The Myth of Brain Death: A Medical Deception

Interview with Dr. Heidi Klessig

The concept of brain death, introduced in 1968 by the Harvard Ad Hoc Committee, redefined mortality to facilitate organ transplantation, yet it remains a contentious prognosis rather than a definitive diagnosis of death. Dr. Heidi Klessig, an anesthesiologist whose skepticism was sparked during her residency in the late 1980s, recounts a pivotal moment when she was instructed to administer anesthesia to a “brain dead” patient “just in case,” despite the patient’s vital signs mirroring those of the living. This experience, coupled with the 1972 National Institute of Neurologic Diseases and Stroke Collaborative Study’s finding that only 40% of “brain dead” patients had diffuse brain destruction, underscores the fragility of the brain death paradigm. The supporting article, The Brain Death Lie: Harvesting the Organs of the Living, amplifies this critique, noting that the Harvard Committee’s report lacked scientific evidence, driven instead by utilitarian motives to harvest viable organs. Klessig’s advocacy exposes a medical system—that I prefer to describe as “cartel medicine”—that prioritizes institutional interests over patient care and autonomy. The absence of high-quality evidence, as admitted in the 2023 American Academy of Neurology guidelines, invites skepticism about a practice that declares death while partial brain functions, such as hypothalamic activity, persist in 50-84% of cases.

The ethical and legal ramifications of brain death diagnoses reveal a troubling disconnect, exemplified by cases like Jahi McMath, who, despite being declared dead, later exhibited neurological improvement, likely due to Global Ischemic Penumbra. I am firmly of the view that this medical system “should not be given the slightest incentive to work against your interest,” and I concur with Klessig’s warning against dehumanizing language, like “vegetable,” which strips patients of dignity and facilitates organ procurement. The Nevada Supreme Court’s 2015 ruling that current brain death guidelines fail to meet the Uniform Determination of Death Act’s requirement of “irreversible cessation of all functions of the entire brain” further exposes this legal fiction. Financial incentives, with the organ transplantation industry valued at $48 billion in 2020, compound these concerns, potentially skewing medical decision-making. Klessig’s work, as highlighted in the interview, challenges readers to question a system that obscures truth with slogans like “give the gift of life,” urging families to trust their instincts when confronted with a loved one who appears alive despite a brain death declaration.

Dr. Klessig’s reference to Dr. Cicero Coimbra’s concept of Global Ischemic Penumbra (GIP) further illuminates the potential for recovery in patients misdiagnosed as brain dead, as GIP explains how the brain may remain viable despite appearing unresponsive. Coimbra, a neurologist whose groundbreaking work challenges conventional neurological prognoses, has similarly critiqued medical paradigms that overlook reversible conditions, as explored in our interview, Unveiling Autism’s Roots. His insights into brain function preservation resonate with Klessig’s advocacy, urging a reevaluation of hasty declarations of death that serve institutional agendas over patient welfare.

With thanks to Dr. Heidi Klessig.

The Brain Death Fallacy: Klessig MD, Heidi

1. Dr. Klessig, could you please tell us about your background as an anesthesiologist and what initially drew you to medicine, particularly your specialty in anesthesiology and pain management?

I entered the medical field because I liked helping people and was fascinated by science. During medical school, our training rotates through the different specialties, and I enjoyed my anesthesia rotation because of the immediate impact the anesthesiologist makes on a patient’s care. In many specialties, a doctor prescribes a drug and then must wait weeks to months to determine whether it was effective. During surgery, the anesthesiologist gets to titrate the effects of medication in real time, and seeing people come out of their needed surgeries happy and comfortable was very gratifying. But after a year of private practice in operating room anesthesia, I realized that I missed talking to patients! So, I left the operating room, and a partner and I opened an outpatient chronic pain clinic. This was the perfect situation for me: I was able to talk to my patients and because we did interventional techniques like nerve blocks, I was able to continue the hands-on work I enjoyed.

2. You've described a pivotal moment during your residency when you were asked to prepare a "brain dead" patient for organ harvesting, and how your supervising anesthesiologist suggested you give anesthesia to a supposedly dead patient "just in case." Can you walk us through what you observed that night and what went through your mind during that experience that first made you question the brain death diagnosis?

One evening during my anesthesiology residency training in the late 1980s, I came in for night call and was told to go up to the intensive care unit (ICU) and prepare a brain dead man for organ harvesting. This was something new for me; I vaguely remembered hearing a medical school lecture on brain death, but I hadn’t really thought much about it. Not wanting to look stupid, I asked the staff anesthesiologist, “An organ harvest? Is there anything different about this I need to know?”

He snorted and rolled his eyes. “Just be sure someone has actually declared him brain dead. The transplant team can be a little eager.”

In the ICU, my patient was waiting. He was a young man who had sustained a head injury during a motorcycle accident. And yes, the neurologist had declared him “brain dead.” When I went to examine him, my first thought was how glad I was that his family was not in the room with him. Usually, anesthesiologists try to reassure patients and families that everything will be done to keep them safe and comfortable during surgery…but what do you say to a family whose loved one isn’t coming back?

On examining him, I was surprised to find that this “dead” patient looked just like every other ICU patient I had cared for. In fact, he looked better than most! He was warm, his skin was supple, he had a normal heart rate and blood pressure, and his blood oxygen saturation was excellent.

I went back down to the operating rooms and found the attending anesthesiologist who would be supervising me. I reviewed the case with him, and he asked me to present my anesthetic plan of care. I told him that I planned to use a paralyzing agent to keep the man from moving during surgery, and that I would use a narcotic such as fentanyl to decrease any heart rate or blood pressure responses to pain that might adversely affect the organs. He then asked me if I was planning to give a drug to block consciousness. I was stunned. “Why would I do that?” I asked, “Isn’t he dead?”

I’ll never forget the long look he gave me over his surgical mask. “Why don’t you give one…just in case,” he said, and walked away. To my regret, despite my doubts I did as I was told. In the operating room, the young man responded to surgery just like anyone else, requiring the same types and amounts of anesthesia. Later, a pathologist friend told me that when she removes organs during an autopsy in the morgue, she doesn’t have to use any of these drugs.

This experience made me wonder…when is someone dead? Most people consider death to be the separation of the soul/spirit/life principle from the physical body. But because the spirit is immaterial, we have no way of determining the exact moment when the spirit departs. So, for millennia, people have determined death at home, on the farm, or on the battlefield by the complete absence of all vital functions beyond any hope of return. The two usual index signs for this have been the irreversible loss of heartbeat and breathing.

3. The Harvard Ad Hoc Committee's 1968 report essentially created the concept of brain death without new medical evidence. What were the stated reasons for this new definition, and why do you believe it was so readily accepted?

Before 1968, organ transplantation was not particularly successful because after biological death (once circulation stops), organs very quickly begin to break down and become unsuitable for transplantation. Doctors needed a way to move more quickly, but they also wanted to avoid being sued for removing organs from people who were still alive. In 1967, Dr. Christiaan Barnard performed his first heart transplant in South Africa. At the time, he said that the donor’s heart had stopped, but his brother later stated that they had intentionally stopped her heart during surgery with a shot of potassium. The recipient of the first heart only lived a matter of weeks before dying of pneumonia. In January of 1968, a young black man with a neurologic injury became the second heart donor. Barnard’s transplant team put considerable pressure on the young man’s doctor to declare him “dead” while his heart was still beating, and the doctor caved. This procedure was much more successful, with the recipient living 19.5 months. Because of these surgeries, Barnard was catapulted into stardom, becoming a media darling and even dating movie actresses such as Gina Lollobrigida (despite the fact he was already married).

It was now clear that fresh, viable organs were going to be an absolute necessity for successful transplants. Shortly after Dr. Barnard performed his second heart transplant, thirteen men at Harvard Medical School met to redefine death: they decided that certain people in a coma could be considered “dead already.” Their landmark article, which appeared in the Journal of the American Medical Association in August of 1968, had zero scientific references. There were no tests, studies, or evidence that these comatose people, who had always previously been considered to be alive, were now somehow dead. The Harvard Committee based their redefinition upon utility: they said that these comatose people’s lives were a burden to themselves and others, and that defining them to be dead would remove the controversy about obtaining their organs for transplantation.

In retrospect, it is staggering that this new definition of death, made by fiat without evidence of any kind, was so quickly accepted -- especially as the legalization of abortion just a few years later was met with such fierce opposition. I think Drs. Youngner and Arnold were correct in their article, “Philosophical Debates About the Definition of Death: Who Cares?” in 2001 when they wrote: “Brain death was introduced by a prestigious group of academics at a time that marks almost the end of an era of unquestioned belief and trust in medical science.”

4. You mention that the only major study of brain death, conducted in the early 1970s, found that only 40% of "brain dead" patients actually had diffuse brain destruction. How has the medical community responded to these findings over the decades?

It wasn’t until 1972 that the first (and only) multicenter, prospective study of the neuropathology of brain death was published. The National Institute of Neurologic Diseases and Stroke Collaborative Study enrolled 503 patients from eight clinical centers across the United States to find out whether people declared to be brain dead actually had total brain destruction. Their results? Of 226 brains autopsied after a diagnosis of brain death, ten were grossly normal and only 40% showed diffuse tissue destruction. It was “not possible to verify that a diagnosis made before cardiac arrest by any set or subset of criteria would invariably correlate with a diffusely destroyed brain.” (Cardiac arrest, of course, is the traditional means of determining death.)

Dr. Gaetano Molinari, one of the principal investigators, wrote:

“While the prognosis for recovery of function is nil and the probability of death within days to weeks is extremely high, one major question remains and perhaps has been brought into focus by the NINCDS Collaborative Study. That question is: does a fatal prognosis permit the physician to pronounce death? It is highly doubtful whether such glib euphemisms as ‘he’s practically dead,’ … ‘he can’t survive,’ … ‘he has no chance of recovery anyway,’ will ever be acceptable legally or morally as a pronouncement that death has occurred…This is more than a mere semantic distinction. A physician must pronounce that death has occurred before he can either perform an autopsy or remove the ‘cadaver’ organs for transplantation into another human being.”

So, the conclusion of this study was that brain death is a PROGNOSIS, not a diagnosis of death. But despite Dr. Molinari’s doubts about the legal and moral legitimacy of turning a prognosis of death into a statement of death as fact, history shows that this is exactly what hapened. The medical community, in their zealous quest for viable organs, simply ignored these results.

5. The case of Jahi McMath became a national story when a teenager declared brain dead by multiple doctors was able to recover neurological function and live for several more years. Can you explain how this was possible, and how does the condition called Global Ischemic Penumbra potentially explain her apparent recovery from brain death?

In 2013, Jahi McMath was a quiet, cautious teenager with sleep apnea who underwent a tonsillectomy and palate reconstruction to improve her airflow while sleeping. An hour after the surgery, she started spitting up blood. Her parents requested repeatedly to see a doctor without success. Jahi continued to bleed until she had a cardiac arrest just after midnight. She was pulseless for ten minutes during her “code blue” resuscitation. Two days later, her electroencephalogram (EEG) was flatline and it was clear that Jahi had suffered a severe brain injury which was worsening. But rather than treating these findings aggressively, her doctors proceeded toward a diagnosis of brain death. Three days after her surgery, her parents were informed that their daughter was “dead” and that Jahi could now become an organ donor. The family was stunned. How could Jahi be dead? She was warm, she was moving occasionally, and her heart was still beating. As a Christian, Nailah believed her daughter’s spirit remained in her body as long as her heart continued to beat.

While the family sought medical and legal assistance, Children’s Hospital Oakland doubled down, refusing to feed Jahi for three weeks. The hospital finally agreed to release Jahi to the county coroner for a death certificate, following which her family would be responsible for her.

On January 3, 2014, Jahi received a death certificate from California, listing her cause of death as “Pending Investigation.” Why was the hospital so adamant about insisting Jahi was dead, even to the point of issuing a death certificate? Possibly, because California’s Medical Injury Compensation Reform Act limits noneconomic damages to $250,000. If Jahi was “dead,” the hospital and its malpractice insurer would only be liable for $250,000. But if Jahi was alive, there would be no limit to the amount her family could claim for her ongoing care.

Thankfully, Jahi’s family received help from Dr. Paul Byrne, a long-time advocate of people victimized by a brain death diagnosis. With his assistance, Jahi was air-lifted to New Jersey, the only US state with a religious exemption to a diagnosis of brain death. In New Jersey, Jahi received a tracheostomy and a feeding tube and began to improve. After noticing that Jahi’s heart rate would decrease at the sound of her mother’s voice, the family began asking her to respond to commands and videoed her correct responses. Jahi went through puberty and began to menstruate -- something not seen in corpses! By August 2014 she was stable enough to move into her mother’s apartment for continuing care. Subsequently, Jahi was examined by two neurologists (Dr. Calixto Machado and Dr. D. Alan Shewmon) who found that she had definitely improved: she no longer met the criteria for brain death and was in a minimally conscious state. Jahi continued responding to her family in a meaningful way until her death in June 2018 from complications of liver failure.

How could Jahi McMath have improved despite being declared brain dead by 3 doctors, failing to breathe on 3 apnea tests, having 4 flatline EEGs, and 1 “no flow” cerebral blood flow scan? Very likely due to a condition called Global Ischemic Penumbra, or GIP, which was described in 1999 by Dr. Cicero Coimbra. This is how it happens:

1. During periods of low blood flow, the brain (like every other organ) shuts down its functions to reduce its metabolic requirements.

2. At about a 50% reduction in blood flow, the EEG becomes silent, and the brain becomes unresponsive to testing.

3. But tissue destruction doesn’t occur until brain blood flow is reduced to 20% of normal for several hours.

4. Between 20-50%, the brain is silent, but still has enough blood flow to support viability, meaning that recovery is still possible.

GIP is very much like a power outage in your home: nothing works, but the wiring isn’t destroyed. Get the current flowing again, and the lights will come back on. In the same way, with continued efforts to support the brain and improve its blood flow, a number of these patients could also potentially improve.

6. The Nevada Supreme Court ruled unanimously that current brain death guidelines don't meet legal requirements. What was the significance of this ruling, and how did Nevada respond legislatively?

In 2015, University of Nevada-Reno student Aden Hailu suffered an unexpected brain injury during exploratory surgery for abdominal pain. Her father was told that what happened to her was a medical mystery. He advocated strongly for the hospital to care for his daughter, but the hospital said that she fulfilled the requirements of the American Academy of Neurology (AAN) brain death guideline and was dead. Ultimately, the case was tried by the Nevada Supreme Court, who ruled unanimously that the AAN brain death guideline did not meet the legal definition of brain death under the Uniform Determination of Death Act (UDDA). This is because the UDDA states that there must be the irreversible cessation of ALL functions of the entire brain, including the brain stem, for a legal declaration of death in the US. But the AAN guideline does not test all functions of the entire brain: it just tests for the triad of coma, loss of some brain stem reflexes, and lack of spontaneous breathing. In fact, the way doctors diagnose brain death has NEVER complied with the law under the UDDA.

Unfortunately, Aden Hailu died in early 2016 of cardiopulmonary arrest. The following year, in a surprising turn of events, the Nevada legislature responded to her case by changing state law so that now for Nevada citizens, brain death must be diagnosed according to the AAN guidelines, including any revised guidelines put forth by the AAN’s successor organizations in perpetuity. A 2017 news article reveals that representatives of organ donation networks were advising legislators as they drafted this new law. Nevada Revised Statute 451.007 now says that families may be responsible for all costs of life-sustaining treatment after a diagnosis of brain death unless the person becomes an organ donor. Jason Guinasso, a Reno lawyer with Donor Network West, said, “Our families need to understand that once they decide to give the gift of life, they are not going to be responsible for these charges.”

Following the Aden Hailu case, the AAN petitioned the Uniform Law Commission (ULC) to revise the UDDA across all US states to make the law reflect the limited scope of their brain death guideline. But after several years of study and debate, the ULC refused to act, tabling their work on revising the UDDA in September 2023. Just three weeks later, the AAN came out with their newest brain death guideline, essentially recapitulating the changes refused by the ULC.

7. The newest American Academy of Neurology guidelines explicitly allow declaring death even when partial brain function remains. How does this contradict the legal definition requiring "irreversible cessation of all functions of the entire brain"?

Once again, there were no new tests, studies, or evidence prompting the latest AAN guideline. Their Methods section is clear about this: “Because of a lack of high-quality evidence on the subject,” the new AAN guideline was determined by three rounds of anonymous voting, and they excluded the opinions of doctors who might disagree. Doesn’t it seem strange that after declaring people to be brain dead for nearly 60 years, there is still no high-quality evidence for it?

And the newest brain death guideline explicitly allows death to be declared in the presence of partial brain function. The previous guidelines have always stated by inference that a diagnosis of brain death could be made in the presence of a functioning hypothalamus, a part of the brain that provides neuroendocrine function. But the new guideline makes this explicit. “Clinicians may initiate a BD/DNC [brain death/death by neurologic criteria] evaluation and determine a patient BD/DNC [brain dead/dead by neurologic criteria] despite evidence of neuroendocrine function.” Obviously, this does not comply with the law under the UDDA which demands the “irreversible cessation of all functions of the entire brain, including the brain stem.”

So, the way doctors diagnose brain death does not comply with the law under the UDDA, except in the state of Nevada.

8. You've noted that Dr. Eelco Wijdicks, an author of brain death guidelines, stated that brain death diagnosis is primarily driven by organ transplantation needs. How does this utilitarian approach conflict with medical ethics?

According to Eelco F. Wijdicks, MD, PhD, a neurocritical care specialist at Mayo Clinic and an author of the 1995, 2010, and 2023 brain death guidelines, the diagnosis of brain death is driven by the desire for transplantable organs. He stated at a Vatican conference in 2006:

“…the diagnosis of brain death is driven by whether there is a transplantation programme (sic) or whether there are transplantation surgeons. I do not think brain death examination now, in practice, would have much if any meaning if it were not for the sake of transplantation.”

This reveals that brain death is not death, but a legal fiction, an ethical choice that is made to supply viable organs for transplantation. It violates the bioethical principles of:

1. Beneficence, which is the obligation to act for the benefit of the patient. Redefining certain neurologically injured people as being dead already to allow the removal of their organs in no way benefits the patient.

2. Nonmaleficence, which is the obligation not to harm the patient. “Brain death” is a prognosis, not a diagnosis of death. But it effectively removes human rights protections from these people who then are harmed either by having their support withdrawn or by becoming organ donors -- often without the benefit of proper anesthesia.

3. Autonomy, which is the ethical principle stating that people should have the power to make their own rational decisions about what shall be done with their bodies. The ongoing obfuscation surrounding the brain death prevents the public from being able to make informed decisions about their care at the end of life. Put bluntly, people are being given slogans (“give the gift of life”) instead of receiving the information they need to make a fully informed decision when they sign up to be an organ donor.

4. Justice is the fourth bioethical principle being violated. The number of people who have been hurt by the brain death diagnosis is legion. The conscience rights of people who both donate and receive organs is being violated by the lack of truth-telling involved. Families who contest a brain death diagnosis are mocked, vilified, and often escorted out of hospital rooms by security. (Jahi McMath’s family was reportedly told by her doctor, “What don’t you understand? She’s dead, dead, dead!”) Currently, there are eight US states with medical freedom laws that allow healthcare personnel to opt out of a brain death case, but only one state (New Jersey) that give patients the right to opt-out of brain death.

9. The National Catholic Bioethics Center, formerly a supporter of brain death, recently called the current situation "a decisive breakdown in shared understanding." What prompted this significant shift in their position?

Recognizing the disconnect between the law and the AAN guideline, the National Catholic Bioethics Center (NCBC), formerly a staunch advocate of brain death, issued a landmark position statement in April 2024:

“Events in the last several months have revealed a decisive breakdown in a shared understanding of brain death (death by neurological criteria) which has been critical in shaping the ethical practice of organ transplantation. At stake now is whether clinicians, potential organ donors, and society can agree on what it means to be dead before vital organs are procured.”

Because of these concerns, the NCBC, along with the Center for Law and the Human Person at the Catholic University of America and the Pellegrino Center for Clinical Bioethics at Georgetown University convened a symposium on brain death in February 2025. The symposium featured speakers both for and against the brain death concept, as well as speakers for and against the legitimacy of the AAN brain death guideline. Other speakers included nurses, bioethicists, and lawyers. At the conclusion of the conference, attendees had one very significant area of complete agreement: data to justify the brain death diagnosis is sadly lacking! This prompted some to call for a new study on brain death to be performed. During a brainstorming session about this proposed study, a philosopher raised her hand, “What will be your endpoint, given that we have no device to determine when the soul departs?”

10. When families are told their loved one is brain dead, they often see someone who appears very much alive - warm, with a beating heart, good oxygen levels. How do you advise families facing this confusing situation?

People confronted with this situation need to trust the evidence of their eyes. “Brain dead” people are very ill, and their prognosis may be death, but they are not dead already. There is nothing wrong with withdrawing ineffective care at the end of life and allowing a loved one to die in a dignified manner. I tell people in this situation to hold their dear one in their arms, to pray over them, sing to them, and let them pass into eternity knowing that they were loved. What they should not do is send their relative into a cold operating room to be dismembered to death among strangers, often with just paralyzing drugs instead of a proper anesthetic.

But nothing is lost by continuing to provide aggressive care to optimize brain blood flow in case the person is in a state of GIP, which is an exact mimic of brain death, and from which recovery is still possible. No one should be forced to withdraw care because of this contrived and false diagnosis that does not comply with US law. I advise people to seek legal representation to prevent hospitals from disconnecting support over the family’s objections. New Jersey has allowed people to do this for years, and that state is not financially any worse off than any other state. People should be able to opt-out of a brain death diagnosis for any reason.

Sadly, if you are a registered organ donor, your organs will be taken. Organ procurement organizations have successfully sued families and have harvested the organs of registered donors over the objections of their families. This is why I recommend that no one be a registered organ donor.

11. You mention that 50-84% of patients declared brain dead still have functioning hypothalamus. Why is hypothalamic function significant, and what does this mean for the brain death diagnosis?

The NCBC’s statement I referenced above cites the fact that between 50-84% of patients declared brain dead still have a functioning hypothalamus. What is the hypothalamus? The NCBC statement describes it this way:

“The hypothalamus can be understood as a kind of “smart” coordinating center in the brain which is involved in regulating temperature, salt-water balance, sex drive, and sleep. Recent studies show that it may play a role in phenomenal awareness and pain detection. Hypothalamic functioning shows that not all functions of the entire brain have ceased, as stipulated by the UDDA. Consequently, patients with confirmed hypothalamic function should not be diagnosed as brain dead, nor treated as dead, for the purpose of organ procurement.”

In the US, the legal standard for brain death is the irreversible cessation of all functions of the entire brain, including the brain stem. This means that not only are these people not biologically dead, but under US law neither are they legally dead, leaving physicians open to lawsuits.

12. The organ transplantation industry was worth $48 billion in 2020. How do financial incentives potentially influence medical decision-making around brain death diagnoses?

The transplant industry has a large financial lobby which continues to push research funding back into transplantation. Meanwhile, other new and innovative solutions for organ failure go unfunded. For example, we should have had an artificial heart long ago.

Also, we are way behind where we should be in our ability to treat brain injury because we are writing off all the difficult cases and making them organ donors. What if we had treated cancer this way, saying in 1968 that cancer was irreversible and too difficult to treat?

13. You've spoken about the dehumanizing language often used - terms like "vegetable" or "brain dead." How does this language affect both families and medical professionals?

Historically, dehumanizing language has been used to remove human rights from people deemed less socially valuable. When you are declared brain dead, the electronic hospital medical record actually takes away your name and gives you a number! This dehumanizing language makes it easier to treat people as objects, and in the case of organ procurement, as a bag of spare parts.

In my public speaking, people who are in favor of brain death are often very sensitive to language too. I have been chided for using the term organ “harvesting” instead of “procurement.” I have also been taken to task for using the term “homicide” for what happens to organ donors in the operating room. So, I try to minimize emotionally charged language so as not to alienate people. But while I do try to avoid using the term “murder,” I am still trying to come up with a better word than homicide…physician-assisted death? Medical aid in dying?

14. The case of TJ Hoover, who woke up during organ procurement, made headlines recently. How common do you believe such cases might be, and what does this reveal about current practices?

For those unfamiliar with the case, in 2021 a supposedly brain dead man, Anthony Thomas “TJ” Hoover II, opened his eyes and looked around while being wheeled to the operating room to donate his organs. Hospital staff at Baptist Health hospital in Richmond, Kentucky assured his family that these were just “reflexes.” But organ preservationist Natasha Miller also thought Hoover looked alive. “He was moving around – kind of thrashing. Like, moving, thrashing around on the bed,” said Miller in a National Public Radio interview. “And then when we went over there, you could see he had tears coming down. He was visibly crying.” Thankfully, the procedure was called off, and Hoover was able to recover and even dance at his sister’s wedding.

Because brain death is not true biological death, but merely a social construct, I can tell you exactly how many of these people are still alive: all of them. But there is no way of knowing how many are still inwardly aware because doctors have no way of detecting consciousness. We can only tell if people are able and willing to respond, which is not the same thing. In 2007, Zack Dunlap was declared brain dead, but after a cousin (and not his medical team) proved that he was able to respond to a painful stimulus, Zack made a full recovery. Later, Zack said that he had heard doctors telling his parents that he was dead! He said he felt angry but was unable to move or sign that he was alive and listening. Doctors call this inability “cognitive motor dissociation” and are beginning to realize that it’s much more common than previously thought. Because most brain dead people very quickly either have their care withdrawn or become organ donors, there’s no way to know how many were still aware. Brain death is a self-fulfilling prophecy.

15. What are you currently focused on in your advocacy work, and how can people who want to learn more about these issues stay connected with your research and writing?

I just finished volunteering to help translate a Dutch book called “Organ Donation: A Matter of Life and Death” into English. Currently, I am preparing to give a paper against brain death at the annual meeting of the Center for Bioethics and Human Dignity, and just after that I am presenting these same facts at a medical grand rounds for physicians via Zoom. I am also in the middle of producing a series of short videos for the lay public on such topics as brain death, circulatory death, tissue donation, and whole body donation which can be viewed on my YouTube channel (@HeidiKlessigMD). People who want to learn more can find my book, “The Brain Death Fallacy,” on Amazon, or visit my website at respectforhumanlife.com, or follow my X account @heidiklessigmd.

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