Old and New Concepts in Brain Death: A Medico-Legal Overview
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Abstract
Although brain death has been extensively dealt within the contemporary literature, there does exist some ambiguities regarding its definition, clinical criteria, ethical and religious perspectives. The neurological criteria helped in subduing the much talked about issues of whole brain death and brainstem death to a greater extent, but the recently introduced cardiac or circulation death made the issue of brain death more complicated and indeed a conundrum. We would touch upon brain death issues since the terminology was initially introduced till the present day when the cardiac death connivingly made its way as a means of organ procurement in the so called dead patients. This review article is the authors' own perception and understanding of the conundrum of brain death, and should not be misinterpreted as a narrative or a systematic review of the subject. In conclusion, this review aims at filling the void that exists about the criteria for brain death in the contemporary literature.
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2. Wertheimer P, Jouvet M, Descotes J, De Rougemont J, Descotes J, Jouvet M. Données angiographiques relatives à la mort de l'encéphale au cours des comas avec arrět respiratoire. Lyon chir. 1960;56:641-8. [French]
3. Beck CS, Pritchard WH, Feil HS. Ventricullar fibrillation of lung duration abolished by electric shock. J Am Med Assoc. 1947;135(15):985-6.
4. Bower AG, Bennett VR, Dillon JB, Axelroad B. Investigation on the care and treatment of poliomyelitis patients. Ann West Med Surg. 1950;4(10):561-82.
5. Puri N, Puri V, Dellinger RP. History of technology in the intensive care unit. Crit Care Clin. 2009;25(1):185-200.
6. Belkin GS. Brain death and the historical understanding of bioethics. J Hist Med Allied Sci. 2003;58(3):325-61.
7. Mollaret P, Goulon M. The depassed coma (preliminary memoir). Re Neurol. 1959;101:3-15.
8. Schwab RS, Pootts F, Bonazzi A. EEG as an aid to determining death in the presence of cardiac activity. (ethical, medical and legal aspects.) Electroencephalogr. Clin Neurophysiol. 1963;15:145-56.
9. Haid B. Religioes-sittliche Fragen betreffend die wiederbelebung. (Resuscitation, Reanimation). Der Anaesthetist. 1958;7:241-3. [German]
10. Pius XII. Discours en réponse à trois questions de morale médicale sur la reanimation. Acta Apostolica Sedis. 1957;49:1027-33. [French]
11. Bernard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Shuur Hospital, Cape Town. S Afr Med J. 1967;41(48):1271-4.
12. A Definition of Irreversible Coma. Report of the Ad Hoc committee of the harvard medical school to examine the definition of brain death. JAMA. 1968;205(6):337-40.
13. Singer P. The sanctity of brain death for the sanctity of life ethic. Ethics & Bioeth. 2018;8(3-4):153-65.
14. Diagnosis of braindeath. Statement issued by the honorary secretary of the Conference of Medical Royal Colleges and their Faculties in the United Kingdom on 11 October 1976. Br Med J. 1976;2(6045):1187-8.
15. Pallis C, Harley DH, ABC of brainstem death. London: BMJ Publishing Group, 1996. 52 p.
16. Baron L, Shemie SD, Teitelbaum J, Doig CJ. Brief review: history, concept and controversies in the neurological determination of death. Can J Anaesth. 2006;53(6):602-8.
17. Hassler R. Basal ganglia systems regulating mental activity. Int J Neurol. 1997;12:53-72.
18. Manara A, Varelas P, Wijdicks EF. Brain death in patients with isolated brainstem lesions: A case against controversy. J Neurosurg Anesthesiol 2019;31(2):171-3.
19. Walter U, Fernandez-Torre JL, Kirschstein T, Laureys S. When is "brainstem death" brain death? The case for ancilliary testing is primary infatentorial brain lesion. Clin Neurophysiol. 2018;129(11):2451-65.
20. Smith M. Braindeath. Time for an international consensus. Br J Anaesth. 2012;108 Suppl 1:i6-9.
21. Wijdicks EF, Varelas PN, Gronseth GS, Greer DM. American Academy of Neurology. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74(23):1911-8.
22. Lewis A, Bernat JL, Blosser S, Bonnie RJ, Epstein LG, Hutchins J, et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology. 2018;90(9):423-6..
23. Sawicki M, Solek-Pastuszka J, Chamier-Cieminska K, Walecka A, Walecki J, Bohatyrewicz R. Computered tomography perfusion is a useful adjunct to computed tomography angiography in the diagnosis of brain death. Clin Neuroradiol. 2019;29(1):101-8.
24. Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology. 2002;58(1):20-5.
25. EF Wijdicks. The clinical criteria of brain death throughout the world: why has it come to this? Can J Anaesth. 2006;53(6):540-3.
26. Nathaniel M. Robbins, James L. Bernat. Practice Current: When do you order ancillary tests to determine brain death? Neurol Clin Pract. 2018;8(3):266–74.
27. Goila AK, Pawar M. The diagnosis of brain death. Indian J Crit Care Med. 2009;13(1):7–11.
28. Ying-Ying Su, Wei-Bi Chen, Gang Liu, et al. An Investigation and Suggestions for the Improvement of Brain Death Determination in China. Chin Med J (Engl). 2018;131(24):2910–4.
29. Sekar KC. Brain death in the newborn. J Perinatol. 2007;27(S1):S59.
30. Young GB, Shemie SD, Doig CJ, Teitelbaum J. Brief review: the role of ancillary tests in the neurological determination of death. Can J Anaesth. 2006;53(6):620-7.
31. Aulisio MP, Devita M, Luebke D. Taking values seriously: ethical challenges in organ donation and transplantation for critical care professionals. Crit Care Med. 2007;35(2):S95-101.
32. Committee on increasing rates of organ-donation board on health sciences policy institue of medicine. Organ donation; opportunities for action. Washington, DC: The National Academy Press; 2006.
33. Du Bois J, Anderson E. Attitudes toward death criteria and organ donation among healthcare personnel and the general public. Prog Transplant. 2006;16(1):65-73.
34. Mandell SM, Zamudio S, Seem D, et al. National evaluation of healthcare provider toward donation after cardiac death. Crit Care Med. 2006;34(12):2952-8.
35. Shemie SD, Baker AJ, Knoll G, et al. Donation after cardiocirsulatory death in Canada. CMAJ. 2006;175(8):S1-24.
2. Wertheimer P, Jouvet M, Descotes J, De Rougemont J, Descotes J, Jouvet M. Données angiographiques relatives à la mort de l'encéphale au cours des comas avec arrět respiratoire. Lyon chir. 1960;56:641-8. [French]
3. Beck CS, Pritchard WH, Feil HS. Ventricullar fibrillation of lung duration abolished by electric shock. J Am Med Assoc. 1947;135(15):985-6.
4. Bower AG, Bennett VR, Dillon JB, Axelroad B. Investigation on the care and treatment of poliomyelitis patients. Ann West Med Surg. 1950;4(10):561-82.
5. Puri N, Puri V, Dellinger RP. History of technology in the intensive care unit. Crit Care Clin. 2009;25(1):185-200.
6. Belkin GS. Brain death and the historical understanding of bioethics. J Hist Med Allied Sci. 2003;58(3):325-61.
7. Mollaret P, Goulon M. The depassed coma (preliminary memoir). Re Neurol. 1959;101:3-15.
8. Schwab RS, Pootts F, Bonazzi A. EEG as an aid to determining death in the presence of cardiac activity. (ethical, medical and legal aspects.) Electroencephalogr. Clin Neurophysiol. 1963;15:145-56.
9. Haid B. Religioes-sittliche Fragen betreffend die wiederbelebung. (Resuscitation, Reanimation). Der Anaesthetist. 1958;7:241-3. [German]
10. Pius XII. Discours en réponse à trois questions de morale médicale sur la reanimation. Acta Apostolica Sedis. 1957;49:1027-33. [French]
11. Bernard CN. The operation. A human cardiac transplant: an interim report of a successful operation performed at Groote Shuur Hospital, Cape Town. S Afr Med J. 1967;41(48):1271-4.
12. A Definition of Irreversible Coma. Report of the Ad Hoc committee of the harvard medical school to examine the definition of brain death. JAMA. 1968;205(6):337-40.
13. Singer P. The sanctity of brain death for the sanctity of life ethic. Ethics & Bioeth. 2018;8(3-4):153-65.
14. Diagnosis of braindeath. Statement issued by the honorary secretary of the Conference of Medical Royal Colleges and their Faculties in the United Kingdom on 11 October 1976. Br Med J. 1976;2(6045):1187-8.
15. Pallis C, Harley DH, ABC of brainstem death. London: BMJ Publishing Group, 1996. 52 p.
16. Baron L, Shemie SD, Teitelbaum J, Doig CJ. Brief review: history, concept and controversies in the neurological determination of death. Can J Anaesth. 2006;53(6):602-8.
17. Hassler R. Basal ganglia systems regulating mental activity. Int J Neurol. 1997;12:53-72.
18. Manara A, Varelas P, Wijdicks EF. Brain death in patients with isolated brainstem lesions: A case against controversy. J Neurosurg Anesthesiol 2019;31(2):171-3.
19. Walter U, Fernandez-Torre JL, Kirschstein T, Laureys S. When is "brainstem death" brain death? The case for ancilliary testing is primary infatentorial brain lesion. Clin Neurophysiol. 2018;129(11):2451-65.
20. Smith M. Braindeath. Time for an international consensus. Br J Anaesth. 2012;108 Suppl 1:i6-9.
21. Wijdicks EF, Varelas PN, Gronseth GS, Greer DM. American Academy of Neurology. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74(23):1911-8.
22. Lewis A, Bernat JL, Blosser S, Bonnie RJ, Epstein LG, Hutchins J, et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology. 2018;90(9):423-6..
23. Sawicki M, Solek-Pastuszka J, Chamier-Cieminska K, Walecka A, Walecki J, Bohatyrewicz R. Computered tomography perfusion is a useful adjunct to computed tomography angiography in the diagnosis of brain death. Clin Neuroradiol. 2019;29(1):101-8.
24. Wijdicks EF. Brain death worldwide: accepted fact but no global consensus in diagnostic criteria. Neurology. 2002;58(1):20-5.
25. EF Wijdicks. The clinical criteria of brain death throughout the world: why has it come to this? Can J Anaesth. 2006;53(6):540-3.
26. Nathaniel M. Robbins, James L. Bernat. Practice Current: When do you order ancillary tests to determine brain death? Neurol Clin Pract. 2018;8(3):266–74.
27. Goila AK, Pawar M. The diagnosis of brain death. Indian J Crit Care Med. 2009;13(1):7–11.
28. Ying-Ying Su, Wei-Bi Chen, Gang Liu, et al. An Investigation and Suggestions for the Improvement of Brain Death Determination in China. Chin Med J (Engl). 2018;131(24):2910–4.
29. Sekar KC. Brain death in the newborn. J Perinatol. 2007;27(S1):S59.
30. Young GB, Shemie SD, Doig CJ, Teitelbaum J. Brief review: the role of ancillary tests in the neurological determination of death. Can J Anaesth. 2006;53(6):620-7.
31. Aulisio MP, Devita M, Luebke D. Taking values seriously: ethical challenges in organ donation and transplantation for critical care professionals. Crit Care Med. 2007;35(2):S95-101.
32. Committee on increasing rates of organ-donation board on health sciences policy institue of medicine. Organ donation; opportunities for action. Washington, DC: The National Academy Press; 2006.
33. Du Bois J, Anderson E. Attitudes toward death criteria and organ donation among healthcare personnel and the general public. Prog Transplant. 2006;16(1):65-73.
34. Mandell SM, Zamudio S, Seem D, et al. National evaluation of healthcare provider toward donation after cardiac death. Crit Care Med. 2006;34(12):2952-8.
35. Shemie SD, Baker AJ, Knoll G, et al. Donation after cardiocirsulatory death in Canada. CMAJ. 2006;175(8):S1-24.
| Files | ||
| Issue | Vol 4 No 4 (2020): Autumn (October) | |
| Section | Review article | |
| Keywords | ||
| Brain Death Legislation and Jurisprudence Patient Selection | ||
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How to Cite
1.
Khan ZH, Dehghan-Tezerjani M, Minagar M. Old and New Concepts in Brain Death: A Medico-Legal Overview. Front Emerg Med. 2020;4(4):e92.
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