Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation. [1] There is no documented case of a person who fulfils the preconditions and criteria for brain death ever subsequently developing any return of brain function. [2,3] Clear medical standards for death certification augment the quality and rigor of death determination. [4][5][6] Currently there are no clinical guidelines on death determination in South Africa (SA), with clinicians using available international guidelines, which vary markedly and are not always applicable to the SA context. [7][8][9][10] The World Federation This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.