Life After Brain Death

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Notes

1 Definition of “death,” https://www.merriam-webster.com/dictionary/death.

2 Recent research has shown that glial cells in the brain actually grew in the hours after death; see Fabien Dachet et al., Selective Time-Dependent Changes in Activity and Cell-Specific Gene Expression in Human Postmortem Brain, 11 Sci. Rep. (2021). This suggests that even the most conservative current definition of death is biologically inaccurate in regard to cessation of all function in the brain, but the research is new enough that potential implications for defining death are unclear.

3 Frederick J. White, Controversy in the Determination of Death: The Definition and Moment of Death, 86 Linacre Q. 366-80 (2019).

4 Doyen Nguyen, Brain Death and True Patient Care, 83 Linacre Q. 258-82 (2016).

5 The use of a ventilator in patients under consideration for BD is common because an inability to breathe independently is part of many current medical and legal definitions of BD; if a patient can breathe independently, they are not going to be considered BD. See Practice Parameters for Determining Brain Death in Adults: (Summary Statement), 45 Neurology 1012-14 (1995).

6 Nguyen, supra note 4.

7 Id.

8 Robert D. Truog, Organ Transplantation without Brain Death, 913 Ann. N. Y. Acad. Sci. 229-39 (2000).

9 D. Alan Shewmon, Chronic “Brain Death”: Meta-Analysis and Conceptual Consequences, 51 Neurology 1538-45 (1998).

10 Robert D. Truog & Franklin G. Miller, The Dead Donor Rule and Organ Transplantation, 359 N. Engl. J. Med. 674-75 (2008).

11 Scott J. Schweikart, Reexamining the Flawed Legal Basis of the “Dead Donor Rule” as a Foundation for Organ Donation Policy, J Ethics, https://journalofethics.ama-assn.org/article/reexamining-flawed-legal-basis-dead-donor-rule-foundation-organ-donation-policy/2020-12.

12 M. Potts & D. W. Evans, Does It Matter That Organ Donors Are Not Dead? Ethical and Policy Implications, 31 J. Med. Ethics 406-9 (2005).

13 A Definition of Irreversible Coma: Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, 205 JAMA 337-40 (1968).

14 White, supra note 3.

15 Uniform Determination of Death Act, 12 Uniform Laws Annotated (U.L.A.) 589 (West 1993 and West Supp. 1997).

16 Practice Parameters, supra note 5.

17 For example, history of oxygen loss to the brain, stroke, or traumatic head injury.

18 Practice Parameters, supra note 5.

19 Id.

20 Eelco F.M. Wijdicks, The Diagnosis of Brain Death, 344 N. Engl. J. Med. 1215-21 (2001).

21 Christopher M. Burkle, Agnes M. Schipper & Eelco F. M. Wijdicks, Brain death and the courts, 76 Neurology 837-41 (2011).

22 Id.

23 This strong statement is well supported by the UDDA legally (and BD proponents insistently) declaring these patients dead despite their continuing vital functions that are consistent with their being alive.

24 Robert M. Veatch, Would a Reasonable Person Now Accept the 1968 Harvard Brain Death Report? A Short History of Brain Death, 48 Hastings Ctr. Rep. S6-9 (2018).

25 Robert D. Truog, Organ Transplantation without Brain Death, 913 Ann. N. Y. Acad. Sci. 229-39 (2000).

26 Truog, supra note 8.

27 Schweikart, supra note 11.

28 A new term could have been decided upon that does not rely on either “death” or “coma” to describe a person with no brain function whose vital functions are otherwise maintained only artificially.

29 Potts & Evans, supra note 12.

30 Potts & Evans, supra note 12, at 3.

31 Id.

32 Id.

33 Organ Donation Statistics, Organdonor.gov, https://www.organdonor.gov/learn/organ-donation-statistics.

34 Id.

35 Mark A. Schnitzler et al., The Life-Years Saved by a Deceased Organ Donor, 5 Am. J. Transplant. 2289-96 (2005).

36 Laura A. Siminoff, Christopher Burant & Stuart J. Youngner, Death and Organ Procurement: Public Beliefs and Attitudes, 14 Kennedy Inst. Ethics J. 217-4 (2004); Veatch, supra note 24.

37 David Shaw, Organ Donation Is the Right Decision: A Delicate Truth, 41 Intensive Care Med. 1487-88 (2015).

38 Schweikart, supra note 11.

39 Scott J. Schweikart & Robert D. Truog, Organ Transplantation without Brain Death, 913 Ann. N. Y. Acad. Sci. 229-39 (2000).

40 Robert M. Veatch, Abandon the Dead Donor Rule or Change the Definition of Death?, 14 Kennedy Inst. Ethics J. 261-76 (2004); Veatch, supra note 24.