In 1968, a group of Harvard faculty proposed the first clinical definition as the Harvard Brain Death Criteria, which consisted of clinical and EEG criteria. Neurologists began to postulate that neurologic function was equally or more vital than cardiopulmonary function, and began a process to define death neurologically, independent of other essential organ functions. In 1959, the concept of brain death/death by neurologic criteria (BD/DNC) was first theorized as “le coma dépassé”, by Mollaret and Goulon, who described an apneic, comatose patient without brainstem reflexes or electroencephalographic (EEG) activity.

In the years that followed, the development of advanced live support measures including cardiopulmonary resuscitation (CPR) and positive pressure ventilation (PPV) brought this interdependence and the traditional definition of death into question. It naturally followed that cessation of brain function occurred after the loss of respiration and circulation, and indeed loss of brain activity was considered a critical component of death. Preceding the 1950s, the concept of death revolved around cessation of cardiorespiratory function.

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