The problems with the validity of the diagnosis of brain death

Summary • The diagnosis of brain death as ‘death’ and organ transplantation have been closely historically linked since the mid twentieth century • It will be argued in this article that the development of a neurological definition of death was introduced to justify the removal of fresh viable organs for transplantation • Brain death cannot be diagnosed reliably using ‘established practices’ • Improved understanding of the pathophysiology of raised intracranial pressure has challenged our understanding of brain death • We need to move forward in our conceptualization of phenomenon of profound coma associated with massive brain damage • If examination for ‘brain death’ is to be carried out at all, there needs to be an examination and re-evaluation of practices and protocols