A Survey Of American Neurologists About Brain Death: Understanding Of The Conceptual Basis And Diagnostic Tests For Brain Death

Joffe, Ari R.; Anton, Natalie; Duff, Jonathan P.; DeCaen, Allan

doi:10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a6218

Cited by 5 publications

(5 citation statements)

References 15 publications

(61 reference statements)

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“…gung keine konsistente Rationale für das Hirntodkonzept hatten und kein klares Verständnis der Hirntoddiagnostik. Nur 27 % gaben an, dass für sie der Hirntod als irreversibler Hirnfunktionsausfall dem Tod gleichzusetzen sei[27]. Hirntod als sicheres Zeichen für den Tod eines Menschen an und besteht auf der Einhaltung der Dead-donor-Regel.…”

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„Non-heart-beating donors“ sind nicht geeignet

Heide

2016

Nervenarzt

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The death of the donor is a mandatory prerequisite for organ transplantation (dead donor rule) worldwide. It is a medical, legal and ethical consensus to accept the concept of brain death, as first proposed in 1968 by the ad hoc committee of the Harvard Medical School, as a certain criterion of death. In isolated cases where the diagnosis of brain death was claimed to be wrong, it could be demonstrated that the diagnostic procedure for brain death had not been correctly performed. In March 2014 a joint statement by the German neuromedical societies emphasized that 1) the diagnosis of brain death is one of the safest diagnoses in medicine if performed according to accepted medical standards and criteria and 2) the concept of non-heart-beating donors (NHBD, i. e. organ donation after an arbitrarily defined duration of circulatory and cardiac arrest) practiced in some European countries must be absolutely rejected because it implicates a high risk of diagnostic error. According to the current literature it is unclear at what time cardiac and circulatory arrest is irreversible and leads to irreversible cessation of all functions of the entire brain including the brainstem, even though clinical signs of cessation of brain functions are always found after 10 min. Furthermore, is it often an arbitrary decision to exactly define the duration of cardiac arrest if continuous echocardiographic monitoring has not been carried out from the very beginning. Last but not least there are ethical concerns against the concept of NHBD because it might influence therapeutic efforts to resuscitate a patient with cardiac arrest. Therefore, the German Medical Council (BÄK) has repeatedly rejected the concept of NHBD for organ transplantation since 1995.

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unclassified

„Non-heart-beating donors“ sind nicht geeignet

Heide

2016

Nervenarzt

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“…Nasıl intoksikasyon sonucu gelişen bir beyin ölümü tablosunda karar verirken destekleyici test olarak EEG değerlendirmesi yerine, serebral dolaşımın olmadığının gösterilmesi doğru ve hızlı kararda en etkili yöntemse, aSAK vakalarında da beyin sapı refleksleri olmayan beyin ölümü muayene bulgularını veren hastalarda beynin kortikal elektriksel aktivitenin olmadığının gösterildiği EEG'nin kullanımının hızlı ve doğru tanı konmasında yararlı olabileceği inancındayız. Ancak hala beyin ölümü konusunda dünyada kabul edilmiş tanıyı kesinleştirecek bir inceleme yöntemi olmadığı kabul edilmektedir (14).…”

Section: Discussionunclassified

Anevrizmal Subaraknoid Kanama Hastalarında Beyin Ölümü Kararının Verilmesinde Elektroensefalografinin Önemi

Akıncı¹,

Basel²,

Sencer³

et al. 2012

Tybbd

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“…Incoherence between Theory and Praxis S urveys consistently reveal that, despite fifty years of educational effort by the establishment, many medical professionals who would claim to endorse the concept of brain death actually believe that these patients are biologically alive but no longer human "persons," or that they are "as good as dead." 18 The inability of mainstream doctrine to convince the most affected group of professionals-to say nothing of the general public-is a natural consequence of its intrinsic incoherence.…”

Section: Incoherence Between Tests and Conceptmentioning

confidence: 99%

Brain Death: A Conclusion in Search of a Justification

Shewmon¹

2018

Hastings Center Report

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At its inception, “brain death” was proposed not as a coherent concept but as a useful one. The 1968 Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death gave no reason that “irreversible coma” should be death itself, but simply asserted that the time had come for it to be declared so. Subsequent writings by chairman Henry Beecher made clear that, to him at least, death was essentially a social construct, and society could define it however it pleased. The first widely endorsed attempt at a philosophical justification appeared thirteen years later, with a report from the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and a seminal paper by James Bernat, Charles Culver, and Bernard Gert, which introduced the insightful tripartite scheme of concept, criterion, and tests for death. Their paper proposed that the correct concept of death is the “permanent cessation of functioning of the organism as a whole,” which tenuously remains the mainstream concept to this day. In this essay, I focus on this mainstream concept, arguing that equating brain death with death involves several levels of incoherence: between concept and criterion, between criterion and tests, between tests and concept, and between all of these and actual brain death praxis.

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A Survey Of American Neurologists About Brain Death: Understanding Of The Conceptual Basis And Diagnostic Tests For Brain Death

Cited by 5 publications

References 15 publications

„Non-heart-beating donors“ sind nicht geeignet

„Non-heart-beating donors“ sind nicht geeignet

Anevrizmal Subaraknoid Kanama Hastalarında Beyin Ölümü Kararının Verilmesinde Elektroensefalografinin Önemi

Brain Death: A Conclusion in Search of a Justification

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