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This year marks the 40th anniversary of the publication of the landmark Harvard Medical School Ad Hoc Committee report that established brain death as an accepted medical phenomenon.1 Therefore, it is an appropriate time for neurologists to reflect on the current status of brain death determination in the United States.
“Brain death” is the colloquial term for the determination of human death by showing the irreversible cessation of the clinical functions of the brain. “Brain death” is a time-honored but misleading term because it wrongly implies that there is more than one kind of death or that it is only the brain that dies in such cases. Rather, death is a unitary biologic phenomenon that can be tested in two ways.2 In the majority of death determinations in which ventilation is not supported, physicians need only show the permanent cessation of respiratory and circulatory functions. Brain-based tests are employed only in that small minority of death determinations …
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