Management of Patients with Brain Death: A Position Statement

Clinical Takeaway

: The American Academy of Neurology provides guidance on communication with decision makers, objections, and pregnancy in patients with brain death.

Context

All U.S. states have brain death statutes, but public understanding of brain death/death by neurologic criteria (BD/DNC) remains poor, and clinicians frequently confront challenging scenarios. This position statement complements a guideline published jointly in 2023 by the American Academy of Neurology (AAN) and other organizations.

Key Points:

Before clinicians evaluate patients for BD/DNC, they should educate surrogate decision makers about the underlying brain injury, the BD/DNC determination process, and the equivalency of BD/DNC to circulatory death.
In the U.S., clinicians have no ethical obligation and no legal obligation (outside of New Jersey) to continue organ support once death is declared. Unilateral withdrawal of organ supp…

Reviewing Author

Craig A. Williamson, M.D., M.S.

Disclosures

Consultant/Advisory BoardNational Football League

RoyaltiesUpToDate, Inc.

Grant/Research SupportNational Institutes of Health

Editorial BoardsNeurocritical Care