Brain Death as Legal Death: Challenges and Implications in the Ethiopian Context

Background:The recognition of brain death as legal death marks a significant advancement in medical and legal practice globally.In Ethiopia, the Health Service Administration and Regulation Proclamation (HSARP) No. 1362/2024, which came into effect in May 2025, formally recognized brain death as legal death.However, its implementation is likely to raise complex challenges at the intersection of law, medicine, and socioreligious beliefs, as tensions may emerge between the application of the brain death standard and families' cultural or religious values, leading to ethical, legal, and social dilemmas.Objective: This article aimed to examine the legal recognition of brain death in Ethiopia, assess its alignment with ethical, religious, and social norms, and explore the challenges and implications it presents for both legal and healthcare practice.Methods: A comprehensive review of Ethiopian laws, including the Federal Democratic Republic of Ethiopia (FDRE) Constitution, HSARP, as well as foreign laws, court cases, and guidelines was conducted.In addition, relevant literature was analyzed to trace the evolution of brain death criteria and to provide insights into current standards applied across jurisdictions, as well as their ethical, legal, religious, and sociocultural implications. Results and conclusion:Although HSARP recognizes brain death as legal death, it does not specify the standard to be applied in its determination and confirmation, nor does it refer to any operative medical guideline to be followed in practice.Furthermore, the law provides no guidance for accommodating religious or cultural objections, potentially resulting in conflicts with families and legal disputes.Effective communication between medical professionals and families, along with greater legal clarification and public awareness, is essential to build trust in medical decision-making and ensure that practices are ethically aligned with societal values.