AIIMS begins first-ever passive euthanasia

AIIMS-Delhi has initiated protocols to implement the Supreme Court verdict allowing passive euthanasia for Harish Rana, a process that will take about two to three weeks, say insiders.

The 31-year-old, who has been in a coma since 2013, was shifted from his Ghaziabad home to the palliative care unit at Dr BR Ambedkar Institute Rotary Cancer Hospital at the All-India Institute of Medical Sciences on Saturday.

A specialised medical team headed by Dr Seema Mishra, professor and head of the department of anaesthesia and palliative medicine, has been constituted to implement the process, the first ever in India.

The team comprises doctors from departments of neurosurgery, onco-anaesthesia and palliative medicine, and psychiatry.

In a landmark judgment, the Supreme Court on March 11 allowed passive euthanasia for Harish, who was a BTech student at Panjab University who fell from a fourth-floor balcony in 2013 and suffered severe head injuries. He has been in a coma since, with artificial nutrition support and occasional oxygen support.

The apex court also directed AIIMS-Delhi to ensure that life support is withdrawn with a tailored plan so that dignity is maintained.

“The process generally involves withholding or withdrawing the nutritional support gradually while ensuring adequate pain relief. The patient is given palliative sedation so that he or she is not in distress. Life support measures such as artificial nutrition, oxygen and medications are slowly withdrawn. The aim is not to prolong nor hasten death,” Dr Sushma Bhatnagar, former head of the department of onco-anaesthesia, pain and palliative care, AIIMS-Delhi.

In Harish’s case, sources said the entire process could take two to three weeks to complete.

A video from the Rana home in Ghaziabad showed relatives offering prayers as a member of the Brahma Kumaris puts a ‘tilak’ on Harish’s forehead and says softly, “Sabko maaf karte hue, sabse maafi mangte hue, so jaao… theek hai... (Forgiving everyone and asking forgiveness from everyone. Now sleep. It’s ok).”

The Brahma Kumari seen in the heartbreaking video was Sister Lovely from the Mohan Nagar Seva Kendra in Ghaziabad, Komal, a member of the Brahma Kumaris based at Mount Abu, told PTI over phone.

“She is following a ritual with the words that mean he (Harish) leave the world in a happy state, seeking and giving forgiveness... it is part of a meditative chant that comforts the soul and eases the entire process of the soul merging with the sublime,” Komal said.

She added that the family has been deeply spiritually inclined, which helped them endure the difficult 13-year period of caring for Harish.

“Although the couple has another son, advancing age had begun to worry them about who would look after Harish in the future once they were no longer able to,” she said, adding that members of the organisation counselled the family during this phase.

While the family was reluctant to talk, Harish’s father, Ashok Rana, could not be reached for comment.

According to Komal, alongside medical consultations, the family also sought spiritual guidance as they prepared for the inevitable after the Supreme Court’s directions.

The top court allowed withdrawal of life-sustaining treatment after medical boards concluded that Harish’s condition was irreversible and continued clinical intervention would not restore neurological function.

Ashok Rana, who had approached the apex court seeking permission for passive euthanasia, had said after the verdict that the decision was extremely painful but necessary.

“No parent would ever want to see their son in such a condition,” he said, adding that the decision was taken in his son’s best interests.

“We believe that in the larger public interest, the decision could help families of many people who may be in a condition like Harish,” Ashok Rana had told reporters outside his residence.

The Supreme Court had clarified that the order did not amount to active euthanasia but involved withdrawal of the feeding tube and continuation of palliative care so that the natural process of death may take place with dignity.