Brain Death: Lessons From the McMath Case

Copnell, Beverley

doi:10.4037/ajcc2014654

Cited by 2 publications

(1 citation statement)

References 24 publications

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“…This case highlights relevant issues and typifies potential problems that may arise, thereby serving as an effective nidus for discussion (33)(34)(35). Pertinent facts surrounding the McMath case have been summarized from prior publications and news reports.…”

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Radionuclide Evaluation of Brain Death in the Post-McMath Era

Zuckier

2016

J Nucl Med

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Learning Objectives: On successful completion of this activity, participants should be able to (1) relate the diagnostic protocols and recommendations regarding the clinical diagnosis of brain death; (2) list the relative advantages and disadvantages of lipophilic and nonlipophilic blood flow radiopharmaceuticals for brain blood flow studies; and (3) consider how the nuclear medicine blood flow study could assist the clinician in making the difficult diagnosis of brain death.Financial Disclosure: The author of this article has indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through October 2019.The pronouncement of death is a determination of paramount social, legal, and ethical import. The novel construct of "brain death" was introduced 50 years ago, yet there persist gaps in understanding regarding this diagnosis on the part of medical caregivers and families. The tragic, much-publicized case of Jahi McMath typifies potential problems that can be encountered with this diagnosis and serves as an effective point of departure for discussion. This article recapitulates the historical development of brain death and the evolution of scintigraphic examinations as ancillary or confirmatory studies, emphasizing updated clinical and imaging practice guidelines and the current role of scintigraphy. The limitations of clinical and radionuclide studies are then reviewed. Finally, the article examines whether radionuclide examinations might be able to play an expanded role in the determination of brain death by improving accuracy and facilitating effective communication with family members.

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confidence: 98%