title: Why brain death is considered death and why there should be no confusion.
abstract: Neurologic determination of brain death is a complex assessment that may be misunderstood by nonspecialists and families. Recent guidelines clarify how to proceed with such an examination and are available to physicians, with the time of death in adults and children being determined by the last defining test-the apnea test. This core principle in neurology has been challenged recently in court and resulted in an unprecedented continuation of care in a 13-year-old child declared dead. This review comments on the medical, legal, and ethical quandaries introduced by this case and highlights the major elements of consensus on matters related to brain death that have been forged over 3 decades of sustained medical and societal debate. A clear appreciation by physicians and the public of the diagnostic determination of death following loss of brain function will help to prevent similar conflicts from occurring in the future.
authors.affiliation: From the Department of Anesthesiology (C.M.B.), the Biomedical Ethics Program, Departments of Health Sciences Research and General Internal Medicine (R.R.S.), and the Department of Neurology (E.F.W.), Mayo Clinic, Rochester, MN. burkle.christopher@mayo.edu.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Burkle
authors.affiliation: From the Department of Anesthesiology (C.M.B.), the Biomedical Ethics Program, Departments of Health Sciences Research and General Internal Medicine (R.R.S.), and the Department of Neurology (E.F.W.), Mayo Clinic, Rochester, MN.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Sharp
authors.affiliation: From the Department of Anesthesiology (C.M.B.), the Biomedical Ethics Program, Departments of Health Sciences Research and General Internal Medicine (R.R.S.), and the Department of Neurology (E.F.W.), Mayo Clinic, Rochester, MN.
authors.forename: Eelco F
authors.initials: EF
authors.lastname: Wijdicks
mesh_terms: D000293:Adolescent; D001926:Brain Death / Q000175:diagnosis* / Q000331:legislation & jurisprudence* / Q000503:physiopathology; D002140:California; D003643:Death; D004992:Ethics, Medical; D017408:Guidelines as Topic; D006266:Health Education; D006801:Humans; D008297:Male; D014481:United States