Brain death

Current law in the United States authorizes physicians to diagnose brain de ath by applying generally accepted neurologic criteria for determining loss of function of the entire brain. This article offers a medical-legal persp ective on problems that may arise with respect to the determination of brai n death. These include the possibility of diagnostic error, conceptual disa greements that may constrain the use of neurologic criteria to diagnose dea th, and the conflation of brain death and loss of consciousness. This artic le also addresses legal aspects of the debate over whether to expand the de finition of brain death to include permanent unconsciousness. Although exis ting laws draw a clear distinction between brain death and the persistent v egetative state, many courts have authorized removal of life support from i ndividuals whose unconsciousness is believed to be permanent on proof that removal accords with preferences expressed before sentience was lost.