June 1983

Brain Death

Author Affiliations

Multidisciplinary Intensive Care Unit Children's Hospital Medical Center 300 Longwood Ave Boston, MA 02115

Am J Dis Child. 1983;137(6):545-546. doi:10.1001/archpedi.1983.02140320021002

The issue of clinical and laboratory criteria for brain death in the child has been marked by confusion and controversy since the Harvard Medical School criteria were published in 1968.1 In the many reports that have since appeared, the most recent ones have emphasized clinical criteria rather than laboratory data in diagnosing brain death in adults. Although we, as pediatricians, have recognized the same clinical signs of brain death in children, virtually every report to date has excluded their applicability to the pediatric population. To determine brain death in children in our intensive care practice, we have relied both on clinical criteria, as well as laboratory confirmation, for several reasons. Many pediatricians are reluctant to depend exclusively on clinical skills for making such an important decision. Also, parents in a state of shock and disbelief at the loss of a previously healthy child need time and objective data before