Few Indian doctors trained in brain death certification, Aiims study finds

According to the findings, 37.3% of respondents said there was no fixed curriculum for resident training in BDC, and only 10% reported regularly training their residents

Less than half of India’s neurosurgeons, neurologists and critical care specialists have received training on certifying brain death during their MBBS course, a study led by doctors from Aiims, Delhi has found.

 

The study, conducted among 177 specialists, revealed significant gaps in medical education and practice related to Brainstem Death Certification (BDC), a crucial step in the organ donation process.

 

According to the findings, 37.3 per cent of respondents said there was no fixed curriculum for resident training in BDC, and only 10 per cent reported regularly training their residents. Over one-fifth (22.6 per cent) said they never train their residents in brain death certification or organ donation.

 

 

“It is crucial to address gaps in the knowledge and practices of BDC among physicians to enhance organ donation rates in India,” the study stated.

 

BDC is a key procedure that determines brain death, the legal and ethical basis for retrieving organs from deceased donors. Despite its importance, the study noted that awareness and standardised training remain limited.

 

Nearly three-fourths of the participating doctors worked in teaching hospitals, with 51.4 per cent in the public sector and 24.9 per cent in the private sector.

 

The respondents identified a lack of public awareness as the leading reason for India’s low organ donation rate. Family refusal was cited by 62.1 per cent of participants, followed by the absence of transplant facilities in their hospitals (43.5 per cent), indifferent attitudes toward BDC (43.5 per cent), and a lack of confidence among doctors in declaring brain death (36.7 per cent). Religious beliefs were also cited by 50.2 per cent as a reason for refusal to donate organs.

 

India’s organ donation rate remains among the lowest in the world, just 0.7 per million population (pmp), compared with 40-50 pmp in countries such as Spain and the United States, the study noted.

 

“The low rates of organ donation in India can be attributed to multiple factors, including lack of awareness or misinformation among the public and lack of comprehensive knowledge about organ donation among treating physicians,” the authors said.

 

They added that a consistent understanding and application of brain death criteria are essential to ensure potential donors are identified and managed properly.

 

The study also pointed out that while the Transplantation of Human Organs Act (THOA), enacted in 1994, provides a legal framework for organ donation and transplantation, its implementation has been hampered by limited training and awareness among medical professionals.

 

The survey aimed to identify knowledge gaps and inconsistencies in BDC practices among doctors involved in organ donation in India, underscoring the need for policy measures to improve training and awareness.

 

The research was conducted by experts from the Department of Neurosurgery at AIIMS, Delhi; the University of Messina in Italy; Christian Medical College, Vellore; Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram; and Madras Medical Mission Hospital, Chennai.