The problems with the validity of the diagnosis of brain death

The diagnosis of brain death as 'death' and organ transplantation have been closely historically linked since the mid twentieth century. It will be argued in this article that the development of a neurological definition of death was introduced to justify the removal of fresh viable organs for transplantation. Brain death cannot be diagnosed reliably using 'established practices'. Improved understanding of the pathophysiology of raised intracranial pressure has challenged our understanding of brain death. We need to move forward in our conceptualization of phenomenon of profound coma associated with massive brain damage. If examination for 'brain death' is to be carried out at all, there needs to be an examination and re-evaluation of practices and protocols.