Brain death

Brain death means the complete and irreversible loss of all brain function, including the brainstem. A person who is brain-dead has no consciousness, no reflexes, and cannot breathe on their own — the heart may still beat because a ventilator is delivering oxygen, but the person is no longer alive by medical and legal definitions. Brain death is different from coma or a vegetative state; recovery is not possible.

How it happens

Brain death usually follows catastrophic brain injury from:

• Severe head injury (road traffic accidents, falls)
• Massive stroke or brain haemorrhage
• Cardiac arrest leading to prolonged lack of oxygen to the brain
• Severe brain infection
• Brain tumour

How it's diagnosed

Brain death is diagnosed only when specific strict criteria are met, by qualified doctors:

• The cause of brain injury is known and irreversible
• Other reversible causes (drugs, hypothermia, low blood pressure, metabolic problems) are excluded
• No response to stimuli, no brainstem reflexes
• No ability to breathe (apnoea test)
• Confirmed by a panel of doctors, usually at two separate examinations

Organ donation

In India, brain death is recognised under the Transplantation of Human Organs Act. Because the heart continues to pump while on ventilator support, organs from a brain-dead person can be donated — transforming devastating loss into the saving of several other lives. The family is always offered the choice; donation is only taken forward with consent. Speaking with family about wishes regarding organ donation, before a crisis, makes decisions easier during the worst moments.

For families facing this situation, hospital grief counsellors and transplant coordinators provide support.