K_Z
Verified Anesthetist
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- Nov 8, 2010
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With the caveat that this occurred outside of the US so I'm not completely clear on their medical system, policies, protocols, and laws:
-It doesn't appear that she was ever truly declared brain dead. At least in the US absence of brain stem reflexes is only part of the criteria. It doesn't appear that the doctors actually went through the full criteria and made the determination. Instead they explained to the family (including a physician brother of some sort) that the prognosis was grim and recommended that they withdraw support. I get the impression that their feeling was that brain death was the likely outcome but that the ultimate outcome hadn't been reached.
-The patient in question began showing signs of improvement within less than 48 hours after her arrest.
There is the other issue (which unfortunately I think will be worse after this case) that there is a lot of misunderstanding of what brain death is. Brain death=death. Brain death is not the same as a coma, or as a persistent vegetative state (i.e.. Terry Schiavo etc). In many cases there are patients who are profoundly neurologically devastated but have some residual brain function. Their prognosis may be very grim but the important distinction is that they are not dead.
I agree that the issue has been made worse, nationally, not better or clearer. And I think the media has a lot to do with that.
I'm concerned that now a very high profile "example", or precedent, has been set. Meaning, other families will cite this case as an example of why they might not want to "agree to" brain death and withdrawl of ventilator support. (We know they don't have to, but I think the issue has been tremendously muddied, rather than clarified.)