Brain Death MBBS Notes | EduRev

MBBS : Brain Death MBBS Notes | EduRev

 Page 1


BRAIN DEATH 
Pediatric Critical Care Medicine 
Emory University 
Children’s Healthcare of Atlanta 
Page 2


BRAIN DEATH 
Pediatric Critical Care Medicine 
Emory University 
Children’s Healthcare of Atlanta 
2 
Background 
• Before the 1960’s, donation after cardiac death (DCD) was 
the general approach to organ donation 
 
• 1968, an ad hoc committee at Harvard Medical School 
proposed a neurologic based death definition, which 
replaced DCD 
Page 3


BRAIN DEATH 
Pediatric Critical Care Medicine 
Emory University 
Children’s Healthcare of Atlanta 
2 
Background 
• Before the 1960’s, donation after cardiac death (DCD) was 
the general approach to organ donation 
 
• 1968, an ad hoc committee at Harvard Medical School 
proposed a neurologic based death definition, which 
replaced DCD 
3 
Background 
• 1980, with modifications, by the President’s Commission for 
the Study of Ethical Problems in Medicine & Biomedical 
Research, as a recommendation for state legislature & court 
• The “brain death” standard was also employed in the model 
legislation known as the Uniform Determination of Death 
Act, which has been enacted by a large number of 
jurisdictions & the standard has been endorsed by the 
influential American Bar Association 
Page 4


BRAIN DEATH 
Pediatric Critical Care Medicine 
Emory University 
Children’s Healthcare of Atlanta 
2 
Background 
• Before the 1960’s, donation after cardiac death (DCD) was 
the general approach to organ donation 
 
• 1968, an ad hoc committee at Harvard Medical School 
proposed a neurologic based death definition, which 
replaced DCD 
3 
Background 
• 1980, with modifications, by the President’s Commission for 
the Study of Ethical Problems in Medicine & Biomedical 
Research, as a recommendation for state legislature & court 
• The “brain death” standard was also employed in the model 
legislation known as the Uniform Determination of Death 
Act, which has been enacted by a large number of 
jurisdictions & the standard has been endorsed by the 
influential American Bar Association 
4 
Background 
• Even though there has been legal acceptance of the concept 
of brain death, there is a lack of a standardized approach 
• No national brain death law exists 
• State law & statutes may restrict the determination of brain 
death 
• Reasons for revising guidelines 
– Allow physicians to pronounce brain death in pediatric patients in a 
more precise and orderly manner 
– Appropriate documentation 
 
Page 5


BRAIN DEATH 
Pediatric Critical Care Medicine 
Emory University 
Children’s Healthcare of Atlanta 
2 
Background 
• Before the 1960’s, donation after cardiac death (DCD) was 
the general approach to organ donation 
 
• 1968, an ad hoc committee at Harvard Medical School 
proposed a neurologic based death definition, which 
replaced DCD 
3 
Background 
• 1980, with modifications, by the President’s Commission for 
the Study of Ethical Problems in Medicine & Biomedical 
Research, as a recommendation for state legislature & court 
• The “brain death” standard was also employed in the model 
legislation known as the Uniform Determination of Death 
Act, which has been enacted by a large number of 
jurisdictions & the standard has been endorsed by the 
influential American Bar Association 
4 
Background 
• Even though there has been legal acceptance of the concept 
of brain death, there is a lack of a standardized approach 
• No national brain death law exists 
• State law & statutes may restrict the determination of brain 
death 
• Reasons for revising guidelines 
– Allow physicians to pronounce brain death in pediatric patients in a 
more precise and orderly manner 
– Appropriate documentation 
 
5 
Brain Death 
• An individual who has sustained either 
– Irreversible cessation of circulatory & respiratory functions 
– Irreversible cessation of all functions of the entire brain, including 
the brainstem, is dead 
 
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