New Delhi: The Supreme Court on Tuesday (November 3) reserved its verdict on a petition challenging the procedure by which patients are declared brain dead in India, after a three-judge bench concluded hearings in a case that could reshape the safeguards around brain-stem death certification and organ donation.

Source: PTI via Health and Family

The bench of Justices Vikram Nath, Sandeep Mehta and Aparesh Kumar Singh was hearing a petition filed by Dr S. Ganapathy, who challenged a June 2017 order of the Kerala High Court concerning alleged irregularities in brain-death certification. The petition questions whether the clinical parameters prescribed under the law are always followed before a patient is certified as brain-stem dead.

Source: MedGate Today

The petitioner has alleged that, in some critical-care settings, patients may have been declared brain dead without adequately meeting the prescribed clinical parameters, and that such declarations could in some cases be influenced by the aim of facilitating organ retrieval for transplantation. These are allegations made before the court; they have not been established as findings of malpractice against any hospital or doctor.

Source: MedGate Today

AIIMS panel and the new 2026 guidelines were placed before the court

The court had earlier taken the concerns seriously enough to act: on April 28, 2026, it directed the All India Institute of Medical Sciences (AIIMS), New Delhi, to constitute a multidisciplinary expert committee to examine the existing certification procedures and recommend appropriate protocols in light of advances in medical science.

Source: PTI via Health and Family

During the concluding arguments, Additional Solicitor General Aishwarya Bhati, appearing for the Union government, placed on record the National Guidelines on Brain-Stem Death Certification (2026), notified by the National Organ and Tissue Transplant Organization (NOTTO) on July 31, 2026, along with the report of the AIIMS expert committee. The Centre's case is that the new guidelines and the committee's recommendations together provide comprehensive medical and administrative safeguards.

Source: PTI via Health and Family

For his part, the petitioner questioned the adequacy of the existing bedside clinical assessments and suggested that additional investigations — including cerebral angiography, which evaluates blood flow in the brain, and electroencephalography (EEG), which measures its electrical activity — should be used to strengthen the reliability of a brain-death determination.

Source: MedGate Today

Under the existing framework, brain-stem death certification is governed by the Transplantation of Human Organs and Tissues Act, 1994. Certification is not a single doctor's call: it requires a designated board of medical experts and prescribed clinical assessments to establish the irreversible loss of brain-stem functions, the point at which a person is legally dead even though a ventilator may keep the heart beating.

Source: MedGate Today

The court has reserved its decision and has not ordered any new certification requirement at this stage. When the judgment is delivered, it could set the safeguards hospitals and medical boards must follow across the country — a matter of direct consequence for patient rights, for families asked to accept a brain-death declaration, and for public confidence in India's organ-transplantation system, which depends on deceased donation being both timely and trustworthy.

Source: MedGate Today