PDF herunterladen
Semin Neurol 2018; 38(05): 576-582
DOI: 10.1055/s-0038-1668075
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Contentious Ethical and Legal Aspects of Determination of Brain Death

Ariane Lewis
1   Division of Neurocritical Care, Departments of Neurology and Neurosurgery, NYU Langone Medical Center, New York, New York
› Institutsangaben Funding None.
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
15. Oktober 2018 (online)

    Lizenzen und Reprints

Abstract

Although the concept of death by neurologic criteria is accepted throughout much of the world and death can legally be determined by neurologic criteria throughout the United States, the process is fraught with contentious ethical and legal controversies. I explore historic and contemporary ethical and legal disputes about determination of death by neurologic criteria including the need for consent from patients' surrogates prior to determination of death, the role of religion in determination of death, management of objections to determination of death by neurologic criteria, the approach to patients who are dead by neurologic criteria but are pregnant, and gamete retrieval after determination of death.

Keywords

brain death - ethics - medicolegal
 

  • References

  • 1 Mollaret P, Goulon M. [The depassed coma (preliminary memoir)]. Rev Neurol (Paris) 1959; 101: 3-15
    PubMedGoogle Scholar
  • 2 Pabisiak K. Brain death criteria formulated for transplantation purposes: fact or myth?. Anaesthesiol Intensive Ther 2016; 48 (02) 142-145
    CrossrefPubMedGoogle Scholar
  • 3 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 (06) 337-340
    CrossrefPubMedGoogle Scholar
  • 4 Wijdicks EFM. The neurologist and Harvard criteria for brain death. Neurology 2003; 61 (07) 970-976
    CrossrefPubMedGoogle Scholar
  • 5 Beecher HK. Definitions of “life” and “death” for medical science and practice. Ann N Y Acad Sci 1970; 169 (02) 471-474
    CrossrefPubMedGoogle Scholar
  • 6 Powner DJ, Snyder JV, Grenvik A. Brain death certification. A review. Crit Care Med 1977; 5 (05) 230-233
    CrossrefPubMedGoogle Scholar
  • 7 American Academy of Pediatrics Task Force on Brain Death in Children. Report of special Task Force. Guidelines for the determination of brain death in children. Pediatrics 1987; 80 (02) 298-300
    CrossrefPubMedGoogle Scholar
  • 8 Nakagawa TA, Ashwal S, Mathur M, Mysore M. ; Committee for Determination of Brain Death in Infants Children. Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations-executive summary. Ann Neurol 2012; 71 (04) 573-585
    CrossrefPubMedGoogle Scholar
  • 9 Wijdicks EFM. Determining brain death in adults. Neurology 1995; 45 (05) 1003-1011
    CrossrefPubMedGoogle Scholar
  • 10 Wijdicks EFM, 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) 1911-1918
    CrossrefPubMedGoogle Scholar
  • 11 Lewis A, Bernat JL, Blosser S. , et al. An interdisciplinary response to contemporary concerns about brain death determination. Neurology 2018; 90 (09) 423-426
    CrossrefPubMedGoogle Scholar
  • 12 Wang HH, Varelas PN, Henderson GV, Wijdicks EFM, Greer DM. Improving uniformity in brain death determination policies over time. Neurology 2017; 88 (06) 562-568
    CrossrefPubMedGoogle Scholar
  • 13 Shemie SD, Hornby L, Baker A. , et al; The International Guidelines for Determination of Death phase 1 participants, in collaboration with the World Health Organization. International guideline development for the determination of death. Intensive Care Med 2014; 40 (06) 788-797
    CrossrefPubMedGoogle Scholar
  • 14 Sprung CL, Truog RD, Curtis JR. , et al. Seeking worldwide professional consensus on the principles of end-of-life care for the critically ill. The Consensus for Worldwide End-of-Life Practice for Patients in Intensive Care Units (WELPICUS) study. Am J Respir Crit Care Med 2014; 190 (08) 855-866
    CrossrefPubMedGoogle Scholar
  • 15 Wahlster S, Wijdicks EF, Patel PV. , et al. Brain death declaration: practices and perceptions worldwide. Neurology 2015; 84 (18) 1870-1879
    CrossrefPubMedGoogle Scholar
  • 16 Bernat JL. Controversies in defining and determining death in critical care. Nat Rev Neurol 2013; 9 (03) 164-173
    PubMedGoogle Scholar
  • 17 Defining Death. Medical, Legal and Ethical Issues in the Determination of Death. Washington, DC: 1981
    Google Scholar
  • 18 Lewis A, Cahn-Fuller K, Caplan A. Shouldn't dead be dead? The search for a uniform definition of death. J Law Med Ethics 2017; 45 (01) 112-128
    CrossrefPubMedGoogle Scholar
  • 19 In Re: Guardianship of Hailu. 2015
    PubMed
  • 20 An Act Relating to the Determination of Death, 2017 Nevada Acts ch. 315 (A.B. 424), effective October 1, 2017
    PubMed
  • 21 Shewmon AD. The brain and somatic integration: insights into the standard biological rationale for equating “brain death” with death. J Med Philos 2001; 26 (05) 457-478
    CrossrefPubMedGoogle Scholar
  • 22 Shah SK, Truog RD, Miller FG. Death and legal fictions. J Med Ethics 2011; 37 (12) 719-722
    CrossrefPubMedGoogle Scholar
  • 23 Bernat JL. The biophilosophical basis of whole-brain death. Soc Philos Policy 2002; 19 (02) 324-342
    CrossrefPubMedGoogle Scholar
  • 24 Nair-Collins M, Northrup J, Olcese J. Hypothalamic-pituitary function in brain death: a review. J Intensive Care Med 2016; 31 (01) 41-50
    CrossrefPubMedGoogle Scholar
  • 25 Nair-Collins M, Miller FG. Do the ‘brain dead’ merely appear to be alive?. J Med Ethics 2017; 43 (11) 747-753
    CrossrefPubMedGoogle Scholar
  • 26 President's Council on Bioethics. Controversies in the determination of death: a white paper by the President's Council on Bioethics. Washington, DC: 2008
    Google Scholar
  • 27 Bernat JL. Whither brain death?. Am J Bioeth 2014; 14 (08) 3-8
    PubMedGoogle Scholar
  • 28 Burkle CM, Sharp RR, Wijdicks EF. Why brain death is considered death and why there should be no confusion. Neurology 2014; 83 (16) 1464-1469
    CrossrefPubMedGoogle Scholar
  • 29 Truog RD. Brain death - too flawed to endure, too ingrained to abandon. J Law Med Ethics 2007; 35 (02) 273-281
    CrossrefPubMedGoogle Scholar
  • 30 Lewis A, Adams N, Varelas P, Greer D, Caplan A. Organ support after death by neurologic criteria: results of a survey of US neurologists. Neurology 2016; 87 (08) 827-834
    CrossrefPubMedGoogle Scholar
  • 31 Lewis A, Adams N, Chopra A, Kirschen MP. Organ support after death by neurologic criteria in pediatric patients. Crit Care Med 2017; 45 (09) e916-e924
    CrossrefPubMedGoogle Scholar
  • 32 In Re: Mirranda Grace Lawson. 2016
    PubMed
  • 33 In Re: Allen Callaway. 2016
    PubMed
  • 34 Alex Pierce v. Loma Linda University Medical Center. 2016
    PubMed
  • 35 In the Court of Appeals of the State of Kansas: Brett and Yvonne Shively vs. Wesley Medical Center and Lindall Smith. 2006
    PubMed
  • 36 Supreme Court of Virginia Apellate Case Management System. SCV Record Number 161321
    PubMed
  • 37 Richer AD. Mirranda Grace Lawson dies; was focus of fight over brain death test. Culpeper Star Expon. Available at: http://www.dailyprogress.com/starexponent/news/mirranda-grace-lawson-dies-was-focus-of-fight-over-brain/article_ce555172-c4b0-5bc1-82f3-be2d694b02aa.html . Accessed May 25, 2018
    PubMedGoogle Scholar
  • 38 Truog RD, Tasker RC. Counterpoint: Should informed consent be required for apnea testing in patients with suspected brain death?. Chest 2017; 152 (04) 702-704
    CrossrefPubMedGoogle Scholar
  • 39 Lewis A, Pope TM. Physician power to declare death by neurologic criteria threatened. Neurocrit Care 2017; 26 (03) 446-449
    CrossrefPubMedGoogle Scholar
  • 40 Lewis A, Greer D. POINT: should informed consent be required for apnea testing in patients with suspected brain death? No. Chest 2017; 152 (04) 700-702
    CrossrefPubMedGoogle Scholar
  • 41 Datar S, Fugate J, Rabinstein A, Couillard P, Wijdicks EFM. Completing the apnea test: decline in complications. Neurocrit Care 2014; 21 (03) 392-396
    CrossrefPubMedGoogle Scholar
  • 42 Roth C, Deinsberger W, Kleffmann J, Ferbert A. Intracranial pressure and cerebral perfusion pressure during apnoea testing for the diagnosis of brain death - an observational study. Eur J Neurol 2015; 22 (08) 1208-1214
    CrossrefPubMedGoogle Scholar
  • 43 Lewis A, Greer D. Rebuttal from Drs Lewis and Greer. Chest 2017; 152 (04) 704-705
    CrossrefPubMedGoogle Scholar
  • 44 Truog RD, Tasker RC. Rebuttal from Drs Truog and Tasker. Chest 2017; 152 (04) 705-706
    CrossrefPubMedGoogle Scholar
  • 45 Lewis A. Contemporary legal updates to the definition of brain death in Nevada. JAMA Neurol 2017; 74 (09) 1031-1032
    CrossrefPubMedGoogle Scholar
  • 46 Lewis A, Varelas P, Greer D. Prolonging support after brain death: when families ask for more. Neurocrit Care 2016; 24 (03) 481-487
    CrossrefPubMedGoogle Scholar
  • 47 Setta SM, Shemie SD. An explanation and analysis of how world religions formulate their ethical decisions on withdrawing treatment and determining death. Philos Ethics Humanit Med 2015; 10: 6
    CrossrefPubMedGoogle Scholar
  • 48 Breitowitz RYA. The Brain Death Controversy in Jewish Law. Jewish Law 2015; Available at: http://www.jlaw.com/Articles/brain.html . Accessed May 25, 2018
    PubMedGoogle Scholar
  • 49 Miller AC, Ziad-Miller A, Elamin EM. Brain death and Islam: the interface of religion, culture, history, law, and modern medicine. Chest 2014; 146 (04) 1092-1101
    CrossrefPubMedGoogle Scholar
  • 50 Haas JM. Catholic teaching regarding the legitimacy of neurological criteria for the determination of death. Natl Cathol Bioeth Q 2011; 11: 279-299
    PubMedGoogle Scholar
  • 51 Ca. Health & Saf. Code §1254.4
    PubMed
  • 52 New York State Guidelines for Determining Brain Death. 2011; Available at: http://www.health.ny.gov/professionals/hospital_administrator/letters/2011/brain_death_guidelines.htm . Accessed May 25, 2018
    PubMed
  • 53 210 Ill. Comp. Stat. §85/6.24
    PubMed
  • 54 New Jersey Brain Death Statute. 2014; Available at: http://www.njsharingnetwork.org/file/Brain-Death-Guidelines-July-27-2014sq-2.pdf . Accessed May 25, 2018
    PubMed
  • 55 Liao S, Ito S. Brain death: ethical challenges to palliative care concepts of family care. J Pain Symptom Manage 2010; 40 (02) 309-313
    CrossrefPubMedGoogle Scholar
  • 56 Burt RA. The medical futility debate: patient choice, physician obligation, and end-of-life care. J Palliat Med 2002; 5 (02) 249-254
    CrossrefPubMedGoogle Scholar
  • 57 The Constitution of the United States Amendment I and Amendment IV.
    PubMed
  • 58 Burck R, Anderson-Shaw L, Sheldon M, Egan EA. The clinical response to brain death: a policy proposal. JONAS Healthc Law Ethics Regul 2006; 8 (02) 53-59
    CrossrefPubMedGoogle Scholar
  • 59 Bosek MSD. Respecting a patient's religious values: what does this require?. JONAS Healthc Law Ethics Regul 2008; 10 (04) 100-105
    CrossrefPubMedGoogle Scholar
  • 60 Smith ML, Flamm AL. Accommodating religious beliefs in the ICU: a narrative account of a disputed death. Narrat Inq Bioeth 2011; 1 (01) 55-64
    PubMedGoogle Scholar
  • 61 Spike J, Greenlaw J. Ethics consultation: persistent brain death and religion: must a person believe in death to die?. J Law Med Ethics 1995; 23 (03) 291-294
    CrossrefPubMedGoogle Scholar
  • 62 Shalom Ouanounou v. Humber River Hospital, Ali Ghafouri, Garret Pulle, Sanjay Manocha, Dr. David Giddons, Coroner, and Office of the Chief Coroner. 2017
    PubMedGoogle Scholar
  • 63 Davidson T. Clear definition of death, accommodation of religious beliefs is needed, says lawyer in life support case. Lawyer's Dly 2017; Available at: https://www.thelawyersdaily.ca/articles/5200 . Accessed May 25, 2018
    PubMedGoogle Scholar
  • 64 Israel Stinson v. Children's Hospital Los Angeles. 2016
    PubMed
  • 65 Re: A (A Child). 2015
    PubMed
  • 66 George S, Thomas M, Ibrahim WH. , et al. Somatic survival and organ donation among brain-dead patients in the state of Qatar. BMC Neurol 2016; 16 (01) 207
    CrossrefPubMedGoogle Scholar
  • 67 Gostin LO. Mandatory vaccination: understanding the common good in the midst of the global polio eradication campaign. Isr J Health Policy Res 2018; 7 (01) 4
    CrossrefPubMedGoogle Scholar
  • 68 Labate BC. Consumption of ayahuasca by children and pregnant women: medical controversies and religious perspectives. J Psychoactive Drugs 2011; 43 (01) 27-35
    PubMedGoogle Scholar
  • 69 Lewis A, Varelas P, Greer D. Controversies after brain death: when families ask for more. Chest 2016; 149 (02) 607-608
    CrossrefPubMedGoogle Scholar
  • 70 Burkle CM, Tessmer-Tuck J, Wijdicks EF. Medical, legal, and ethical challenges associated with pregnancy and catastrophic brain injury. Int J Gynaecol Obstet 2015; 129 (03) 276-280
    CrossrefPubMedGoogle Scholar
  • 71 Dillon WP, Lee RV, Tronolone MJ, Buckwald S, Foote RJ. Life support and maternal death during pregnancy. JAMA 1982; 248 (09) 1089-1091
    CrossrefPubMedGoogle Scholar
  • 72 Esmaeilzadeh M, Dictus C, Kayvanpour E. , et al. One life ends, another begins: Management of a brain-dead pregnant mother - a systematic review. BMC Med 2010; 8: 74
    CrossrefPubMedGoogle Scholar
  • 73 Fadel HE. Postmortem and perimortem cesarean section: historical, religious and ethical considerations. J IMA 2011; 43 (03) 194-200
    PubMedGoogle Scholar
  • 74 Farragher RA, Laffey JG. Maternal brain death and somatic support. Neurocrit Care 2005; 3 (02) 99-106
    CrossrefPubMedGoogle Scholar
  • 75 Dickens B. ; FIGO Committee for Ethical Aspects of Human Reproduction and Women's Health. Brain death and pregnancy. Int J Gynaecol Obstet 2011; 115 (01) 84-85
    CrossrefPubMedGoogle Scholar
  • 76 Ramsay G, Paglia M, Bourjeily G. When the heart stops: a review of cardiac arrest in pregnancy. J Intensive Care Med 2013; 28 (04) 204-214
    CrossrefPubMedGoogle Scholar
  • 77 European Resuscitation Council. Part 8: advanced challenges in resuscitation. Section 3: special challenges in ECC. 3F: cardiac arrest associated with pregnancy. Resuscitation 2000; 46 (1-3): 293-295
    CrossrefPubMedGoogle Scholar
  • 78 Gostin LO. Legal and ethical responsibilities following brain death: the McMath and Muñoz cases. JAMA 2014; 311 (09) 903-904
    CrossrefPubMedGoogle Scholar
  • 79 Humphrey WA. “But I'm brain-dead and pregnant”: advance directive pregnancy exclusions and end-of-life wishes. Wm. & Mary J. Women & L 2015; L: 21
    PubMedGoogle Scholar
  • 80 Flamm AL, Smith ML, Mayer PA. Family members' requests to extend physiologic support after declaration of brain death: a case series analysis and proposed guidelines for clinical management. J Clin Ethics 2014; 25 (03) 222-237
    PubMedGoogle Scholar
  • 81 Lewis A, Varelas P, Greer D. ; Hospital Policies. Pregnancy and brain death: lack of guidance in U.S. hospital policies. Am J Perinatol 2016; 33 (14) 1382-1387
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 82 Erick Munoz v. John Peter Smith Hospital. 2014
    PubMed
  • 83 University of Health Services v. Robert Piazzi, David Hadden, and The Division of Family and Children Services of the Department of Human Resources of the State of Georgia, and Samuel G. Nicholson, as Guardian ad litem for the Unborn Child of Donna Piazzi. 1986
    PubMedGoogle Scholar
  • 84 Finnerty JJ, Thomas TS, Boyle RJ, Howards SS, Karns LB. Gamete retrieval in terminal conditions. Am J Obstet Gynecol 2001; 185 (02) 300-307
    CrossrefPubMedGoogle Scholar