Debate simmers over when doctors should declare brain death

When can a person be declared dead? The question can be hard to answer ...

MORNING EDITION – Benjamin Franklin famously wrote: “In this world nothing can be said to be certain, except death and taxes.”

While that may still be true, there’s a controversy simmering today about one of the ways doctors declare people to be dead.

The debate is focused on the Uniform Determination of Death Act, a law that was adopted by most states in the 1980s. The law says that death can be declared if someone has experienced “irreversible cessation of all functions of the entire brain.”

But some parts of the brain can continue to function in people who have been declared brain dead, prompting calls to revise the statute.

Many experts say the discrepancy needs to be resolved to protect patients and their families, maintain public trust and reconcile what some see as a troubling disconnect between the law and medical practice.

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The debate became so contentious, however, that the Uniform Law Commission, the group charged with rewriting model laws for states, paused its process last summer because participants couldn’t reach a consensus.

“I’m worried,” says Thaddeus Pope, a bioethicist and lawyer at Mitchell Hamline School of Law in St. Paul, Minnesota. “There’s a lot of conflict at the bedside over this at hospitals across the United States. Let’s get in front of it and fix it before it becomes a crisis. It’s such an important question that everyone needs to be on the same page.”

Criteria for brain death are the challenge

There are two ways doctors can declare someone dead. The original method, which remains the most common, is known as circulatory death. It occurs when someone stops breathing permanently and their heart stops beating permanently, such as from a heart attack. This method is applicable if CPR or breathing machines are unsuccessful or will not be used.

The second method, brain death, can be declared for people who have sustained catastrophic brain injury causing the permanent cessation of all brain function …


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