Brain Death Scenarios

After reading your post and many of the colleague in the class, most agree that is not professional to disregard the conversation that the family was having. Although the patient wishes were not to remain on life support and had a document to prove it he also fail to have a proxy to carry one his whishes. The Health Care Proxy is a simple document, legally valid in many states, which allows a person to name someone (an "agent") to make health care decisions their behalf if they are unable to make or communicate those decisions. (Society, 2015).

Louis Pojman and Roland Puccetti took the position that neocortical brain death was the best definition of death. Many implications resulted from this, including views on assisted death and organ transplant. Would this lead to a slippery slope regarding what death was? Would this lead to an increase in organs available for donation? These are only some of the implications that arose from Pojman and Puccetti’s position. Looking at the neocortical brain death position versus the biologically integrative whole brain position allowed for judgement on which definition had better merit. I will argue that the biological whole brain position is more inconsistent in regards to application. As such, I will take the position of advocating for the

Criteria for declaring death using neurological criteria developed, and today a whole brain definition of death is widely used and recognized as an acceptable way to determine death. (Iltis)

The same central issue arises in those placed on life support. If a person is purely in the mind/brain, then in regards to a patient who is brain dead, withholding essential medical treatment or to even actively stop the body from functioning could never be considered unethical, in fact, it could be considered morally justifiable. If the soul is what makes up the person, then who is to say that the soul leaves the body when the brain stops functioning? The medical professional would then still be morally

In the case of a minor unable to consent or make decisions (due to a mental condition or conscious state) and the absence of parents or legal guardians, two medical doctor must make all medical decisions on his behalf including cardio pulmonary resuscitation and termination of life support.

“The final moments of one’s life are difficult for everyone involved-the patient, loved ones, and even the healthcare provider” (Klein, 2005). If a patient’s final wishes regarding his/her care are undefined or not clear, then the situation could be worse or uncomfortable. During what should be a time of caring, mourning and supporting one another can quickly become overshadowed by ethical and legal battles. However, this can be prevented and avoided by the execution of advanced directives.

Traditionally death was defined with the heart-lung criterion which referred to cardio-respiratory death. The lower brain is what controls respiration therefore the destruction of the brainstem causes loss of all cardio-respiratory vital signs and so death ensues. In 1981, a new definition arose which was labelled as Whole Brain Death. It is defined as an individual being declared dead, despite continuing functional vital signs. (Pojman, pp. 102) There is no consciousness, no control of brainstem reflexes, and a loss of cognitive functions. The individual’s survival is dependent on artificial mechanisms that are provided by doctors. This newer definition was created due to modern technology being able to revive someone who is cardio-respiratory

In cases where CPR is more likely to prolong suffering, it is important for doctors to communicate this with the patient. Though many will decide to opt out of CPR after understanding, doctors must be careful that they allow the patient to make the decision themselves. This is complicated, however, by the fact that family members may be required to make decisions regarding the patient, and often will make choices that the patient would not agree with.

No matter the age, everyone should have a plan for when he or she is comatose and unable to make decisions. When there is no living will or medical power of attorney assigned for the patient the spouse and the patient’s family may not see eye to eye on how to go about the situation. The spouse may want to let the patient die and family may think that the patient will come out of their comatose state or vice versa. There was a case known as the Terri Shiavo case that occurred almost eleven years ago. She had no medical power of attorney or living will leaving her life in the hands of her husband, Michael, who thought he knew what was best and her family who thought the same.

In the medical world, we are sometimes placed into situations with an undesirable outcome. The least desirable outcome imaginable to being pronounced dead, or in our scenario, being labeled “brain dead”. Being classified as brain dead, is not an easy diagnosis to be made, and is defined as “irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” Throughout the course of assessing the articles provided, we learned about a patient by the name of Jahi McMath who had tonsillectomy performed at the Children’s Hospital Oakland. Upon entering the procedure, the family was told the procedure was considered normal. Unfortunately, approximately thirty minutes after the procedure, Jahi begin to experience

Before taking this class I was oblivious to the apparently well-known fact that there are two standards of death. One standard is the cardiopulmonary standard, which is when the heart and lungs cease to function on their own. The second standard is the total brain death standard which is when there is complete and irreversible loss of brain function. There are people who stand in both corners of this argument but most, if not all, stand for only one standard. While the definitions of each standard seems to be clear cut, it is not, as there are some cases in which one standard will not suffice, which we will be discussing in a later paragraph. I will argue that both the

I enjoyed reading your DQ 1 post this week, and it is the patients right to choose, but only if they are deemed competent. They also have to respond willingly. It is also important to understand that telling patients the truth no matter what even if the patient is fatally ill is what is required out of a health care professional. Not only is it the right thing to do, but it is considered the standard of care in the United States (U.S.). To preserve and enhance the patient's autonomy the Patient Self-determination Act was enacted. However, some might say that doctors responsibilities and family integrity are being set to the side ( ). But I think otherwise because it is our right to choose what we believe would be

Per the National Center for Biotechnology Information (NCBI), a diagnosis of brain death is considered legally and clinically dead. It is evidenced by coma, absence of brainstem reflexes and apnea, and is defined as an irreversible loss of brain function. (Brain Death) As a healthcare provider, it can be easy to make a

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

These questions are difficult for any of us to answer - even more so if we are dealing with a situation in which we may have to answer one or more of these questions. Yet, for some of us, these questions are all too real. If someone is considered to be in a vegetative state and the doctor determines that they are not