The Supreme Court of India recently directed the AIIMS neurology department to form an expert committee. This committee will evaluate the current **brain death certification protocol**. This decision follows a petition alleging malpractices and questioning the diagnostic reliability of existing methods. Specifically, the court wants to know if India needs additional tests like EEG and angiograms.

Legal Framework and the THOTA Act

The Transplantation of Human Organs and Tissues Act (THOTA), 1994, strictly governs the certification process. Form 10 of the THOTA rules provides the specific documentation framework for doctors. A panel of four independent medical experts must confirm brain stem death. This panel includes a hospital administrator, a neurologist or neurosurgeon, and the treating physician. Furthermore, they must repeat the tests twice with a minimum interval of six hours. Consequently, these layers of verification aim to prevent errors in diagnosis.

Reliability of the Brain Death Certification Protocol

The petition, filed by activist S Ganapathy, challenges the **brain death certification protocol**'s reliance on the apnea test. He argues that the apnea test is subjective and lacks objective proof. Moreover, he claims that hospitals often skip the mandatory videography of the procedure. In contrast, many medical experts believe the apnea test remains the global gold standard for diagnosing brain death. However, the court believes that the medical profession's concerns carry a \"ring of truth.\" Therefore, the AIIMS committee will examine if hospitals follow the rules properly.

Scientific Validity of Auxiliary Tests

The Supreme Court is also exploring the safety and viability of using EEG and cerebral angiograms. These tests can objectively show the absence of brain electrical activity and blood flow. Additionally, some experts suggest that these methods might be more reliable than clinical tests alone. Nevertheless, other specialists argue that routine use of these tests would increase the healthcare system's burden. They note that the existing protocol already includes adequate checks and balances. The expert committee will provide its report in a sealed cover by July.

Frequently Asked Questions

Q1: What is the primary test used in the brain death certification protocol in India?

The apnea test is the primary clinical method used to confirm brain stem death under the THOTA guidelines.

Q2: How many doctors are required to certify brain death?

A board of four independent medical experts, including a neurologist or neurosurgeon, must certify brain death twice.

Q3: Why is the Supreme Court reviewing these protocols?

The court is responding to allegations of malpractices and questioning the reliability of the apnea test compared to more objective methods like EEG.

Disclaimer: This content is for informational and educational purposes only. It does not constitute medical advice or replace professional judgment. Refer to the latest local and national guidelines for clinical practice.

References

1. SC seeks AIIMS review of brain death protocol - ETHealthworld


2. Vajiram & Ravi - Why Brain Death Certification Is Under Supreme Court Review (May 2026)


3. Medical Dialogues - Supreme Court orders AIIMS panel to review brain death certification methods (May 2026)