Reader Response: Determination of Death by Neurologic Criteria Around the World

I read the article by Lewis et al.1 with interest. We still lack worldwide consensus on determination of death by neurologic criteria/brain death (DNC/BD). Although achieving international consensus would be ideal, I disagree with the authors’ recommendations that a worldwide consensus be reached on the minimum standards for DNC/BD. We should not compromise on the standards as laid out in the AAN position statement on BD and its determination.2 Compromising the standards to accommodate different countries’ medical, religious, and societal ideal places us on a slippery slope because criteria may be “loosened” to meet the demand for organs in developing countries. If that happens, we risk the loss of public trust and other insurmountable problems.

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