Shouldn't Dead Be Dead?: The Search for a Uniform Definition of Death

Lewis, Ariane; Cahn-Fuller, Katherine; Caplan, Arthur L.

doi:10.1177/1073110517703105

Cited by 49 publications

(39 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The AAN believes that the public trust in accurate brain death determination and the ability of the courts to adjudicate contentious cases will be enhanced by uniform brain death laws, policies, and practices. 6,16 Accordingly, the AAN supports legislation modeled after the Nevada statute and efforts to develop (1) uniform institutional policies for brain death determination within US medical facilities, (2) training programs for physicians who determine brain death, (3) credentialing mechanisms for physicians involved in brain death determination, regardless of specialty, (4) institutional policies that ensure compliance with the medical standards for brain death determination by physicians, (5) research that enhances the brain death knowledge base and the accuracy of its determination, and (6) enhanced professional and public education regarding these considerations.…”

Section: Uniformity Of Brain Death Determinationmentioning

confidence: 99%

“…Accordingly, the AAN believes that death should be determined by criteria that can be objectively and uniformly assessed in order to demonstrate irreversible loss of circulatory or whole brain function, as supported by the President's Commission. 6,7 Physicians are uniquely qualified and authorized by their training, experience, and licensure to determine that death has occurred by either a circulatory or neurologic mechanism, and are professionally obligated to make this determination in a timely and accurate manner. c Accordingly, the AAN believes that its members have both the moral authority and professional responsibility, when lawful, to perform a brain death evaluation including apnea testing, after informing a patient's loved ones or lawful surrogates of that intention, but without obligation to obtain informed consent.…”

Section: Aan Guidance To Its Members Responding To Requests For Accommentioning

confidence: 99%

See 1 more Smart Citation

Brain death, the determination of brain death, and member guidance for brain death accommodation requests

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Uniformity Of Brain Death Determinationmentioning

confidence: 99%

Section: Aan Guidance To Its Members Responding To Requests For Accommentioning

confidence: 99%

Brain death, the determination of brain death, and member guidance for brain death accommodation requests

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…Brain death is legally accepted as death in every state, but the language of state laws on determination of death is not uniform. 25 Summit attendees voiced concern that lack of uniformity in both institutional policies and practices related to brain death determination and statutory definitions of death may, along with other factors, have contributed to the recent surge in lawsuits related to determination of death by neurologic criteria. If brain death is handled inconsistently by the medical or legal community, or handled differently from cardiopulmonary death, there could be erosion of public trust in the use of neurologic criteria to declare death.…”

mentioning

confidence: 99%

An interdisciplinary response to contemporary concerns about brain death determination

et al. 2018

Self Cite

View full text Add to dashboard Cite

In response to a number of recent lawsuits related to brain death determination, the American Academy of Neurology Ethics, Law, and Humanities Committee convened a multisociety quality improvement summit in October 2016 to address, and potentially correct, aspects of brain death determination within the purview of medical practice that may have contributed to these lawsuits. This article, which has been endorsed by multiple societies that are stakeholders in brain death determination, summarizes the discussion at this summit, wherein we (1) reaffirmed the validity of determination of death by neurologic criteria and the use of the American Academy of Neurology practice guideline to determine brain death in adults; (2) discussed the development of systems to ensure that brain death determination is consistent and accurate; (3) reviewed strategies to respond to objections to determination of death by neurologic criteria; and (4) outlined goals to improve public trust in brain death determination.

show abstract

“…All 50 states adopted the definition of death the President's Commission created, or a variation thereof. 12 As a result, it is the medical community's responsibility to ensure that it is clear what constitutes "accepted medical standards" for determination of death and that these criteria are adhered to consistently and accurately. In addition, we would argue Dr. Shabtai's implication that medical societies are epistemologically confined to the scientific method given that physicians, such as Aristotle and Maimonides, have always been key contributors to the philosophical discourse of medical ethics.…”

mentioning

confidence: 99%

Subcutaneous ofatumumab in patients with relapsing-remitting multiple sclerosis

2018

Neurology

View full text Add to dashboard Cite

We disagree with redefining death "based on loss of clinical function of the heart and lungs or the brain," 1 because it deviates from the legal definition of irreversible cessation of cardiorespiratory function or of all functions of the brain, including the brainstem. The latter was intended to protect the general public from injury and harm due to incorrect death declaration. The contemporary clinical criteria have been challenged on scientific, philosophical, legal, and religious grounds. 2-4 Lewis et al. reduce this opposition to "moral or religious beliefs, hope that a patient will recover, or a lack of acceptance that a determination of brain death is the legal equivalent of Editors' note: An interdisciplinary response to contemporary concerns about brain death determination "An interdisciplinary response to contemporary concerns about brain death determination" generated several readers' responses. Commenting on the paper, Verheijde et al. argue that cardiopulmonary death is not the equivalent to brain death and add that public trust in brain death requires that there be zero false-positive determinations of death. Dr. Sethi suggests that lawsuits related to brain death may be linked more to breakdowns in communication between the medical teams and patient families rather than validity of determination of death by neurologic criteria. Machado et al. suggest that ancillary tests should have a decisive role in helping to delineate the brain death concept since clinical evaluation might have pitfalls. Finally, Dr. Shabtai feels that it is an error to frame the debate as one of religious or moral beliefs vs science, and suggests continued discussion, including broad public debate. Authors Lewis et al. defend their article citing several prominent American medical societies who support that brain death is equivalent to cardiopulmonary death. They add that when the American Academy of Neurology guidelines are appropriately applied, there are zero false-positive determinations of death. They suggest including a social worker, psychologist, palliative care specialist, chaplain, and religious figure in conversations about brain death. They explain that ancillary testing is recommended to assess for lack of intracranial blood flow or cerebral activity if a clinical evaluation cannot be completed, but the gold standard for determination of brain death is a full clinical evaluation. Further, they add that ancillary testing is imperfect and there are risks when performing testing and interpreting the results. Finally, they remind the reader that the 1981 President's Commission determined that death should be defined based on complete loss of function of the brain or the heart and lungs, but deferred to the medical community to establish the specific criteria for determination of death. They stress that it is the medical community's responsibility to ensure that it is clear what constitutes "accepted medical standards" for determination of death and that these criteria are adhered to consistently and accurately.

show abstract

Shouldn't Dead Be Dead?: The Search for a Uniform Definition of Death

Cited by 49 publications

References 23 publications

Brain death, the determination of brain death, and member guidance for brain death accommodation requests

Brain death, the determination of brain death, and member guidance for brain death accommodation requests

An interdisciplinary response to contemporary concerns about brain death determination

Subcutaneous ofatumumab in patients with relapsing-remitting multiple sclerosis

Contact Info

Product

Resources

About