• W Andrew Kofke.
• University of Pennsylvania. Electronic address: William.Kofke@uphs.upenn.edu.
• J Crit Care. 2014 Dec 1;29(6):1117-8.

AbstractThe notion of brain death from its inception has not been uniformly understood with many grisly conceptions of it as it pertains to reliability and to organ donation. Accordingly, the aforementioned recitation of statutes and commission reports has served a useful societal role in addressing controversies and misconceptions while promulgating unifying foundational concepts and guidance in practical translation to clinical practice. There is clearly a consensus that statutory uniformity across jurisdictions is important and that there are two ways to define death. The first is the traditional cardiopulmonary criteria of cessation of cardiac function and breathing. The second is through established procedures to reliably determine the presence of total brain death with the presence of a comatose state which is irreversible. Another common thread through the ethically focused reports has been recognition that organ donation and death are temporally and geographically associated but there is emphasis that the processes of determination of death(by somatic or cerebral criteria) must be logically, ethically, and procedurally separate from the procedures for performing organ harvesting and transplantation.

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