Definition of Brain Death

1983 ◽  
Vol 40 (1) ◽  
pp. 5-14
Author(s):  
John J. Paris ◽  
Ronald E. Cranford
Keyword(s):  
Public Policy ◽  
Brain Death ◽  
Policy Position ◽  
Determination Of Death ◽  
Definition Of

“It is important to be clear on what determination of death statutes involve…. It is equally important to understand the objections to such legislation, analyze and evaluate them, and devise a coherent public policy position on the issue. That policy must be medically sound, ethically appropriate, and theologically acceptable.”

scholarly journals Does the Uniform Determination of Death Act Need to Be Revised?

2020 ◽  
Vol 87 (3) ◽  
pp. 317-333 ◽  
Author(s):  
Doyen Nguyen
Keyword(s):  
Brain Death ◽  
Legal Status ◽  
Determination Of Death ◽  
Moral Principles ◽  
Root Cause ◽  
Brain Functions ◽  
Christian Anthropology ◽  
The Status ◽  
Definition Of

Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain death (BD), Lewis and colleagues recently proposed a revision of the Uniform Determination of Death Act (UDDA). The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination. By analyzing Lewis and colleagues’ revision, this article shows that this revision is fraught with difficulties. Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust. Summary: This article critically examines the recent revision of the Uniform Determination of Death Act (UDDA) advanced by Lewis and colleagues. The revision only further reinforces the status quo of brain death without taking into account the root cause of the litigations and controversies about the declaration of death by neurological criteria. In view of this deficiency, this article offers two approaches to revising the UDDA, both of which are founded on sound moral principles.

Death, Brain Death, and the Limits of Science: Why the Whole-Brain Concept of Death is a Flawed Public Policy

2010 ◽  
Vol 38 (3) ◽  
pp. 667-683 ◽  
Author(s):  
Mike Nair-Collins
Keyword(s):  
Public Policy ◽  
Brain Death ◽  
Brain Stem ◽  
Real World ◽  
Determination Of Death ◽  
Whole Brain ◽  
Legislative Changes ◽  
The Brain ◽  
Irreversible Cessation

The 1981 Uniform Determination of Death Act (UDDA) states:An individual that has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.The “whole-brain concept of death,” appealed to in the UDDA, has been roundly criticized for many years. However, despite a great deal of legitimate criticism in academic circles no real clinical or legislative changes have come about. At least one reason for this inertia is aptly stated by James Bernat, one of the principal and founding proponents of the brain death doctrine: “In the real world of public policy on biological issues, we must frequently make compromises or approximations to achieve acceptable practices and laws.” While acknowledging that the brain death doctrine is not flawless and that he and other proponents have been unable to address all valid criticisms, Bernat nonetheless maintains that the brain death doctrine is optimal public policy.

scholarly journals Pope John Paul II and the Neurological Standard for the Determination of Death: A Critical Analysis of his Address to the Transplantation Society

2017 ◽  
Vol 84 (2) ◽  
pp. 155-186 ◽  
Author(s):  
Doyen Nguyen
Keyword(s):  
Brain Death ◽  
Catholic Church ◽  
The Body ◽  
Human Organism ◽  
Determination Of Death ◽  
Pope John Paul Ii ◽  
John Paul Ii ◽  
The Brain ◽  
The Catholic Church

The introduction of the “brain death” criterion constitutes a significant paradigm shift in the determination of death. The perception of the public at large is that the Catholic Church has formally endorsed this neurological standard. However, a critical reading of the only magisterial document on this subject, Pope John Paul II's 2000 address, shows that the pope's acceptance of the neurological criterion is conditional in that it entails a twofold requirement. It requires that certain medical presuppositions of the neurological standard are fulfilled, and that its philosophical premise coheres with the Church's teaching on the body-soul union. This article demonstrates that the medical presuppositions are not fulfilled, and that the doctrine of the brain as the central somatic integrator of the body does not cohere either with the current holistic understanding of the human organism or with the Church's Thomistic doctrine of the soul as the form of the body. Summary The concept of “brain death” (the neurological basis for legally declaring a person dead) has caused much controversy since its inception. In this regard, it has been generally perceived that the Catholic Church has officially affirmed the “brain death” criterion. The address of Pope John Paul II in 2000 shows, however, that he only gave it a conditional acceptance, one which requires that several medical and philosophical presuppositions of the “brain death” standard be fulfilled. This article demonstrates, taking into consideration both the empirical evidence and the Church's Thomistic anthropology, that the presuppositions have not been fulfilled.

Brain Death

2017 ◽  
Author(s):  
Anupamaa Seshadri ◽  
Ali Salim
Keyword(s):  
Brain Death ◽  
Apnea Test ◽  
Brainstem Reflex ◽  
Practice Parameters ◽  
Confirmatory Tests ◽  
History Of ◽  
Pediatric Populations ◽  
Definition Of

The concept of “brain death” is one that has been controversial over time, requiring the development of clear guidelines to diagnose and give prognoses for patients after devastating neurologic injury. This review discusses the history of the definition of brain death, as well as the most recent guidelines and practice parameters on the determination of brain death in both the adult and pediatric populations. We provide specific and detailed instructions on the various clinical tests required, including the brain death neurologic examination and the apnea test, and discuss pitfalls in the diagnosis of brain death. This review also considers the most recent literature and guidelines as to the role of confirmatory tests making this diagnosis.  Key Words: apnea test, brain death, brainstem reflex, death examination

Building a Fence Around Brain Death: The Shielded-Brain Formulation

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012641
Author(s):  
Douglas J Gelb
Keyword(s):  
Clinical Practice ◽  
Brain Death ◽  
Determination Of Death ◽  
Clinical Standards ◽  
History Of ◽  
Uniform Law ◽  
New Formulation ◽  
Law Commission ◽  
Current Practices

The concept of brain death was proposed more than 50 years ago and it has been incorporated in laws and clinical practice, but it remains a source of confusion, debate, and litigation. Because of persistent variability in clinical standards and ongoing controversies regarding policies, the Uniform Law Commission (ULC), which drafted the Uniform Determination of Death Act (UDDA) in 1980, has appointed a committee to study whether the act should be revised. This article reviews the history of the concept of brain death and its philosophical underpinnings, summarizes the objections that have been raised to the prevailing philosophical formulations, and proposes a new formulation that addresses those objections while preserving current practices.

Challenges to the Determination of Death by Neurological Criteria

2019 ◽  
Vol 19 (4) ◽  
pp. 583-599
Author(s):  
Tadeusz Pacholczyk ◽  
Stephen Hannan ◽  
Keyword(s):  
Brain Death ◽  
Determination Of Death ◽  
Ethical Concerns ◽  
Diagnostic Practices ◽  
Testing Potential ◽  
Brain Dead ◽  
Testing Protocols ◽  
The Brain ◽  
Apnea Testing

Ethical concerns regarding the conceptual framework for the determination of death by neurological criteria, including several clinical and diagnostic practices, are addressed. The significance of a diagnosis of brain death, diagnostic criteria, and certain technical aspects of the brain-death exam are presented. Standard and ancillary tests that typically help achieve prudential certitude that an individual has died are indicated. Ethical concerns surrounding interinstitutional variability of testing protocols are evaluated and considered, as are potential apnea-testing confounders such as hypotension, hypoxemia, hypercarbia, and penumbra effects during ancillary testing. Potential adjustments to apnea-testing protocols involving capnography, thoracic impedance monitors, or spirometers to assess respiratory efforts are discussed. Situations in which individuals determined to be brain dead “wake up,” or fail to manifest the imminent cessation of somatic functioning typically seen when supported only by a ventilator, are also briefly reviewed.

The Determination of Death

1977 ◽  
Vol 7 (4) ◽  
pp. 277-296 ◽  
Author(s):  
Gerald M. Devins ◽  
Robert T. Diamond
Keyword(s):  
Brain Death ◽  
Science And Technology ◽  
Medical Science ◽  
Determination Of Death ◽  
Recent Developments ◽  
The Brain

Recent developments in medical science and technology have rendered obsolete the traditional medical criteria for determining death in a small but growing number of terminal patients. Philosophical problems encountered in attempts to develop a more sophisticated set of operational procedures are discussed. Both the traditional conditions indicating death as well as more recent reformulations required to pronounce a state of brain death in those moribund individuals in whom the traditional signs have been obscured are reported. Finally, some of the medical, legal, and social considerations which arise from recognition of the brain death definition are discussed briefly.

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