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An interdisciplinary response to contemporary concerns about brain death determination
Ariane Lewis1, James L Bernat2, Sandralee Blosser2
1From the Departments of Neurology and Neurosurgery, Division of Neurocritical Care (A.L.), NYU Langone Medical Center, New York, NY; Department of Neurology (J.L.B.), Dartmouth-Hitchcock Medical Center, Lebanon, NH; Pittsburgh Critical Care Associates (S.B.), PA; Schools of Law, Medicine, and Public Policy (R.J.B.), University of Virginia, Charlottesville; Department of Pediatrics, Division of Neurology (L.G.E.), Northwestern University Feinberg School of Medicine, Chicago, IL; American Academy of Neurology Deputy General Counsel (J.H.), Minneapolis, MN; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Pediatrics (M.P.K.), The Children's Hospital of Philadelphia, PA; Departments of Neurology & Neurotherapeutics and Neurological Surgery (M.R.), UT Southwestern Medical Center, Dallas, TX; Department of Neurology (J.A.R.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurology (J.A.S.) University of Wisconsin, Madison; Department of Neurology, Division of Critical Care Neurology (E.F.M.W.), Mayo Clinic, Rochester, MN; and Department of Neurology (D.M.G.), Boston University School of Medicine, MA. ariane.kansas.lewis@gmail.com.
Legal challenges prompted a summit on brain death determination. Experts reaffirmed neurologic criteria for brain death and outlined goals to enhance accuracy and public trust in the process.
Area of Science:
- Neurology
- Medical Ethics
- Legal Medicine
Background:
- Recent lawsuits have raised concerns regarding the determination of brain death.
- The American Academy of Neurology Ethics, Law, and Humanities Committee convened a summit to address these issues.
Purpose of the Study:
- To summarize discussions from a multisociety quality improvement summit on brain death determination.
- To reaffirm the validity of neurologic criteria for determining brain death.
- To outline strategies for improving consistency, accuracy, and public trust in brain death determination.
Main Methods:
- A multisociety quality improvement summit was convened in October 2016.
- Discussions focused on addressing aspects of brain death determination that may have contributed to lawsuits.
- The article summarizes the key outcomes and recommendations from the summit.
Main Results:
- The validity of determination of death by neurologic criteria was reaffirmed.
- The use of the American Academy of Neurology practice guideline for adult brain death determination was supported.
- Development of systems for consistent and accurate brain death determination was discussed.
- Strategies for responding to objections and improving public trust were outlined.
Conclusions:
- The determination of death by neurologic criteria remains a valid medical practice.
- Ongoing efforts are needed to ensure consistency, accuracy, and public confidence in brain death determination.
- Collaboration among stakeholders is crucial for refining guidelines and addressing legal challenges.
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