Controversies
Thomas Nakagawa, MD, , FCCM
Professor
University of Florida College of Medicine Wolfson Children's Hospital
Jacksonville, Florida
Disclosure(s): HonorBridge Organ Procurement Organization: Salary (Ongoing); Wolters-Kluwer UpToDate: Receipt of Royalties (Ongoing)
Cherylee Chang, MD, FNCS, FACP
Professor; Division Chief, Neurocritical Care
Duke University Medical Center, North Carolina
Disclosure(s): No relevant financial relationship(s) to disclose.
The concept of death by neurologic criteria is supported by a consensus of critical care professionals involved in death determination. A number of highly publicized cases of brain death determination in patients with catastrophic brain injuries have increased public distrust and family discord around the acceptance of brain death as a diagnosis. The first working diagnostic criteria for brain death determination were developed 55 years ago, in 1968, by a Harvard ad hoc committee. Although brain death is a legal standard of death in the United States, increasing numbers of clinicians are asked to continue organ support after brain death determination, and some families have successfully had brain-dead family members transferred to other institutions for ongoing care. Families request continuation of organ support for a variety of reasons, including belief that a brain-dead patient could regain neurologic function, lack of acceptance that a person can be dead if the heart is still beating, and religious beliefs. Most hospital protocols do not address family objections to death determination; consequently, clinicians, administrators, and ethics committees lack adequate guidance. This session will address current challenges around brain death diagnoses and management of family members when there is disagreement around the construct of brain death.
Concurrent Session Faculty: Angela M. Nelson, ACNP, DNP, FCCM – NYU Langone Medical Center and School of Medicine
Concurrent Session Faculty: Joshua M. Levine, MD (he/him/his) – Hospital of The University of Pennsylvania
Concurrent Session Faculty: Erin Paquette, MD, JD, M. Bioethics – Ann and Robert H Lurie Childrens Hospital of Chicago