The concept and practice of brain death

Area of Science:

• Neurology and Bioethics
• Medical-Legal Definitions of Death

Background:

• Brain death, the irreversible cessation of clinical brain function, has been a recognized concept since the 1960s.
• The whole-brain formulation is the most widely accepted definition, supported by the concept of organismal death.

Observation:

• Diagnosis is primarily clinical, with confirmatory tests for intracranial blood flow cessation.
• Concerns exist regarding proper test performance by some physicians, suggesting a need for confirmatory tests in certain situations.

Findings:

• The whole-brain formulation of brain death is widely accepted globally, with most major religions endorsing it.
• Despite some scholarly objections on conceptual and pragmatic grounds, brain death statutes and clinical practices remain largely unchanged.

Implications:

• Brain death is a durable concept forming the basis of public policy in diverse societies.
• Ongoing acceptance and established practice underscore its significance in end-of-life medical and legal contexts.