Clinical and Bioethical Perspective on Brain Death, Organ Donation, and Family Communication

The concept of brain death emerged about 60 years ago, when the development of ventilators and other intensive care unit technologies allowed patients with devastating neurological injury to be kept alive for prolonged periods. Although it has been accepted as a legal criterion for determining death for over 50 years, death by neurological criteria remains controversial in the USA. Significant variability still exists in clinical practice and legal application. In this chapter, the essential clinical and ethical elements of brain death are discussed.