INTRODUCTION
Euthanasia, often referred to as “mercy killing” is a complex and highly debated topic within legal and ethical realms. There exists active and passive euthanasia, the former being when a medical professional, or another person, deliberately does something which lets the patient die, and passive euthanasia due to negligence.[1] Recently the court approved passive Euthanasia case of Harish Rana is the first of its kind where the Supreme court took a different approach towards Euthanasia[2].[3] The legal approach to euthanasia in India and the United Kingdom reflects both similarities and important differences. India allowed passive Euthanasia recently and the United Kingdom maintains a restriction and more legal framework, In the latter under the Suicide Act 1961 euthanasia is punishable with 14 years, both suicide and active euthanasia are criminal offences. Although patients in the United Kingdom have the right to refuse medical treatment, there is no legal recognition of assisted dying, and any form of direct assistance can lead to prosecution. This blog in detail discusses the concept of euthanasia in a comparative approach between India and United Kingdom.
Types of Euthanasia
Active Euthanasia entails a deliberate medical act most commonly a lethal injection or controlled overdose that terminates life. A physician's conduct is the direct and proximate cause of death, effectively truncating the patient's natural lifespan through external intervention. This form is criminalised in both India and the United Kingdom[4].
Passive Euthanasia operates through omission. When treatment a ventilator, feeding tube, dialysis is withdrawn or withheld with appropriate consent and oversight, the patient's pre-existing condition, rather than any external act, causes death. The distinction between act and omission is legally foundational in both jurisdictions. A further axis divides voluntary euthanasia (patient's expressed prior consent through a Living Will) from non-voluntary euthanasia (patient incapacitated, decisions made by family and medical boards applying a best-interests standard). The Harish Rana case involved the latter.
Euthanasia Law in India
India's entire euthanasia framework rests not on legislation but on a succession of Supreme Court judgments expanding Article 21 of the Constitution the right to life to include the right to live, and in appropriate circumstances die, with dignity.[5]
The first time that there was a clear judicial understanding of passive euthanasia took place in the case of Aruna Ramachandra Shanbaug Union of India (2011). The Delhi High Court refused the specific request related to assisting Aruna Shanbaug to die, as she has been in a persistent vegetative state since she was raped in a basement of a hospital in 1973 and is not unable to be declared as "brain dead". However, the Delhi High Court decision to refuse the request was made with landmark recommendations on permitting passive euthanasia under very limited conditions subject to oversight from the High Court. [6]The Law Commission of India furthered the development of the doctrine in its 196th report (2006), which characterised the removal of futile treatment as a lawful omission, and its 241st report (2012), which recommended legislation concerning passive euthanasia[7]. The turning point arrived in Common Cause (A Regd Society) v. Union of India (2018), where the five-member Constitution Bench of the Supreme Court unanimously ruled that the right to die with dignity is a fundamental right protected by Article 21 of the Constitution of India[8]. The Supreme Court's ruling in Common Cause permitted the use of Living Wills (Advance Medical Directives) for individuals wishing to indicate their refusal to receive life-prolonging medical treatment in advance, and established a two-tiered process through which a medical board would be established in the event no prior written directive had been made[9]. The Supreme Court subsequently made procedural changes in 2023 for the establishment of a medical board in order to facilitate the removal of unnecessary delay.[10]
Despite this framework operating since 2018, no court had previously approved its application to a named individual until Harish Rana. The Delhi High Court had rejected the family's petition in 2024 on the narrow ground that Rana was not on a mechanical ventilator and therefore was not "terminally ill." The Supreme Court overruled this restrictive interpretation, holding that CANH constitutes medical treatment not basic nursing care and can be lawfully withdrawn where it merely prolongs a vegetative state without therapeutic benefit[11]. AIIMS was directed to admit Rana to its Palliative Care Unit, where he died peacefully on 25 March 2026. The Court described the case as one lying "at the intersection of love, loss, medicine and compassion." Scholars have, however, raised legitimate concerns: the expansive application of the "best interests" standard to non-voluntary decisions, absent a robust procedural architecture, risks substituting subjective third-party assessments of dignity for objectively verifiable patient autonomy[12].
Active euthanasia remains firmly prohibited under the Bharatiya Nyaya Sanhita 2023, and the Harish Rana judgment reaffirmed this position without ambiguity[13].
Euthanasia Law in the United Kingdom
Under Section 2(1) of the Suicide Act 1961, an individual may be convicted for intentionally assisting or encouraging another person to die by suicide, and the maximum penalty for such a crime is fourteen years imprisonment[14]. Active euthanasia was determined by common law to be murder through the commission of a positive act, that is, physically inducing someone to die.
The law regarding when treatment may be withdrawn from a patient was definitively stated by the House of Lords in Airedale NHS Trust v. Bland [1993] AC 789. The case of this young man, who was rendered PVS as a result of the 1989 Hillsborough disaster and who had been maintained in PVS with food via a tube, resulted in the House of Lords holding that the cessation of treatment, where that treatment is no longer beneficial to the patient and will not produce any positive result, is a lawful omission from responsibility rather than an unlawful act. His Lordship Goff, in that case, elaborated on the distinction between an act and omission by observing that administering a lethal drug would be an act of assisting another person to die by suicide (i.e., crossing the Rubicon), whereas withdrawing from the provision of futile treatment would be a lawful omission; therefore, the act of withdrawing treatment in that case would not constitute assistance to die by suicide in itself.[15]
The common law structure originally encompassed by the Mental Capacity Act 2005 was put into a statutory form in common legislation. Section 4 ("Code of Best Interests") provides that healthcare professionals must follow the "best interests" standard when making decisions for patients who lack capacity. Section 26 provides for Advance Decisions to Refuse Treatment (ADRT) to be considered legally binding. If an ADRT is valid and applicable, it is mandatory for medical practitioners to comply with it[16]. In An NHS Trust v Y [2018] UKSC 46, the UK Supreme Court ruled that there is no requirement for the court to approve the withdrawal of Treatment in the absence of the Family and Clinicians being in agreement and acting in accordance with professional guidelines.[17]
Killing Yourself: A Historic Day. On October 16, 2024, Kim Leadbeater MP introduced the Terminally Ill Adults (End of Life) Bill into the House of Commons; after passing its Second Reading on June 20, 2025, through a vote of 314 in favour to 291 [18]against, the Bill will allow terminally ill adults (18+) to request help from medical professionals to kill themselves, provided they are diagnosed as terminally ill and suffer from no other cognitive impairment. [19]To ensure safety of patients under this law:
1. Two independent doctors must approve the request
2. At least 21 days must pass from the time the request is made to when suicide assistance is given.
3. A senior judge, psychiatrist and social worker must unanimously approve the request as part of a multi-disciplinary committee.[20]
If enacted, this Bill would amend the Suicide Act of 1961 by creating a defence against prosecution for providers of this service, provided that sufficient evidence exists showing that the provider acted in accordance with the provisions of the Bill. At the time of writing, this Bill has received no further progress through the House of Lords due to more than 1000 proposed amendments to the Bill. A similar assisted suicide bill proposed in Scotland was defeated in its third reading on March 31, 2026, by a vote of 69 to 57.[21]
Comparative Analysis
Both India and the United Kingdom share foundational legal commitments: the act/omission distinction, the "best interests" standard for incapacitated patients, recognition of advance directives, and the absolute prohibition on active euthanasia. Both frameworks are also the product of judicial rather than legislative initiative a shared institutional vulnerability.
The divergences, however, are significant. India's framework is entirely judge-made; the UK is moving toward comprehensive statute. More fundamentally, the UK's proposed Bill ventures into territory India has not approached: physician-assisted suicide for terminally ill adults who retain mental capacity — a regulated, voluntary form of death assistance that is qualitatively distinct from India's passive euthanasia model. Procedurally, India relies on a dual-tier medical board; the UK proposes a novel tripartite panel with judicial, psychiatric, and social work oversight.
Both systems also share unresolved ethical tensions: the risk of coercion or abuse of vulnerable persons; the impact of assisted dying frameworks on palliative care investment; and the fundamental question of who speaks for the incapacitated patient and on what terms.[22]
Conclusion
The Harish Rana judgment and Terminally Ill Adults (End of Life) Bill mark a new chapter in global end-of-life law. While India has made significant strides in law regarding end-of-life decisions, it does not yet have the statutory framework to match its progress. The UK has taken steps further towards allowing autonomy at the end of life than do Indian laws; however, both jurisdictions hold similar fundamental principles regarding legal protection for a person's death. The ultimate challenge for both legislatures and judges is providing that protection fairly, clearly and fairly to people who are most vulnerable to abuse and not able to advocate for themselves.
References
[1] FP Explainers, “Harish Rana dies after spending 13 years in coma: What are India’s euthanasia laws?”, March 25, 2026, https://www.firstpost.com/explainers/harish-rana-13-years-coma-india-euthanasia-laws-active-passive-assisted-dying-13993045.html
[2] Harish Rana v. Union of India, Miscellaneous Application No. 2238 of 2025, Supreme Court of India, 2026 INSC 222, decided on March 11, 2026 (J.B. Pardiwala and K.V. Viswanathan JJ.).
[3] Cherylann Mollan, “Indian man whose life support was removed after court go-ahead dies”,25/03/2026, https://www.bbc.com/news/articles/cvgkp52njj7o
[4] Sanskriti IAS, "Supreme Court Allows Passive Euthanasia in Harish Rana Case", March 2026, https://www.sanskritiias.com/current-affairs/supreme-court-allows-passive-euthanasia-in-harish-rana-case
[5] Gian Kaur v. State of Punjab, (1996) 2 SCC 648.
[6] Aruna Ramachandra Shanbaug v. Union of India, (2011) 4 SCC 454 (Justices Markandey Katju and Gyan Sudha Misra JJ.); the Court permitted passive euthanasia in exceptional circumstances under High Court supervision but declined to grant it on the facts, finding that Shanbaug was not brain-dead.
[7] Law Commission of India, 196th Report on Medical Treatment to Terminally Ill Patients (2006); 241st Report on Passive Euthanasia – A Relook (2012).
[8] Common Cause (A Regd. Society) v. Union of India, (2018) 5 SCC 1 (Dipak Misra CJI, A.K. Sikri, A.M. Khanwilkar, D.Y. Chandrachud and Ashok Bhushan JJ.).
[9] ibid; the Court validated Living Wills and established a two-tier medical board framework comprising (i) a Primary Board constituted by the treating hospital and (ii) a Secondary Board drawn from a panel maintained by the District Medical Officer.
[10] Common Cause (Modified Guidelines), Supreme Court of India, 2023; the Court reduced the required years of experience for board members from twenty to five years and streamlined the role of the Judicial Magistrate First Class.
[11] Harish Rana v. Union of India, 2026 INSC 222 (n 2); see also VisionIAS, "Passive Euthanasia in India: What the Harish Rana Case Means for End-of-Life Care", https://www.visionias.in/blog/current-affairs/passive-euthanasia-in-india-what-the-harish-rana-case-means-for-end-of-life-care
[12] Raghav Sengupta, "Dignity at the End: Analysing the Indian Supreme Court's First Judicially Sanctioned Passive Euthanasia Order", VerfBlog, March 28, 2026, https://verfassungsblog.de/harish-rana-v-union-of-india/
[13] Bharatiya Nyaya Sanhita 2023, ss 99–105 (culpable homicide and murder). The Harish Rana bench explicitly reaffirmed the impermissibility of active euthanasia under Article 21.
[14] Suicide Act 1961 (England and Wales), s 2(1); maximum sentence of fourteen years' imprisonment.
[15] Airedale NHS Trust v. Bland [1993] AC 789 (HL), per Lord Goff at p. 865: "Euthanasia is not lawful at common law."
[16] Mental Capacity Act 2005 (UK), s 4 (best interests test), s 26 (advance decisions to refuse treatment). An Advance Decision to Refuse Treatment, if valid and applicable, is legally binding on medical practitioners.
[17] An NHS Trust v. Y [2018] UKSC 46.
[18] Terminally Ill Adults (End of Life) Bill 2024–25, introduced October 16, 2024; Third Reading passed June 20, 2025 (314–291). Wikipedia, "Terminally Ill Adults (End of Life) Bill", https://en.wikipedia.org/wiki/Terminally_Ill_Adults_(End_of_Life)_Bill
[19] House of Commons Library, Research Briefing CBP-10123 (updated January 2026), /blog/our-blog-1/euthanasia-in-india-vs-the-uk-law-ethics-and-the-right-to-die-with-dignity-13#cite
[20] Dignity in Dying, "Assisted Dying Bill — safeguards", https://www.dignityindying.org.uk/assisted-dying/assisted-dying-bill/; the panel must be unanimous and must directly question the applicant before issuing a certificate of eligibility.
[21] Wikipedia, "Assisted Suicide in the United Kingdom", https://en.wikipedia.org/wiki/Assisted_suicide_in_the_United_Kingdom (Scotland Stage 3 vote, March 17, 2026: 57 in favour, 69 against).
[22] Aprajita Ray, "Harish Rana v. Union of India (2026 INSC 222): A Landmark Judgment on Passive Euthanasia in India", Indian Journal of Law and Legal Research, April 2026, https://www.ijllr.com