Development of the concept of brain death: international data review

The concept of brain death was introduced in the late 1960s and continues to develop. The article presents a brief history of the evolution of the idea of death by neurologic criteria. The concept is accepted worldwide, but there is still considerable variability in brain death determination protocols. New treatments for critical patients change the preconditions for brain death testing. The refinement of diagnostic techniques improves the capabilities of confirmatory tests. Controversial cases of determination of brain death cause public resonance and justified criticism of opponents of the concept. All these factors lead to review of some concept statements, terminology and update diagnostic protocols. In 2020, an international expert working group presented the minimum clinical standards for determination of brain death/death by neurologic criteria with guidance for various clinical circumstances. Some countries have already started to implement international recommendations and revise national diagnostic protocols. The extensive debate accompanying this process is an important contribution to the improvement of the concept of brain death.