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May 1992

Brain Death: Occurs Only With Destruction of the Cerebral Hemispheres and the Brain Stem

Author Affiliations

From the Department of Medicine (Neurology), Dartmouth Medical School, Hanover, NH, and the Neurology Section, Veterans Administration Medical Center, White River junction, Vt.

Arch Neurol. 1992;49(5):569-570. doi:10.1001/archneur.1992.00530290161027

Brain death is the colloquial term used when human death is determined by tests showing global brain destruction or irreversible cessation of global brain functions. Since the original delineation of this concept in 1959, with few exceptions, Western society has evolved a consensus that brain death represents the medical, philosophical, and legal standard of human death. This societal consensus has permitted the statutory recognition of brain death in about 90% of the states in the United States and in many other Western countries.

All accepted medical tests to determine brain death and all enacted statutes of brain death utilize the "wholebrain" criterion of death: death is the irreversible cessation of hemispheric and brain-stem neuronal functions. Physicians have constructed batteries of bedside and confirmatory laboratory tests to show that this criterion of death has been satisfied. Tests to demonstrate absence of the brain-stem functions are pivotal to all published batteries of

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