Appropriate Confusion Over `Brain Death'

Youngner et al¹ report in this issue of The Journal that even the experts are having trouble understanding the concept of "brain death." More than one third of surveyed physicians responsible for identifying "brain dead" patients and declaring them dead were unable to identify irreversible loss of all brain function as the criterion of death and to apply it to two simple cases. The same was true of nearly three fourths of another group of medical residents, anesthesiologists, and nurses who work in the areas of intensive care and transplantation. Those surveyed varied widely in their concepts of death. These results are troubling, coming as they do 8 years after publication of the President's Commission report,² which formulated and argued for a whole-brain definition of death endorsed by the American Medical Association and the American Bar Association and subsequently enacted by most state legislatures.

Care must be taken