Diagnosis and dilemas: the intersection between brain death and bioethics

Abstract

Brain death is a complex medical and bioethical concept that requires rigorous diagnostic criteria to ensure
accuracy and safety. In Brazil, Federal Medical Council Resolution 2,173/2017 establishes a protocol that
combines a detailed neurological clinical examination—absence of responsiveness, brainstem reflexes,
and apnea—with complementary tests, such as transcranial doppler, angiotomography, and perfusion
studies, especially in inconclusive cases. This literature review compares national and international
guidelines and discusses the application of Beauchamp and Childress’ bioethical principles – autonomy,
beneficence, non-maleficence, and justice – in the doctor-patient relationship to respect dignity, values,
and cultural context. The integration of medical science, diagnostic technology, and ethical principles
favors safer, more humane, and legally supported decisions. Despite the limitations inherent in narrative
reviews, the research reinforces the need for standardized protocols and suggests future investigations
into diagnostic accuracy and the practical application of bioethical principles in determining brain death.