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July 11, 2023; 101 (2) Contemporary Issues in Practice, Education, & Research

What Is the Ideal Brain Criterion of Death? Nonclinical Considerations

The UDDA Revision Series

Michael A. Rubin
First published July 10, 2023, DOI: https://doi.org/10.1212/WNL.0000000000207360
Michael A. Rubin
From the Departments of Neurology and Neurosurgery, UT Southwestern Medical Center, Dallas, TX.
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What Is the Ideal Brain Criterion of Death? Nonclinical Considerations
The UDDA Revision Series
Michael A. Rubin
Neurology Jul 2023, 101 (2) 86-87; DOI: 10.1212/WNL.0000000000207360

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Although the assessment of death has long been accepted as the physician's domain, death as a concept is shared with several stakeholders, including religion, philosophy, and society as a whole. This is not to say that the physician is not part of the conceptual understanding of death, but rather that the physician cannot claim sole ownership of defining death. This claim is illustrated by the fact that the well-known Harvard criteria were written by clinicians,1 but writers of the Uniform Determination of Death Act and planned revisions will include policymakers, theologians, physicians, and attorneys.2 Furthermore, a search of the ethics literature features a robust dialog on the topic, including many pieces written by nonclinicians. Consequently, a complete understanding of the dialog around determination by neurologic criteria requires knowing both a clinician's perspective and that of a theologian, a philosopher, and a member of the general public. While the companion piece written by Nathaniel Robbins focused on the clinician's perspective of criteria for neurologic determination, this piece will examine the criterion from the lens of those who are not clinicians. I will defer the larger question if any neurologic criteria can garner consensus for death equivalency and instead focus on which neurologic criteria would be most widely supported.

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  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Submitted and externally peer reviewed. The handling editor was Editor-in-Chief José Merino, MD, MPhil, FAAN.

  • See page 83

  • Received November 7, 2022.
  • Accepted in final form March 15, 2023.
  • © 2023 American Academy of Neurology
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