Should the Brain Death Exam With Apnea Test Require Surrogate Informed Consent? No

Abstract

When a patient is admitted to a hospital for treatment, it is a general policy and practice that the patient (or their surrogate, if the patient is incapacitated) consents to be treated. Of course, this is not a blanket or all-encompassing consent, and any diagnostic workup or treatment that may pose a risk to the patient necessitates a separate “informed” consent, in which the risks and benefits are explained to the patient or their surrogate and a decision can be made to proceed with, or decline, such treatment. In general, informed consent is obtained when there is (1) medical risk and (2) a diagnostic workup or treatment that is beyond the norm. For example, a simple venipuncture for laboratory studies does not generally require informed consent because it is considered part of standard care; however, placement of a central venous catheter generally does require consent because it carries greater risk and is beyond the “basics” of standard care.

An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project

“…[203][204][205][206][207] Accordingly, in recent years, there have been a myriad of publications debating the need for consent prior to BD/DNC determination and management of objections to the evaluation or discontinuation of organ support. [208][209][210][211][212][213][214][215][216][217][218][219] A 2023 book on controversies related to BD/DNC included detailed discussions of public perspectives on BD/DNC, in general, and specific religious perspectives on BD/DNC (i.e., Christian, Islamic, and Jewish perspectives). [220][221][222][223] Public views on BD/DNC have also been addressed elsewhere in the literature since publication of the WBDP.…”