International Criteria of Brain Death

Brain death criteria have mostly developed when there are organ donation policies in place. The variability in criteria and practices around the world is striking but also inherently problematic, with no consensus in sight. This chapter surveys the criteria across the continents, including in Canada, Europe, South America, Africa, Asian and the Middle East, and Australia and New Zealand. There is a specific focus on the brain death criteria in the United Kingdom and alleged contrasts with U.S. guidelines. A discussion of how best to achieve uniform criteria, despite obstacles, is described. Toward that effort a case is made to and allow the diagnosis of brain death if, after excluding any possible confounder, all brainstem reflexes have disappeared and the patient has become demonstrably apneic.