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Author response: Determination of death by neurologic criteria around the world

  • Ariane Lewis, Neurointensivist, NYU Langone Medical Center
  • Sam D. Shemie, Pediatric Intensivist, Montreal Children's Hospital
  • Gene Sung, Neurointensivist, LAC and USC Medical Center
  • Sylvia Torrance, Canadian Blood Services, Canadian Blood Services
  • David Greer, Neurointensivist, Boston University School of Medicine
Submitted July 13, 2020

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. Due to 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 World Brain Death Project is to establish minimum criteria for BD/DNC internationally, addressing the present variability—or lack of guidance—on 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.

Disclosure

The authors report no relevant disclosures. Contact journal@neurology.org for full disclosures.

References

  1. Lewis A, Bakkar A, Kreiger-Benson E, et al. Determination of death by neurologic criteria around the world. Neurology 2020 Epub Jun 23.
  2. Lewis A, Bernat JL, Blosser S, et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology. 2018;90:423–426.

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Neurology | Print ISSN:0028-3878
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