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There is uneasy conflict between the rationalist view that death occurs when the brain is dead, and the differing view—which must command respect—that death of the whole organism is the final moment in a person’s life. Some religions take the latter approach. A determination that death has occurred is important on several counts. It settles certain legal matters, such as inheritance. It allows relatives to begin the process of grieving and burial according to appropriate ritual. And, in certain circumstances, it allows removal of organs for transplantation. The criteria currently applied in the United States, most European countries, and many other countries are derived from the Harvard Medical School Ad Hoc Committee’s recommendations that permit a determination of death if coma is irreversible.1 This conceptualization introduced the “beating heart, brain-dead donor” into clinical practice. At the time, this was a profound change in medical thinking that provoked wide international and public discussion. Pathologic studies, however, confirmed that the brain lesions associated with this clinical …
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