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To the Editor:
We appreciate the article by Greer et al.1 Similar concerns led to a major review of brain death determinations in New York State and the release of updated guidelines for such determinations.
Brain death policies from facilities across New York were collected by the New York Organ Donor Network and revealed numerous significant differences across institutions and deviations from accepted guidelines. Variations included the number of different professionals required, interval between determinations, role of ancillary testing, and timing of apnea tests. Some institutional policies had requirements that could delay or even prevent the diagnosis of brain death, such as waiting periods of 24 hours or more. The New York State Department of Health (NYSDOH) was concerned by this degree and type of variability.
In November 2004, NYSDOH convened a Brain Death Guideline Panel composed of external experts in conjunction with the New York State Task Force on Life & …
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