Brain Death: You're Legally Dead Despite Your Beating Heart

Andrew N. Wilner, MD

Disclosures

September 23, 2013

In This Article

Consciousness

The current concept of brain death relies on the principle that consciousness is key to meaningful life and that consciousness never returns in a patient who satisfies the criteria for brain death. However, the exact definition of consciousness is open to debate, and the physiology underlying consciousness is incompletely understood.[9]

Although the AAN brain death criteria[4] dependably separate those who will recover consciousness from those who will not, the current criteria may be open to refinement. Research continues in this area, as evidenced by the VI International Symposium on Brain Death and Disorders of Consciousness, December 3-6, 2013, Havana, Cuba.

Conclusion

Brain death is a definitive and irreversible clinical diagnosis. Potential donors of vital organs may be reassured that when pronounced dead by a trained physician appropriately applying the AAN brain death criteria, they have no chance of regaining consciousness.

Consequently, brain death as defined in the AAN guidelines is an appropriate criterion for transplant eligibility. Had Eban Alexander been pronounced brain dead, he might have gone to heaven, but he wouldn't have returned to tell about it.

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