Supreme Court Orders AIIMS Committee To Review Brain Death Tests Amid Concerns Over Apnea Method
Supreme Court directs AIIMS to form expert panel to review scientific methods for determining brain death
The Supreme Court on Tuesday directed the constitution of an expert medical committee by All India Institute of Medical Sciences (AIIMS) to examine and report on scientific methods for determining “brain death,” amid concerns raised over the reliability and transparency of existing procedures.
The bench of Justices Vikram Nath and Sandeep Mehta passed the order while hearing a petition filed by Kerala-based doctor, appearing in person Dr. S. Ganapathy, who questioned the current protocol followed by hospitals in certifying brain death.
The petitioner alleged serious lapses in practice, claiming that patients are often declared brain dead without proper physical examination and primarily on the basis of the apnea test, which he argued is “subjective and not foolproof.” He also contended that in some cases, certification is issued mechanically, with forms signed by doctors without even examining the patient. Dr. Ganapathy referred to an instance where a patient was allegedly declared brain dead without examination, and the hospital offered to waive treatment costs if the family consented to organ donation. He argued that such practices raise serious ethical and legal concerns, especially in the context of organ transplantation.
Questioning the adequacy of the current framework, the Bench observed that while procedures exist under the law, non-compliance is a separate and serious issue. Justice Mehta remarked that the petitioner’s grievance goes to the root of the process itself, particularly the lack of verifiable and objective data supporting brain death certification.
Dr. Ganapathy proposed alternative methods such as brain angiogram and EEG (electroencephalogram), asserting that these tests provide more reliable and scientific indicators of brain function. He submitted that in cases of true brain death, there is no blood flow to the brain, which can be objectively verified through such techniques.
On the other hand, the counsel for the Union government referred to the statutory framework under the Transplantation of Human Organs Act and relevant rules, which mandate the constitution of medical boards for certifying brain death. It was argued that the law already prescribes safeguards, including procedural requirements such as certification by a panel of doctors.
However, the Court pointed out that the petitioner’s concern was not about the existence of procedures, but about the scientific robustness and transparency of the methods used. It questioned whether the current reliance on the apnea test alone provides a sufficiently reliable basis for such a critical determination.
Taking note of the issues raised, the Bench directed that an expert committee comprising 3–5 specialists be constituted by AIIMS, particularly from the neurology department, to examine the safety, feasibility, and scientific validity of the alternative tests suggested by the petitioner. It asked Dr. Ganapathy to submit his suggestions in writing and directed that the committee’s report be placed before it in a sealed cover. The matter has been listed for further hearing in July.
What is the apnea method?
The apnea method, primarily known as apnea testing or apnea-based treatment, refers to two distinct contexts: diagnosing brain death by testing for spontaneous breathing, or the management of sleep apnea.
Notably, in September 2025, the bench of Justice Surya Kant and Justice Joymalya Bagchi had noted that the question essentially pertained to medical science and public health policy. “You have experience and understand the subject well. Why don’t you make a representation to the NMC (National Medical Commission) or another expert body? We can request them to examine it,” the Bench suggested to the petitioner, cautioning that while the grievance may be genuine, the Court’s powers in the matter were limited.
Justice Surya Kant had remarked, “We may agree with you, but our powers are limited. We cannot direct Parliament. Ultimately, this may require legislative intervention.”
Dr. Ganapathy, however had pressed that the judiciary could not abdicate its responsibility to examine whether the current legal position is constitutional. He had cited remarks recently made by the Chief Justice of India at an event in Amravati, where the CJI reportedly said that “it is the Constitution, not Parliament, that is supreme,” and that courts must intervene to uphold constitutional guarantees.
“This case on brain death highlights that the term itself is a misnomer, used only to harvest organs from those who are not truly dead,” he submitted. He recounted instances where patients with treatable brain clots were kept untreated, only to be declared brain dead after a few days, with families then being pressured to either take the body or agree to organ donation. “This has happened to 1,500 youngsters,” he had alleged.
Case Title: Dr. S Ganapathy v. Union of India
Bench: Justices Vikram Nath and Sandeep Mehta
Hearing Date: April 28, 2025