Kerala has become the first Indian state to adopt a Standard Operating Procedure (SOP) for brain death certification in government and private hospitals. The Kerala government has brought out SOP as per the high court directive and to mitigate public fear about the process involved in declaring a person as brain dead. According to the SOP, a medical board comprising four doctors — at least one should be from the government service — will be authorised to declare a patient brain dead. As per the Transplantation of Human Organ Act, two experts are required for brain death certification. The SOP also stated that the main condition for declaring a patient brain dead would be that he/she is 100% out of reversible cause of coma. To check any misuse, the SOP defines brain dead and state of coma in detail.