Brain death and the courts

Brain death determinations have been challenged in courts, but no systematic study has been published in the medical literature. Court cases on brain death determination could provide some insights for the clinical practice of physicians. We reviewed legal cases between 1980 and 2010 involving neurologic criteria for death since adoption of the Uniform Determination of Death Act. Court rulings on brain death determination are uncommon, but 2 major themes emerged: consequences of documentation of the time of brain death and family-physician discord on withdrawal of intensive care support. All court rulings upheld the medical practice of death determination using neurologic criteria according to state law, irrespective of other elements of the rulings. Nothing in the court cases suggests a need to alter the current medical standard of brain death determination. Jurisprudence to date emphasizes that the timing and accurate diagnosis of brain death has important weight in the resolution of conflict between practitioners, hospitals, and family members.