It’s been more than five decades since the inception of brain death as a defined concept denoting an irreversible cessation of all functions of the entire brain including the brain stem. However, there was an initial reluctance to apply brain death criteria to children as they are believed to more likely regain neurologic function after injury. It was almost twenty years later that brain death certification in children was first proposed and since then protocols and guidelines have been developed to standardise brain death determination. Despite this, substantial variability in practice exists throughout the world. Part of the reason for this is the ethical, philosophical as well as legal controversies that continues to exist as well local cultural and religious beliefs. The emergence of new technologies may also change the landscape in assessing brain death criteria. It is therefore imperative for providers to educate themselves regarding the most recent science and guidelines regarding brain death determination. There is also a need to be familiar with published criteria, state laws and institutional protocols as maintaining a uniform definition of death will help to provide an objective determination of death.
Dr Tang Swee Fong