'Brain Death'

To the Editor.—  The editorial entitled "Appropriate Confusion Over 'Brain Death'" by Dr Wikler and Mr Weisbard¹ is inappropriate because it introduces unnecessary confusion where none exists. A decade of clinical data confirm the unequivocal accuracy of the wholebrain definition of death as proposed by the President's Commission² and others, endorsed by the American Bar Association and the American Medical Association, and enacted into law by most state legislatures.Dr Wikler and Mr Weisbard quote Youngner et al,³ whose study "does not suggest that brain death is being misdiagnosed; indeed the diagnosis is as certain as anything in medicine." Yet, Dr Wikler and Mr Weisbard effectively destroy the confidence of the medical profession in the neurological determination of death. In so doing, they endanger organ transplant programs by making it virtually impossible to cease life support therapy on a patient who has an irreversibly nonfunctioning brain including