Abstract
People die either when their heart and respiration stop or when their brain irreversibly
stops functioning. This latter mode of death by neurologic criteria (also called brain death) emerged after the development of ventilators and intensive care units in the late
1950s and 1960s. Brain death is universally accepted as a modern entity, but the complex
process for declaring a patient brain dead is not uniformly followed across country
and state lines or even hospital policies, creating unacceptable variability and risks
for falsely pronouncing a patient dead. If, however, the declaring physician has expertise
and diligently follows the steps that have been published in guidelines, this risk
is mitigated. In this article, the authors describe the steps for brain death declaration,
discuss how to avoid pitfalls, and examine the modern controversies regarding this
medical reality.
Keywords
brain death - brainstem death - apnea test - ancillary tests - prerequisites - challenges
- organ donation
