The court was hearing a petition by a Kerala-based neurosurgeon, who argued that “brain death” is a misnomer devised to serve the interests of the organ transplantation industry. He alleged that patients with potentially treatable brain injuries were sometimes neglected, only to be later declared brain dead.
Published Sep 09, 2025 | 6:44 PM ⚊ Updated Sep 09, 2025 | 6:44 PM
“Brain-stem death” is the permanent and irreversible cessation of all functions of the brain-stem.
Synopsis: The Supreme Court has declined to interfere with the statutory definition of brain-stem death under the Transplantation of Human Organs and Tissues Act, 1994, while hearing a petition that alleged premature certification of poor patients as brain dead to facilitate organ harvesting. The court observed that the issue was a matter for legislative and medical consideration, stressing that wrongful certification could amount to negligence but did not render the law unconstitutional.
The Supreme Court of India has declined to interfere with the legal definition of ‘brain-stem death’ while hearing a petition by Kerala-based neurosurgeon Dr S Ganapathy, who alleged that hospitals prematurely declare poor patients brain dead to harvest organs.
A bench of Justices Surya Kant and Joymalya Bagchi presided over the matter on Monday, 8 September. The judges acknowledged the seriousness of the concerns raised but stressed that the definition of death under the Transplantation of Human Organs and Tissues Act, 1994, was a legislative decision.
Section 2(d) of the Act defines brain-stem death as the permanent and irreversible cessation of all functions of the brain stem.
“The legislature says irreversible cessation of brain activity is the point at which there is an irreversible cessation of human life. We do not see the Transplantation Act as an unlawful intrusion into Article 21,” Justice Bagchi remarked.
The judges emphasised that the concept of death has various medico-legal interpretations, including cardiac and cellular death, and that Parliament’s recognition of brain-stem death falls within this framework.
Dr Ganapathy, who appeared in person, contended that “brain death” is a misnomer designed to serve the interests of the organ transplantation industry. He alleged that patients with potentially treatable brain injuries were sometimes neglected, only to be later declared brain dead.
According to him, this malpractice disproportionately affects the poor, whose families are pressured to consent to organ donation in exchange for waived hospital expenses.
The petitioner also asserted that organ harvesting was often carried out without due compatibility checks, resulting in high rates of transplant failure.
He submitted that although “brain-dead” patients retain functions such as heartbeat, blood circulation, and wound healing, they are still classified as dead under the Act.
“The brain-dead person is not really dead,” his petition stated.
In response, the bench highlighted that the law already requires certification of brain-stem death by a panel that includes an independent medical expert.
Justice Kant noted that individual cases of negligence or malpractice could be challenged as medical misconduct but that this did not make the statute unconstitutional.
“Wrong certification may occur, but that is to be addressed case by case,” he said.
The judges also advised the petitioner to approach institutions such as the National Medical Commission or All India Institute of Medical Sciences, Delhi, for a scientific review of the issue.
Justice Surya Kant observed that the question of brain-stem death was essentially a matter for medical experts and lawmakers, advising the petitioner to place his concerns before the NMC or another expert body, since “any change would ultimately require legislative intervention.”
Despite the court’s reservations, Dr Ganapathy insisted that the judiciary had a constitutional duty to intervene. He cited Chief Justice of India BR Gavai’s recent remarks that “it is the Constitution, not Parliament, that is supreme,” emphasising that courts must act when legislative definitions conflict with fundamental rights.
While reiterating that Parliament alone can redefine death, the bench acknowledged that the issue raised broader ethical and social concerns. Justice Kant remarked that the controversy was “more ethical than legal,” while Justice Bagchi noted that in genuine cases, organ transplantation from brain-dead patients “perpetuates life.”
The petitioner, however, pressed that misuse of the law was rampant, claiming that nearly 1,500 youngsters had been prematurely declared brain dead in hospitals.
He alleged that in some cases, patients with treatable conditions were left unattended until they were certified brain dead, after which families were pushed to agree to organ donation.
The bench responded that such grievances, if substantiated, could amount to medical negligence but did not undermine the constitutionality of the law itself.
Justice Kant underlined that individual instances of wrongdoing “depend on the facts of each case,” and should not be used to challenge the statutory framework as a whole.
The bench finally decided to defer the matter, agreeing to tag it with another pending case concerning the medical and legal contours of brain-stem death.
(Edited by Dese Gowda)
