A life prolonged, a voice unheard: why India must talk about Living Wills

Some stories do not end when life changes. They stretch on, quietly, painfully, long after hope has faded. The case of Harish Rana is one such story. It is not just about a young man who never recovered from a devastating brain injury — it is about everything that followed: the silence, the uncertainty, and the years of waiting without direction.

A young life, suspended

Harish Rana was once a young student with a future ahead of him. After a tragic accident, he was left in a state where he could neither respond nor recover. His body survived, but the life he knew was gone. For years he remained dependent on medical support, unable to communicate his wishes, unable to decide for himself. And that is where the real burden began — not for him alone, but for his family.

The burden no one talks about

In India, families do not give up easily. They hold on — often beyond reason — driven by love, duty, and the fear of regret. But what happens when holding on turns into years of emotional and financial strain, when every day becomes a question with no answer?

Caregiver burden is often spoken about in clinical terms, but in reality it is deeply human. It is the exhaustion of watching a loved one remain unchanged and unresponsive. It is the quiet breaking down of hope. Alongside it sits a harsh reality many hesitate to name: long-term medical care is expensive. Hospital visits, procedures, medications and supportive care accumulate, and families that begin with stability can slowly find themselves facing financial collapse.

There is no one to blame — only something missing

Doctors continue treatment because they are trained to preserve life. Families continue care because love does not come with an off-switch. The system moves forward because there are no clear conversations guiding when, and whether, to stop. What is missing is not effort — it is awareness.

In Harish Rana's case there was no Living Will, no written record of what he would have wanted if he could no longer communicate. Without it, the entire responsibility shifted to the family — and that responsibility is not just heavy, it is overwhelming.

What a Living Will changes

A Living Will is a simple but powerful idea. It allows a person to state, in advance, what treatment they would accept and what they would refuse if they could no longer speak for themselves. It does not take away hope — it brings clarity and dignity.

Eventually, in this case, a decision was made to withdraw life-sustaining treatment. It was not sudden; it came after years of uncertainty, and after the realisation that continuing support was not restoring life but only extending a state with no possibility of recovery. This is where many misunderstand: choosing to stop certain treatments is not giving up. It is an acceptance that medicine has limits, and that dignity matters as much as survival.

Breaking the silence

In India, conversations about death are often avoided as uncomfortable or unnecessary. But avoiding the conversation does not protect anyone — it simply shifts the burden to a moment of crisis, when decisions are hardest. Talking about Living Wills should become as normal as planning for any other stage of life.

Equally important is palliative care — still underused and misunderstood. It is not about stopping treatment; it is about comfort, quality of life, and supporting both patient and family. Introduced early, it can reduce unnecessary interventions and ease distress.

Harish Rana's story is not isolated. In 1972, a young Mumbai nurse, Aruna Shanbaug, was brutally assaulted and remained in a vegetative state for more than four decades — at a time when neither our medical nor legal systems offered any guidance. Across the country, countless families face similar situations, quietly and without direction. The difference is that most of these stories are never spoken about.

In the end, this is not only about how long we live. Living with dignity is important — but leaving with dignity is far more important. A Living Will does not take dignity away; it protects it. It ensures a person's voice is heard even in silence, eases the burden on families, and brings clarity to doctors — so that decisions are made with intention, not desperation.