Indeed, both the concept of brain death and the application of ‘brain death’ diagnostic criteria have brought about a lot of opposition within the medical community. Eminent doctors in Greece (K. Karakatsanis 2001, E. Panagopoulos 1998, M. Vrettos, 1999, I. Kountouras 1999, K. Christodoulidis 1995, N. Balamoutsos 1999, N. Konstantinides 1999, M. Giala 1999, A. Avramidis 1995, P. Kougias 1999, A. Goulianos 1999 and others) and abroad (R.D. Truog 1992, D.A. Shewmon 1997, R.M. Taylor 1997 and others) raise strong medical objections or even suggest abandoning the very concept of “brain death”. 
According to Dr Robert D. Truog, Professor of Child Anaesthesiology at Harvard University and director of ICU at Children’s Hospital, Harvard Medical School, Boston “ ‘brain death’ remains incoherent in theory and confused in practice. Moreover, the only purpose served by the concept is to facilitate the procurement of transplantation organs.” 
Interestingly, in the state of New Jersey, USA, the law forbids the doctor to pronounce dead every patient who is opposed to the concept of ‘brain death’ .
In Greece Dr Emmanuel Panagopoulos, assistant director of the 2nd Surgery Clinic at “Agios Savvas” Hospital in Athens and Professor of Surgery at the University of Athens, explicitly states that “ ‘brain death’ is a process of death but not death”.  Asked whether in a ‘brain dead’ person the process of disintegration has started, Dr Em. Panagopoulos highlights that this is not the case, since “what we, doctors, do through technologically supporting a brain dead person is delaying the coming of death. In other words, there is no disintegration then.”  Moreover, another eminent doctor, Dr Konstantinos Karakatsanis, Associate Professor of Nuclear Medicine at the Aristotle University of Thessaloniki, pinpoints that “biological death is not a continuous process but an instantaneous event”. 
Finally, Dr Alan Shewmon, initially an ardent supporter of ‘brain death’, after studying ‘brain dead’ people with a prolonged survival, shift his ground and now explicitly states that “only a circulatory-respiratory statutory definition has the potential for universal acceptance.” 
According to Dr Mita Giacomini, Assistant Professor at Mc Master University, Ontario, Canada, who studied extensively the files and proceedings of the Harvard ad hoc committee, the decision made was distorted and adulterated in relation to medical data. The findings of Giacomini’s research were that “the early criteria for brain death did not emerge solely from physical features of the dead or even from the capacities of diagnostic and life-support technologies. Brain dead bodies had to be created, recognized, described and defined in the development of brain death criteria: brain death was socially as well as clinically constructed.”  Indeed, a host of experts (Taylor 1997, Truog 1997, Raper & Fisher 1995  and others) agree that the concept of brain death is not equated with that of death and that it was invented for the purpose of harvesting organs for transplantation.
Most organ donors seem to be ignorant of the term ‘brain death’ and what really takes place in the operating theatre. “When they read the phrase ‘after my death’ many imagine a pulseless corpse and might be horrified to learn that it really means and thatMoreover, no one is informed that the rationale for equating “brain death” with death remains controversial and that empirical evidence has been accumulating that casts serious doubt on the mainstream rationale. Thus, information highly relevant for the potential donor’s moral decisionmaking is systematically withheld.” With these words we are introduced to the problem by the distinguished Professor of Child Neurology at UCLA (University of California, Los Angeles), Dr Alan Shewmon. Indeed, both the concept of brain death and the application of ‘brain death’ diagnostic criteria have brought about a lot of opposition within the medical community. Eminent doctors in Greece (K. Karakatsanis 2001, E. Panagopoulos 1998, M. Vrettos, 1999, I. Kountouras 1999, K. Christodoulidis 1995, N. Balamoutsos 1999, N. Konstantinides 1999, M. Giala 1999, A. Avramidis 1995, P. Kougias 1999, A. Goulianos 1999 and others) and abroad (R.D. Truog 1992, D.A. Shewmon 1997, R.M. Taylor 1997 and others) raise strong medical objections or even suggest abandoning the very concept of “brain death”.According to Dr Robert D. Truog, Professor of Child Anaesthesiology at Harvard University and director of ICU at Children’s Hospital, Harvard Medical School, Boston “ ‘brain death’ remains incoherent in theory and confused in practice. Moreover, the only purpose served by the concept is to facilitate the procurement of transplantation organs.”Interestingly, in the state of New Jersey, USA, the law forbids the doctor to pronounce dead every patient who is opposed to the concept of ‘brain death’.
2. Serious objections have been expressed about the substantiation of the term ‘necrosis of the brainstem because this term “is pathologoanatomical and can be substantiated only after the posthumous removal of the patient’s brain and its examination by a special pathologist”.  As a result, experts in Greece and abroad support that “brain death has never acquired a precise clinical or pathological basis and its diagnostic criteria are, therefore, arbitrary.” 
3. Some patients who met the clinical criteria for brain death survived much longer than the anticipated survival period, which is usually less than 2 weeks.  Specifically, Truog (1992), Shewmon (1998) and Karakatsanis (2001) mention cases of ‘brain dead’ patients who survived from 36 days up to 6 months and also a few cases of ‘brain dead’ patients who survived from 6 months up to 17 years after the diagnosis of ‘brain death’. In other words, ‘brain death’ does not lead to imminent cardiac arrest.  Or simply put, we should not confuse the prognosis of ‘dying’ with the diagnosis of death.
4. The difficulties in diagnosing ‘brain death’ were shown in a 1989 study concerning doctors and nurses involved in the harvesting of organs for transplantation. The study proved that “only 42% of the doctors and 25% of the nurses correctly identified the legal and medical criteria for the definition of death, which revealed the confusion around the issue.”  Furthermore, a more recent study in 1999 presented to the Society of Critical Care Medicine demonstrated that “only 39% of pediatric attending physicians correctly defined brain death…Neurologists, neonatologists and other subspecialists were less accurate than pediatric intensivists in correctly defining brain death, interpreting a clinical scenario, and determining whether confirmatory testing was necessary.”  Notably, Dr E. Wijdicks, Professor of Neurology at Mayo Clinic, USA, provides us with valuable information : 22% of 93 children who were considered ‘brain dead’ did not have their organs removed, despite their parents’ consent for organ transplantation, because after a careful neurologic examination it was ascertained that the ‘brain death’ diagnosis was erroneous. 
5. It is noteworthy that ‘brain dead’ people, if properly supported, maintain a steady temperature and many ‘brain dead’ patients retain complex, spinal reflexes, absorb and digest food, gain weight, heal up wounds, continue their pregnancy for weeks or months and give (Caesarean) birth to viable infants. 
6. Despite the fact that, according to the 9/20-3-1985 decree of the Greek National Heath Council, death is defined as the irreversible loss of consciousness and the irreversible loss of spontaneous respiration, “there do not exist medical or other criteria for the diagnosis of the loss of consciousness, since consciousness is by nature a subjective experience … Furthermore, it is impossible to check for the performed content of consciousness”.  And in the 2nd International Symposium on ‘Brain Death’ in 1996 it was supported that “deeply comatose patients fulfilling all brainstem criteria of death, with destroyed brainstems but preserved cerebral hemispheres, might be capable of thinking, feeling and so forth.” 
7. What is the interpretation of the existence of unusual, complex movements, known as “Lazarus sign” made by some ‘brain dead’ people? Dr Fred Plum, eminent Professor of Neurology, defines these movements as “semipurposeful” and “semidirected”. 
8. Could the rare, yet recorded, cases of what has been called recovery from ‘brain death’ be concealed? 
Issues in Law and Medicine , 1998, Vol 14, No 2.
KENNEDY INST , ETHICS J, 1991.
tion of brain death. JAMA 1968, 205 : 85-88.
Med 1997, Vol 44, No 10 : 1465-1482
newspaper ‘Kathimerini’, 12 September 1999.
Greek newspaper ‘Kathimerini’, 10/10/1999 and Archimandrite Tsioutsikas Lucas (doctor), Questioning about the issue
of transplantations, Greek magazine ‘Parakatathiki’, September-October 2000, issue 14.
Havana: could a definitive conceptual re-approach be expected? In: Brain Death. Developments in Neurology 9 ,
Contemporary controversies. Youngner SJ, Arnold Rm, Schapiro R, Eds, The Johns Hopkins University, Baltimore and
London, 1999, σελ. 34-65.
Goumenissa, Axioupolis and Polykastron, The astonishing testimony of a great miracle of faith: How a cerebrally-dead
Greek young man was reanimated! ‘Epaggelia’, No 96, May 2001.