International perspectives in the diagnosis of brain death in adults

SummaryThe determination of death by neurological criteria, or brain death, has been recognised in many countries for more than 40 years. This review will explore the historical context of the concept of brain death and the controversies surrounding its diagnosis today. These are primarily related to the relationship between brain death and death of the whole person, the international differences in the nomenclature and criteria for the determination of brain death and the inextricable link between brain death and organ donation. International differences in the conduct of clinical testing and use of confirmatory tests will be examined, and specific circumstances that can lead to difficulties in diagnosis highlighted.