The use of high-tech intensive care in the 1960s led to the dissociation between cardiac, respiratory, and brain function in patients who would have previously died from apnoea. As a consequence, death had to be re-defined determined by neurological criteria. Ever since, brain death raises diverse neuroethical issues, from estate law and religious practices to patient care and organ donation. Such controversies naturally stem from the exact formulation of brain death. This chapter argues that a neocortical definition of brain death is conceptually inadequate and cannot characterize patients in vegetative or minimally conscious states. The chapter provides some suggestions as to how the medical community can act to promote advanced medical care planning. Finally, the chapter speculates that in the future, improving technologies for brain repair and prosthetic support for brain functions might change our current ideas of irreversibility and eventually force medicine and society to once again revise its definition of death.
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