This clarity may help identify when the brain has stopped working, completely and irrevocably
When your brain stops working — completely and irreversibly — you’re dead. But drawing the line between life and brain death isn’t always easy. A new report attempts to clarify that distinction, perhaps helping to ease the anguish of family members with a loved one whose brain has died but whose heart still beats.Brain death has been a recognized concept in medicine for decades. But there’s a lot of variation in how people define it, says Gene Sung, a neurocritical care physician at the University of Southern California in Los Angeles. “Showing that there is some worldwide consensus, understanding and agreement at this time will hopefully help minimize misunderstanding of what brain death is,” Sung says.
This group, including experts in critical care, neurology and neurosurgery, reviewed the existing research on brain death (which was slim) and used their clinical expertise to write the recommendations, published August 3 in JAMA. In addition to the main guidelines, the final product included 17 supplements that address legal and religious aspects, provide checklists and flowcharts, and even trace the history of relevant medical advances. “Basically, we wrote a book,” Sung says.
The minimum requirement for determining brain death is “a good, thorough clinical examination,” Sung says. Before the exam even occurs, doctors ought to verify that a person has experienced a neurological injury or condition that could cause brain death. Next, clinicians should look for other explanations, conditions that could mimic brain death but are actually reversible. Cooling the body, a procedure for treating heart attacks, can cause brain function to temporarily disappear, the report points out. So can certain drugs, alcohol and other toxins.
