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Updated: Jan 31, 2026

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Brain death: the Asian perspective.

Hoe Chin Chua1, Tong Kiat Kwek2, Hirofumi Morihara3

  • 1Department of Neurology, National Neuroscience Institute, Tan Tock Seng Hospital, Singapore.

Seminars in Neurology
|April 4, 2015
PubMed
Summary

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Brain death criteria vary significantly across Asian countries, despite widespread acceptance of the concept. This variability impacts certification processes and legal frameworks for organ donation and end-of-life care.

Area of Science:

  • Neurology
  • Medical Ethics
  • Public Health Policy

Background:

  • Asia's diverse population necessitates understanding variations in medical practices.
  • Brain death is a critical concept in end-of-life care and organ donation.
  • Existing global guidelines for brain death certification show some regional adaptations.

Purpose of the Study:

  • To investigate the current criteria and practices for certifying brain death across major Asian countries.
  • To identify variations and commonalities in legal and clinical approaches to brain death determination in Asia.
  • To inform potential harmonization efforts for brain death certification in the region.

Main Methods:

  • A survey of 14 Asian countries representing the majority of the continent's population.

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  • Analysis of legal statutes, clinical guidelines, and expert opinions on brain death certification.
  • Comparative review of "whole-brain" versus "brainstem" concepts of brain death.

    • Main Results:

    • Widespread acceptance of the concept of brain death in surveyed Asian nations.
    • Significant variability in specific criteria for brain death certification, including personnel, qualifications, and confirmatory tests.
    • Divergence between "whole-brain" and "brainstem" definitions, with the latter prevalent in countries with UK colonial history.

    Conclusions:

    • While the concept of brain death is accepted, its clinical application and legal certification vary considerably across Asia.
    • The "whole-brain" definition is more common, but "brainstem" criteria persist in some regions.
    • Standardization of brain death certification criteria in Asia could improve consistency in medical practice and organ donation protocols.