Brain death in pregnancy: what will be left of the life of foetus?

2020 ◽  
Vol 69 (3) ◽  
pp. 281-291
Author(s):  
Matteo Gulino ◽  
Gianluca Montanari Vergallo ◽  
Rosagemma Ciliberti ◽  
Antonio G. Spagnolo

Brain death in pregnancy (BDinP) has been described in literature as a “rare event” and “hopeless condition for patients”, who has a devastating potential to negatively affect the poetry of the moment of welcoming a new human life to the world. Clinical consequences of BDinP are extremely dangerous for the life of a foetus that, without prompt medical actions, is doomed to suffer the same fate as the mother. Modern medical techniques make it possible to maintain basic vital functions of the pregnant woman for months, in order to achieve a level of development of the foetus. Although maternal somatic support requires the consideration of specific medical parameters, from a bioethical standpoint, this option gives rise to multiple ethical and social implications. In this manuscript, we identify the main ethical and social implications about maternal somatic support, including the potential impact on the clinical practice of medical staff, and discuss some Italian high-impact media cases.* The authors contributed equally to the work.

Author(s):  
Maria Gaia Dodaro ◽  
Anna Seidenari ◽  
Ignazio R. Marino ◽  
Vincenzo Berghella ◽  
Federica Bellussi

2021 ◽  
Vol 88 (2) ◽  
pp. 149-162
Author(s):  
Charles C. Camosy ◽  
Joseph Vukov

Double Effect Donation claims it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. The reason this act is permissible is that it does not aim at one’s own death but rather at saving the lives of others and because saving the lives of others constitutes a proportionately serious reason for engaging in a behavior in which one foresees one’s death as the outcome. Double Effect Donation, we argue, opens a novel position in debates surrounding brain death and organ donation and does so without compromising the sacredness and fundamental equality of human life. Summary: Recent cases and discussion have raised questions about whether brain death criteria successfully capture natural death. These questions are especially troubling since vital organs are often retrieved from individuals declared dead by brain death criteria. We therefore seem to be left with a choice: either salvage brain death criteria or else abandon current organ donation practices. In this article, we present a different way forward. In particular, we defend a view we call Double Effect Donation, according to which it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. Double Effect Donation, we argue, is not merely compatible with but grows out of a view that acknowledges the sacredness and fundamental equality of human life.


2021 ◽  
Vol 19 ◽  
Author(s):  
Rebecca L Bromley ◽  
Matthew Bluett-Duncan

: Exposure in the womb to antiseizure medications and their potential impact on the developing child's brain has long been researched. Despite this long period of interest, this review highlights above the well-known risks associated with valproate exposure; more data is required for conclusions regarding all other antiseizure medications. Limited experience with phenytoin and phenobarbital in monotherapy clearly defines the risk to later child postnatal functioning difficult. However, the evidence of an impact is stronger for phenobarbital than for phenytoin. The widely prescribed lamotrigine is limited in its investigation compared to unexposed control children. It has been demonstrated to carry a lower risk than valproate for specific outcomes; whether associated with a more moderate impact on broader aspects of neurodevelopmental functioning is still to be understood. Data for levetiracetam, topiramate, and oxcarbazepine are too limited to conclude most neurodevelopmental outcomes confidently. This slow accumulation of evidence impacts the safest use of medications in pregnancy and makes counseling women regarding the risks and benefits of specific antiseizure drugs difficult. Improved focus, funding, and research methodologies are urgently needed.


Author(s):  
Olha Peresada ◽  

The article considers topical issues of definition and qualification of crimes against human life in Ukraine and abroad. It is proved that the problematic issue of criminal law protection of human life is a significant differentiation of approaches to determining the moment of its onset, which reflects the medical and social criteria for the formation of an individual who has the right to life. It is shown that Ukrainian criminal law gives a person the right to life from birth, while the correct approach is to recognize the beginning of human life and appropriate criminal protection from the moment of onset 10 days after conception, which is consistent with European experience (in particular, France) and sufficiently reflects the medical features of the period of formation of a full-fledged embryo. The article also addresses the issue of the fact that Section II of the Special Part of the Criminal Code of Ukraine combines encroachment on two different generic objects - public relations for the protection of life and public relations for the protection of personal health. This provision of the criminal law of Ukraine does not correspond to the international practice on this issue. In addition, it is reasonable to believe that the two relevant categories of the object of criminal encroachment cannot be considered similar, as such an approach in certain cases can significantly complicate the classification of a criminal offense. It is emphasized that, given the exceptional importance of criminal law protection of human life, it is necessary to formulate a separate section of the Special Part of the Criminal Code of Ukraine, which covers only crimes against life as the main object of criminal encroachment.


Author(s):  
Aimee R Hayes ◽  
Anthony J O'Sullivan ◽  
Mark A Davies

Summary Pituitary apoplexy is a rare event in pregnancy. A 41-year-old woman with a known pituitary microadenoma presented with visual disturbance and headache during the second trimester of pregnancy. Magnetic resonance imaging (MRI) demonstrated pituitary apoplexy with chiasmal compression. After treatment with corticosteroid therapy, she underwent transsphenoidal excision of the pituitary adenoma. Visual abnormalities were completely restored and pituitary function preserved. There was no evidence of impact on the foetus. The literature on the subject is reviewed with emphasis on the management of the apoplectic patient with mild and stable neuro-ophthalmological signs. Learning points There are no clear guidelines on the management of pituitary apoplexy in pregnancy. A multidisciplinary approach can minimise morbidity and mortality. Pituitary apoplexy has an unpredictable clinical course and determining which clinical situations warrant early surgery needs to take into consideration the presence and severity of neurological signs and their stability. The management of conscious apoplectic patients with absent or mild and stable neuro-ophthalmological signs is controversial.


2021 ◽  
Author(s):  
Mirko Piersanti ◽  
Massimo Materassi ◽  
Roberto Battiston ◽  
Vincenzo Carbone ◽  
Antonio Cicone ◽  
...  

<p>The short-term prediction of earthquakes is an essential issue connected with human life protection and related social and economics matter. Recent papers have provided some evidence of the link between the lithosphere, lower atmosphere, and ionosphere, even though with marginal statistical evidence. The basic coupling hypothesized being via atmospheric gravity wave (AGW)/acoustic wave (AW) channel. In this work we analyse the scenario of the low latitude earthquake (Mw=6.9) occurred in Indonesia on August 5, 2018, through a multi-instrumental approach, using ground and satellites high quality data. As a result, we derive a new analytical lithospheric-atmospheric-ionospheric-magnetospheric coupling model with the aim to provide quantitative indicators to interpret the observations around 6 hours before and at the moment of the earthquake occurrence.</p>


2013 ◽  
Vol 62 (4) ◽  
Author(s):  
Carlo Casini ◽  
Marina Casini

Dopo vivacissisimi dibattiti e diverse decisioni giudiziarie, il Parlamento irlandese ha approvato nel luglio 2013 la legge sull’aborto Protection of Life During Pregnancy Act (2013) che però non ha fatto cessare le discussioni né sopito le inquietudini. Il contributo, supportato da un’ampia documentazione, si muove contemporaneamente su tre piani: vengono esaminati i profili giuridici (costituzionali, referendari, legislativi e giurisprudenziali) della storia dell’aborto in Irlanda, evidenziando gli aspetti che rendono peculiare la vicenda irlandese rispetto a quella degli altri Paesi europei; affronta la questione dello statuto giuridico dell’embrione umano nell’ordinamento irlandese sia nell’ambito dell’aborto, sia in quello della fecondazione artificiale (diffusa nella prassi e legittimata dalla giurisprudenza); offre interpretazioni e prospettive concrete per tutelare la vita umana sin dal momento della fecondazione in un contesto che, invece, tende a sottrarre la protezione nei primi 14 giorni di vita dell’embrione umano. One of us, l’iniziativa dei cittadini europei, promossa sulla base del Trattato di Lisbona, si presenta come una straordinaria occasione per svolgere un ruolo di contenimento delle possibili derive negative della legge recentemente approvata e per mantenere nella società la consapevolezza che la dignità umana è uguale per tutti gli esseri umani, così tutti, sin dal concepimento, sono titolari del diritto alla vita. I cittadini irlandesi potrebbero confermare con la vastità delle adesioni a “Uno di noi” la stessa volontà manifestata nei referendum del 1983, del 1997 e del 2002: “lo Stato riconosce il diritto alla vita del bambino che deve nascere”. ---------- After several lively debates and judicial decisions, the Irish parliament passed a law on abortion in July 2013 Protection of Life During Pregnancy Act (2013) which, however, has not put an end to the discussion or calmed anxieties. The contribution, supported by extensive documentation, moves simultaneously on three levels: 1. examining the legal aspects (constitutional, referendums, legislation and judicial decisions) of abortion’s history in Ireland highlighting those that make that history unique compared to other European countries; 2. dealing with the question of the legal status of the human embryo into the Irish legal system regarding both abortion, and artificial insemination (widely practiced and legitimized by law); 3. offers interpretations and concrete prospects for protecting human life from the moment of fertilization in a context which, however, tends to deprive human life of protection in the first 14 days of life. One of us, the European citizens’ initiative, promoted on the basis of the Treaty of Lisbon, is presented as an extraordinary opportunity to play a role in limiting the possible negative tendencies of the law recently passed and to maintain awareness in society that human dignity is the same for all human beings. So everyone, from conception, is entitled to the right to life. In particular, One of us gives Irish citizens the great chance to confirm the same desire expressed in the referenda of 1983, 1992 and 2002 – “The State acknowledges the right to life of the unborn child” – by signing in great numbers the “One of Us” citizen’s initiative.


2006 ◽  
Vol 130 (4) ◽  
pp. 533-535 ◽  
Author(s):  
Madalina Tuluc ◽  
Daniel Brown ◽  
Bruce Goldman

Abstract Subarachnoid hemorrhage represents a rare event in pregnancy with a high mortality rate. We present the case of a 39-year-old pregnant woman who developed right vertebral artery dissection with subsequent massive subarachnoid hemorrhage with fatal outcome. The macroscopic and microscopic autopsy findings are described. A review of the literature with a discussion of the varied predisposing factors for vertebral artery dissection and subarachnoid hemorrhage and the rarity of these events in pregnancy is provided.


Author(s):  
David M Hill ◽  
Allison N Boyd ◽  
Sarah Zavala ◽  
Beatrice Adams ◽  
Melissa Reger ◽  
...  

Abstract Keeping abreast with current literature can be challenging, especially for practitioners caring for patients sustaining thermal or inhalation injury. Practitioners caring for patients with thermal injuries publish in a wide variety of journals, which further increases the complexity for those with resource limitations. Pharmacotherapy research continues to be a minority focus in primary literature. This review is a renewal of previous years’ work to facilitate extraction and review of the most recent pharmacotherapy-centric studies in patients with thermal and inhalation injury. Sixteen geographically dispersed, board-certified pharmacists participated in the review. A MeSH-based, filtered search returned 1,536 manuscripts over the previous 2-year period. After manual review and exclusions, only 98 (6.4%) manuscripts were determined to have a potential impact on current pharmacotherapy practices and included in the review. A summary of the 10 articles that scored highest are included in the review. Nearly half of the reviewed manuscripts were assessed to lack a significant impact on current practice. Despite an increase in published literature over the previous 2-year review, the focus and quality remain unchanged. There remains a need for investment in well-designed, high impact, pharmacotherapy-pertinent research for patients sustaining thermal or inhalation injuries.


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