The Supreme Court directed the head of the department of neurology at AIIMS, New Delhi, to constitute a team of three experts in the field of neurology or neurosurgery to examine whether cerebral angiogram and EEG provide a more reliable way to determine brain death. (File Photo)In a significant order, the Supreme Court has directed the All India Institute of Medical Sciences (AIIMS) to set up a panel of three neurology or neurosurgery experts to examine whether methods like cerebral angiogram and electroencephalogram (EEG), as suggested by Kerala-based doctor and activist S Ganapathy, are better modes to determine if a person is brain dead than the currently used apnea test.A bench of Justices Vikram Nath and Sandeep Metha, which concluded that concerns expressed by the medical profession “prima facie, do carry a ring of truth,” said that given the “complexities” of the issue, which calls for “specialised medical expertise”, it would be appropriate to have the expert view of AIIMS to examine it and suggest protocols.“Having regard to the complexities of the important issues raised requiring specialised medical expertise, and considering that this court does not profess the requisite technical expertise in the field, it would be appropriate, in the interest of justice, to direct the constitution of an expert committee at the All India Institute of Medical Sciences, New Delhi to examine the matter and suggest appropriate protocols, keeping in view the advancements in medical science,” the bench said in its April 28 order.“Such an exercise would enable the formulation of a robust and reliable regime, thereby dispelling and allaying the concerns expressed by the petitioner, which, at least prima facie, do carry a ring of truth,” the bench added.“Accordingly, the Head of the Department of Neurology, AIIMS, New Delhi, is directed to constitute a team of three experts in the field of Neurology/Neurosurgery,” the bench said, adding that the panel “shall convene meetings as necessary and submit their considered recommendations to this Court…”.It directed that the “report of the expert committee shall be placed before this court for consideration within a period of two months from today… in a sealed envelope.”Also Read | ‘Parents will choose, not AIIMS’: Supreme Court refuses to hear plea against terminating 15-year-old’s pregnancyOrgan transplantation malpractice: What the PIL statedThe septuagenarian doctor had earlier approached the Kerala High Court with a PIL, stating he has credible information indicating serious malpractices prevailing in the state in relation to organ transplantation procedures. He contended that patients admitted to various hospitals in critical condition are declared “brain-dead” even in cases where the clinical parameters prescribed under the law do not justify such a determination, and that such declarations are, at times, made with the underlying intention of facilitating the harvesting of organs for transplantation.Story continues below this adEven though it expressed concern over alleged malpractices involving patients, the high court closed the proceedings on June 28, 2017, taking on record the assurance of the state government that had directed that in cases of brain death, the apnea test would be done without exception, and the whole procedure videographed.Challenging this before the Supreme Court, Ganapathy said that, in terms of internationally accepted medical standards, including the guidelines of the World Health Organization, the apnea test ought to be resorted to only as a confirmatory test and not as the sole or primary basis for determining brain-stem death. He was of the view that ancillary tests such as EEG, cerebral angiography (including four-vessel angiogram), or other imaging modalities are required to be conducted prior thereto.Ganapathy also contended that the apnea test requires stopping or reducing the cerebral blood flow, which by itself may induce brain death and urged that the best possible procedure to conclusively assess the parameters of brain-stem death would be to subject the patient to appropriate ancillary or supplemental tests, such as EEG, four-vessel cerebral angiography, radionuclide (radioisotope) angiography, or CT angiography.Ananthakrishnan G. is a Senior Assistant Editor with The Indian Express. He has been in the field for over 23 years, kicking off his journalism career as a freelancer in the late nineties with bylines in The Hindu. A graduate in law, he practised in the District judiciary in Kerala for about two years before switching to journalism. His first permanent assignment was with The Press Trust of India in Delhi where he was assigned to cover the lower courts and various commissions of inquiry. He reported from the Delhi High Court and the Supreme Court of India during his first stint with The Indian Express in 2005-2006. Currently, in his second stint with The Indian Express, he reports from the Supreme Court and writes on topics related to law and the administration of justice. Legal reporting is his forte though he has extensive experience in political and community reporting too, having spent a decade as Kerala state correspondent, The Times of India and The Telegraph. He is a stickler for facts and has several impactful stories to his credit. ... Read More © The Indian Express Pvt Ltd