PLoS One
1 in 4 doctors say brain preservation after death could work
Source: Apex Neuroscience
Clinical Takeaway: Physicians may increasingly field patient questions about preservation as an end-of-life option. Even skeptical clinicians may want a framework for handling these requests, since most respondents said they would accommodate patient preferences within current standards of care.
Preservation procedures, including cryopreservation and aldehyde-based fixation, aim to maintain brain structure after legal death in the hope that future technology could enable revival. Several hundred individuals globally have opted for preservation, with thousands more signed up. But the medical community has lacked consensus on how to think about these requests or the clinical steps that might improve outcomes.
Physicians were split but leaned toward skepticism. Asked how plausible they found the idea that preservation could eventually allow some form of revival, 27.9% answered somewhat or very plausible, 47.0% answered somewhat or very implausible, and the rest were neutral or uncertain. Neurosurgeons rated revival highest. Palliative care and radiology rated it lowest.
Most respondents were willing to accommodate patients who chose preservation. A clear majority (58.1%) saw preservation as compatible with compassionate, patient-centered care, and 49.1% reported personal comfort with patients choosing it. Pre-mortem anticoagulation, intended to limit clots that hamper brain perfusion, was endorsed by 70.7% of respondents, with 11.7% opposed.
For terminally ill patients choosing preservation alongside medically assisted dying, 44.3% supported beginning preservation procedures after the patient was unconscious but before cardiac arrest, while 28.8% opposed. Pre-cardiac arrest preservation is currently not legally permitted anywhere in the world.
About 1 in 5 physicians worried that steps to improve preservation could conflict with best standards of care, a smaller but clinically meaningful concern that may shape how requests are handled at the bedside.
Two patterns predicted greater openness. Physicians more familiar with preservation rated revival more plausible and were more comfortable discussing it with patients. Physicians who more frequently engaged in end-of-life discussions were also more supportive of pre-cardiac arrest procedures.
Researchers surveyed 334 U.S. physicians in October 2025. The cohort included 150 primary care physicians and 184 specialists across neurology, neurosurgery, psychiatry, intensive care, anesthesiology, emergency medicine, palliative care, pathology, and radiology.
The authors argue physician openness, paired with current legal ambiguity around pre-mortem interventions and post-mortem procedures, supports developing clearer clinical and legal frameworks for patients who request these procedures.
"A lot of physician hesitancy may come from simple unfamiliarity with the scientific basis of modern preservation methods. The doctors who have actually thought about this, and who regularly sit with dying patients, tend to be more receptive, not less," said lead author Ariel Zeleznikow-Johnston, PhD, of the School of Psychological Sciences at Monash University.
Source: Zeleznikow-Johnston A. PLoS One. 2026 May 20. Physician estimates of the feasibility of preserving the dying for future revival