PT - JOURNAL ARTICLE AU - Matthew P. Kirschen AU - Ariane Lewis AU - Michael Rubin AU - Pedro Kurtz AU - David M Greer TI - New perspectives on brain death AID - 10.1136/jnnp-2020-323952 DP - 2021 Mar 01 TA - Journal of Neurology, Neurosurgery & Psychiatry PG - 255--262 VI - 92 IP - 3 4099 - http://jnnp.bmj.com/content/92/3/255.short 4100 - http://jnnp.bmj.com/content/92/3/255.full SO - J Neurol Neurosurg Psychiatry2021 Mar 01; 92 AB - Brain death, or death by neurological criteria (BD/DNC), has been accepted conceptually, medically and legally for decades. Nevertheless, some areas remain controversial or understudied, pointing to a need for focused research to advance the field. Multiple recent contributions have increased our understanding of BD/DNC, solidified our practice and provided guidance where previously lacking. There have also been important developments on a global scale, including in low-to-middle income countries such as in South America. Although variability in protocols and practice still exists, new efforts are underway to reduce inconsistencies and better train practitioners in accurate and sound BD/DNC determination. Various legal challenges have required formal responses from national societies, and the American Academy of Neurology has filled this void with much needed guidance. Questions remain regarding concepts such as ‘whole brain’ versus ‘brainstem’ death, and the intersection of BD/DNC and rubrics of medical futility. These concepts are the subject of this review.