Raleane Kupferschmidt suffered a massive cerebral haemorrhage in January. According to ABC News, doctors at United Hospital in St. Paul, Minnesota told her family that "there was nothing modern medicine could do to save her life."Pursuant to her advance directive, Kupferschmidt's family removed her from life support, finalized funeral arrangements and brought her home to die. "We were saying our goodbyes, waiting for her to pass," said daughter Lisa Sturm. Then suddenly, in the midst of their mourning, "my mom started to wake up." So they rushed Kupferschmidt back to the hospital, where two holes were drilled in her skull to drain the blood clot that had formed. Kupferschmidt returned home yesterday — "a walking, talking medical miracle her doctors simply can't explain."
Yes, miracles do happen. But remember two important points. First, Kupferschmidt was never diagnosed as PVS. She had not been in a coma for a a sufficient amount of time such there was virtual certainty she would not regain consciousness. Second, many press stories unfortunately report that Kupferschmidt had been diagnosed as "brain dead." That is clearly erroneous and sure to creates lots of false hope and unnecessary family-provider conflict.
Wrongful declaration of brain death to solve the national crisis of shortage of transplant organs
ReplyDeleteThe original Harvard description (Beecher 1968) and the President's Commission report on defining death (1981) described the clinical diagnosis of brain death in adults and not children or babies. The clinical diagnosis of “brain dead" applied on a child or a baby is medically inaccurate and can only be deceptive to the general public. The gold standard to confirm a clinical diagnosis of brain death is to demonstrate the complete absence of blood flow in the four blood vessels supplying the human brain while there is a beating heart and normal blood pressure. This test is rarely performed nowadays because of the speed required to declare brain death in order to harvest organs.
It should be emphasized that “brain dead” human beings are not dead from a biological perspective (http://www.lifestudies.org/truog01.html ). Brain dead individuals have many biological functions shared with other living organisms (growth to puberty, reproduction, pregnancy, etc.) . Pregnancies in “brain dead” human beings can give birth to live health babies.
Besides the scientific argument if a “brain dead” human being is really dead, a recent report of how brain death is declared (NEUROLOGY 2008;70:284-289) in US hospitals provide a disturbing trend in this particular area of medical practice . There is wide variability and inconsistency of how brain death is declared by medial professionals among top 50 leading US hospitals. Wrongful declaration of brain death has serious medical consequences to patients and families. Wrongful declaration of brain death has also serious legal consequences to health care and procurement professionals if organ donation ensued as a result of this wrongful declaration. The slippery slope of wrongful declaration of brain death across ages and especially in children and babies may be convenient to harvest more organs for transplantation in the US. The wrongful declaration of brain death comes at a time when shortage of organs for transplantation is a national crisis on the news headlines.
Is this the way medical professionals intend to solve the national crisis of shortage of transplant organs?
Should harvesting organs for 97,000 patients on US transplant waiting list be of higher priority than preserving the integrity and trust in the medical profession?
The feasibility of reassigning persistent vegetative state PVS under the umbrella of neurological or brain death has also been recently discussed as another way to solve the national crisis of shortage of organs removed for transplant (http://www.bioethics.gov/transcripts/sept07/session1.html ) .
Should medical practice dictate its own moral and legal limits?
Should medical practice have the authority to decide what culturally is acceptable for society?
These are good criticisms of the brain death criteria for death. It is not a scientific concept but a legal one. This definition was adopted by all 50 democratically elected state legislatures.
ReplyDeleteThe medical profession only ascertains when brain death obtains with respect to a particular patient. It has not unilaterally decided upon brain death as a way to determine death (alternative to cardio-pulmonay).
I have a friend who has taking some differents pills such as generic viagra,aspirin,kuiloin, etc and one day he he fell into coma, so I think that the blog says a good new because the woman is so courageous.
ReplyDelete