Maternal brain death: medical, ethical and legal issues

Abstract

A consensus building approach, involving the family, is essential to resolving these potentially conflicting issues.

Guidelines for supporting a pregnant patient with brain death: A case discussion and literature review

“…[1,2,[4][5][6] Understanding the many lines of thinking related to these ethical issues should provide health care professionals with a basis to care for patients who are brain dead and the fetus. Care may include providing education and support to families dealing with difficult decisions about the brain dead mother.…”

“…The literature addresses three lines of ethical reasoning: maintaining the mothers' body as a "fetal incubator" is unethical; mothers who, prior to death, wished to donate their organs are "donating" their organs to the fetus; and the decision to somatically support the mother is a choice of the next of kin. [1,2,[4][5][6] Some professionals believe it is not ethical to maintain the mothers' body as a fetal incubator because this places the mother as a "fetal container" with no autonomous rights. [1] This line of thinking asks "Who makes the decision to continue the somatic support in hopes of a viable fetus?"…”

“…[1] It is generally considered unethical and futile to support vital organs when brain death is diagnosed. [2] Patients who are in a persistent vegetative state (PVS), are in a coma, or are brain dead and pregnant complicate the issue of continued support because the fetus may be viable. As a result, the issue is fraught with questions, both ethical and legal.…”

“…Some literature considers the appropriateness of continuing maternal somatic support in order to prolong gestation until the fetus can be delivered. [1,2,[4][5][6] A national registry could assist in making evidence based guidelines for the management of extended maternal somatic support.…”

Gestação e morte cerebral materna: decisões em torno da vida fetal

“…To Giorgio Agamben 8 , it is a discussion about the differences between biological body and political body, naked life and dignified life or, in his terminology, between "zoé" and "bios". week of pregnancy 21 . It focuses on the decision to prolong somatic support of the mother's vital functions in order to reach fetal viability.…”