Addressing the Problem of Brain Death Misdiagnosis: A ‘Just’ Evaluation of a Difficult Problem

Abstract In their article, Drabiak et al. review the state laws and ethical debates related to the determination of death by neurologic criteria, analyze the recent 2023 American Academy of Neurology practice guidelines, and make policy recommendations. We call this review ‘just’ because the article correctly focuses on the chief ethical, legal, and medical issue in this debate — namely whether patients declared dead by neurological criteria are actually dead, along with the need to improve integrity, honesty, trust, and residency education and training to reduce moral distress and achieve moral certainty in declaring patients dead, initiating organ procurement, and communicating these realities to patient families/surrogates. As the authors invite the reader to comprehend, it should no longer be considered a minority or fringe opinion that determinations of brain death are rife with false positives, inadvertent misdiagnoses, violations of informed consent, and, ultimately, dissent from the law. For the sake of justice, one would do well to heed these words.