations as well as emotional, social, and psychological factors. It also must be considered on a case-by-case basis.
- It affirmed a fundamental distinction between ‘active’ and ‘passive euthanasia’. The former is currently illegal and is an action (usually a lethal injection) taken with the intention of causing death. Importantly, the Court favoured the use of ‘withholding/withdrawal of life-sustaining treatment’ over passive euthanasia.
Click here to download the statement issued by Advance Care Planning- India (ACP- I) for further details.
About the Author:
Dr Savita Butola, Medical Superintendent, Composite Hospital, Srinagar, is an active member of the Advance Care Planning India (ACP-I) group and has been closely involved in efforts to implement the 2023 Supreme Court judgment on living will and the recognition of the right to die with dignity as part of the fundamental right to life. She has also served as the former Secretary of the Indian Association of Palliative Care. A compassionate palliative care physician, academician, and writer, Dr Savita Butola has made significant contributions to the development of palliative care across India. Her work reflects a strong commitment to the humanistic dimensions of medicine.
This article was published on the IAPC website and is republished here with permission.