Brain Death in Infants and Children

In 1987, guidelines for the determination of brain death in children in the United States were proposed by a task force¹ consisting of representatives of several major professional medical and legal societies (Table 1). These guidelines emphasized the importance of evaluation of the patient’s medical history and clinical examination in determining the cause of coma so that remedial or reversible conditions can be differentiated from other nonreversible causes. In addition, age-related observation periods and specific neurodiagnostic tests were recommended for children younger than 1 year. For children older than 1 year, the task force determined that the diagnosis of brain death could be made solely on a clinical basis and that laboratory studies were optional. Since their publication in 1987, these criteria have been generally accepted and have served as explicit guidelines for physicians who are asked to diagnose brain death in children. When these guidelines were developed,...