BRAIN DEATH CERTIFICATION

NEWS: The Supreme Court is hearing a plea alleging malpractices in brain death certification to facilitate ‘organ harvesting’.

Brain Death

• Permanent cessation of all brain activity, including brain stem.
• Loss of vital functions: breathing, consciousness, reflexes.
• Patient survives only on ventilator support.
• Legally recognised as death under Indian law.
• Key source for deceased organ donation (heart, liver, lungs, etc.).

Certification Process (India)

• Guided by National Organ and Tissue Transplant Organisation (NOTTO).
• Certified by a 4-member medical board: Neurologist/neurosurgeon, Treating doctors

Clinical Tests:

• Absence of brainstem reflexes
• No breathing (Apnea test)
• Repeat testing after 6–12 hours.
• Must rule out reversible causes (drugs, hypothermia, metabolic issues).

Issues Highlighted

• Alleged malpractices in declaring brain death for organ harvesting.
• Subjectivity in apnea test → lack of uniform standards.
• Protocol violations (e.g., lack of videography).
• Low training levels → less than 50% doctors adequately trained.
• Public trust deficit in organ donation system.

SC Concerns & Suggestions

Need for objective diagnostic tools:

• EEG, cerebral angiography
• Strengthening transparency & standardisation.
• Ensuring strict compliance with protocols.

Significance

• Balances medical ethics vs organ donation needs.
• Impacts public trust in healthcare system.
• Important for improving organ donation rates in India.
• Raises questions on regulation, accountability, and training.