CURRENT AFFAIRS | SCIENCE & LAW | 29 APRIL 2026
CLAT GK + MEDICAL LAW | THOTA 1994 | Aruna Shanbaug | Common Cause
The Supreme Court of India on 28 April 2026 directed the All India Institute of Medical Sciences (AIIMS), New Delhi to constitute a 3-5 member expert specialist committee to scientifically examine the reliability of brain-death certification protocols currently followed under the Transplantation of Human Organs and Tissues Act, 1994 and the 2014 Rules. A bench of Justices Vikram Nath and Sandeep Mehta was hearing a petition by Kerala-based doctor Dr S Ganapathy, who alleged that the apnea test — currently the linchpin of brain-stem-death certification — is “subjective and not foolproof” and that hospitals sometimes pressure families into organ donation without rigorous examination. The petitioner urged that cerebral angiography and electroencephalography (EEG) — already used in the US and Europe — be mandated as ancillary objective tests. The matter has been listed for further hearing in July 2026.
Background
India’s organ-donation law evolved against the backdrop of organ-trafficking scandals in the 1980s. The Transplantation of Human Organs Act, 1994 (renamed THOTA in 2011) recognised brain-stem death — a legal innovation that permitted retrieval of beating-heart organs (heart, liver, lungs) for transplant. Rule 7 of the 2014 Rules prescribes a 4-member certifying board and two test rounds 6 hours apart. The petitioner pointed to global concern: in 2020-2024 several US and UK studies questioned the apnea test’s safety (risk of cardiac arrest from sudden CO2 rise) and its reliability (subjective observation). The Indian Court has now broadened this medical question into a constitutional one, given that erroneous brain-death certification implicates Article 21 (right to life), the right to die with dignity (Common Cause, 2018) and statutory due process under THOTA.
Key Facts at a Glance
- Petitioner: Dr S Ganapathy (Kerala-based doctor).
- Bench: Justices Vikram Nath and Sandeep Mehta.
- Order: AIIMS to constitute 3-5 specialist committee (neurology) to study alternatives.
- Tests under challenge: Apnea test (current); EEG + brain angiogram (proposed alternatives).
- Statutory anchor: THOTA 1994 (amended 2011) + 2014 Rules.
- Certifying board: 4 doctors (Rule 7) + two tests 6 hours apart.
- Apex body: NOTTO (under MoHFW) + ROTTOs + SOTTOs.
- Next hearing: July 2026.
Constitutional / Legal Framework
- Transplantation of Human Organs and Tissues Act, 1994 (amended 2011) — defines brain-stem death (§2(d)), regulates organ-donation, sets criminal penalties for trafficking; renamed in 2011 to include tissues.
- THOT Rules, 2014 — Rule 7 prescribes the 4-doctor board; Rule 4 lays down the certificate format (Form 10).
- Article 21 — Right to life with dignity; judicially expanded to include right to die with dignity (Common Cause, 2018).
- Aruna Ramchandra Shanbaug v UoI (2011) — first recognition of passive euthanasia in India under court-supervised guidelines.
- Common Cause (A Regd Society) v UoI (2018) — 5-judge bench; permitted advance directives (‘living will’); right to die with dignity is part of Article 21.
- Gian Kaur v State of Punjab (1996) — held earlier that Art 21 does NOT include right to die; partially recalibrated by Common Cause (2018) for passive euthanasia.
- P Rathinam v UoI (1994) — struck down §309 IPC (attempt to suicide) as violative of Art 21; later overruled in Gian Kaur.
- Mental Healthcare Act, 2017 §115 — decriminalised attempt to suicide presumptively (mental illness presumption).
- Article 142 — Common Cause issued procedural directions under Article 142 to fill the legislative vacuum until Parliament legislates.
CLAT Relevance
- Legal Reasoning passage: Article 21 + dignity + medical-due-process triad; apply to a hypothetical where brain-death is wrongly certified, leading to organ retrieval — engages THOTA + tort + Art 21.
- Trap: Common Cause (2018) permits ONLY passive euthanasia (withdrawal of treatment) — NOT active euthanasia (lethal injection, still criminal under §304 BNS / §302 IPC).
- Trap 2: THOTA defines ‘brain-stem death’ (not ‘whole-brain death’ as in some US statutes). Indian standard is brain-stem-only.
- GK fact: NOTTO (apex) → ROTTO (regional, 5 zones) → SOTTO (state-level) — three-tier organ-donation infrastructure under MoHFW.
- Mnemonic for euthanasia evolution: P-G-A-C — P. Rathinam (1994) → Gian Kaur (1996) → Aruna Shanbaug (2011) → Common Cause (2018).
- Application: If a petitioner alleges that AIIMS protocol violates Art 21 because it has weak objective tests, can the court issue a continuing mandamus? — yes, akin to Vishaka and Godavarman lines.
Test Yourself
10 MCQs on THOTA 1994, brain-death law, Aruna Shanbaug and Common Cause — frequently tested in CLAT legal reasoning:
[cg_concept_quiz id=”sc-brain-death-thota-2026″ data=”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”]
