Brain stem death

Death may be regarded as the irreversible loss of all those essential characteristics that are necessary for the existence of a living person, including the capacity for consciousness and the capacity to breathe. The diagnostic criteria for the diagnosis of death differ from country to country. In the UK the concept of brain death has been accepted by the legal and medical professions for more than 30 years. The latest Code of Practice was produced in 2008 by the Academy of Royal Medical Colleges to address the diagnosis and confirmation of death in all situations. Clinical examination of the brain stem reflexes requires minimal specialist equipment and, if performed with all preconditions satisfied, predicts asystole with 100% specificity and sensitivity. This article describes the necessary steps for the diagnosis of brain stem death and draws the reader’s attention to changes to the Department of Health guidance recommendations.