Comment: Is international consensus on brain death achievable?

The wide diversity of brain death practices and perceptions throughout the world catalogued by Wahlster et al.1 raises the question of whether agreement on international standards and practices of brain death is an achievable goal. Worldwide concurrence on death determination criteria can enhance public confidence in physicians' ability to determine death by eliminating the possibility that patients declared dead in one jurisdiction would be considered alive in another. International harmonization also is a constructive step toward improving global systems of organ transplantation. But as the WHO has found,2 formidable medical and societal barriers must be overcome before such consensus becomes possible.