Author Response: Determination of Death by Neurologic Criteria Around the World

We appreciate Dr. Machado's interest in our article.¹ Variability in determination of brain death/death by neurologic criteria (BD/DNC) could lead to loss of public and professional trust in BD/DNC and create the potential for a person to be declared dead and then subsequently recover or to be considered dead in one place but alive in another. Because of recent highly publicized lawsuits related to BD/DNC—such as the case of Jahi McMath—the American Academy of Neurology and other medical stakeholders in BD/DNC have advocated for regulatory oversight to ensure policies on BD/DNC are uniform in all US healthcare institutions.² Similarly, the intent of the World Brain Death Project is to establish minimum criteria for BD/DNC internationally, addressing the present variability—or lack of guidance—in BD/DNC determination in a number of complex situations including (1) patients with primary posterior fossa injuries, (2) patients on extracorporeal membrane oxygenation, and (3) patients treated with targeted temperature management.