That’s why I think it’s a good idea that new guidelines for determining if a patient is brain dead have just been issued.  

Essentially saying it wants to take the guesswork out of the process, the American Academy of Neurology Monday released those new guidelines — the first update in 15 years. 

http://health.usnews.com/health-news/family-health/brain-and-behavior/articles/2010/06/07/experts-revise-guidelines-for-determining-brain-death.html

 The new guides tell physicians to do a extensive evaluation of a patient, with a check list of about 25 tests that must be performed and specific criteria that must be met.

The new guidelines were co-written by Dr. Panayiotis Varelas, director of the Neuro-Intensive Care Service at the Henry Ford Hospital in Detroit.

The U.S. Uniform Determination of Death Act does define when death takes place: When a person permanently stops breathing; the heart stops beating; and all brain functions, including those in the stem, stop.

The problem is that doctors differently determine who meets those criteria.

A 2008 study that included 41 of the country’s top hospitals, done by Varelas, found a lot of variability in how doctors and hospitals judged who fit the criteria. 

 Under the revised guidelines, the three signs of brain death are coma with a known cause; abscence of brain stem reflexes and the permanent cessation of breathing.  

Being in a vegetative state does not equate to being brain dead, according to the new rules.

Brain death is caused by severe traumatic brain injury, stroke or oxygen deprivation following cardiac arrest.