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Topic: Brain death

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	braindeath (Site not responding. Last check: 2007-11-06)
		Today death of the brain is considered to be the death of the individual and death of the brain stem, is accepted as death of the brain and therefore of the individual.
		Brain death was first described by two French physicians, Mollart and Goulon and termed coma depasse (a state beyond coma) They differentiated coma depasse from coma prolonged, the latter being the condition, which is now termed persistent vegetative state.
		This emphasized that permanent functional death of the brainstem constitutes brain death and that this should only be diagnosed in the context of irremediable structural brain damage, after exclusion of certain specified conditions, which might contribute to or cause the coma.
	www.thamburaj.com /brain_death.htm (4344 words)

	Howstuffworks "How Brain Death Works"
		The diagnosis of "brain death" is only possible because of modern medicine's ability to maintain the functions of supporting organs of the body after the brain is no longer viable.
		Once the examination of the brain has determined that it is no longer viable and there is no chance of any recovery of function, the "brain death" diagnosis is made.
		Families of a brain dead patient must, by federal regulations, be provided the option of organ donation.
	health.howstuffworks.com /brain-death5.htm (520 words)

	Brain Death: Is That Dead Enough?
		I believe that brain death is not real death because the patient’s heart is still beating and when we touch him or her, we feel his body is warm, which proves they are still alive.
		But, in the case of brain death, I think life support should be removed after the patient's family has come to terms with the fact that their loved one is gone, and if that takes disconnecting the ventilator so that they can see that their loved one does not breathe, then so be it.
		Brain death as a criterion for death is fine in deciding on a fairly acute basis when to disconnect artificial life support mechanisms in an intensive care unit or hospital situation.
	www-hsc.usc.edu /~mbernste/ethics.braindeath.html (11069 words)

	Jewish Law - Articles - "The Brain Death Controversy in Jewish Law" (Site not responding. Last check: 2007-11-06)
		The "brain death" standard was also employed in the model legislation known as the Uniform Determination of Death Act which has been enacted by a large number of jurisdictions and the standard has been endorsed by the influential American Bar Association.
		The human brain consists of three basic anatomic regions: (1) the cerebrum; (2) the cerebellum; and (3) the brain stem consisting of the midbrain, the pons, and the medulla, which extends downwards to become the spinal chord.
		The time lag between brain death and circulatory death is on the average only two to ten days, though there is at least one case on record where a woman's heart continued to beat for 63 days after a diagnosis of brain death.
	www.jlaw.com /Articles/brain.html (3247 words)

	Brain Death and Technological Change
		Most whole brain partisans are comfortable with family and health care institutions having wide discretion to withhold and withdraw life support, including food and fluids, from bodies in PVS on the grounds of advance directives, surrogate decision-making, quality of life judgments, or resource allocation.
		One of the principal drawbacks of the higher-brain definition of death, acknowledged by both proponents and opponents, is that the diagnosis of whole brain death is technically possible, while the diagnosis of irreversible cessation of cerebral function is more difficult or impossible.
		If the brain tissue that gave rise to a person is destroyed, and replaced by brain tissue or cybernetics which give rise to a new person, it would not be correct to consider this new person as identical with the previous one.
	www.changesurfer.com /Hlth/BD/Brain.html (5462 words)

	Brain Death and Brain Injury Resources (Site not responding. Last check: 2007-11-06)
		Determination of Death Consensus Conference: Voluntary Consensus Guidelines for Determination of Death
		is Margaret Lock's comparison of the adoption of the concept of brain death in Japan and the United States.
		Brain Death : Proceedings of the Second International on Brain Death, Havana, Cuba...
	www.changesurfer.com /BD/Brain.html (323 words)

	End of Life Care (Site not responding. Last check: 2007-11-06)
		Classifying “brain death” as death also was expected to alleviate some of the problems associated with overpopulation in hospital intensive care units.
		A key assumption of "brain death" is that the brain is the body's central, irreplaceable integrating organ, and that irreversible cessation of functioning of the brain represents bodily death.
		Death signifies the separation of this unity, which unity is served by the intercooperation of at least three vital systems--the circulatory and respiratory systems, and the entire brain.
	www.all.org /issues/eol05.htm (1126 words)

	Understanding Brain Death
		For the brain, "destruc-tion" implies such damage to the neurons that they disintegrate physically both individually and collectively.) The converse, of course, is obvious: the total destruction of the entire brain does imply irreversible cessation of every kind of brain function.
		Brain waves were recorded only once and at the time the determination of brain death was made, a therapeutic level of phenobarbital was still in his blood.
		In the United States all laws regarding brain death are couched in cessation of function, functions, or functioning, while the law in Norway calls for destruction of the brain.
	www.vitalsignsministries.org /vsmbraindeath.html (4859 words)

	Catholic Culture : Document Library : Brain Death
		If "brain death" and death were identical and equivalent, there would not be a need for the term "brain death." Everyone knows that the body, the remains that are viewed at a funeral home, is dead.
		Compare that body to the patient in an intensive care unit who has been declared "brain dead" but who is receiving ventilatory support.* The heart is beating, the blood pressure and temperature are being recorded, the color is normal, if the knee is tapped the knee jumps, and many internal organs and systems are functioning.
		Today, however, death is often declared for reasons not related to the patient's welfare — such as organ transplantation, cost containment, and propagation of the euthanasia movement.
	www.catholicculture.org /docs/doc_view.cfm?recnum=830 (544 words)

	The New Yorker: Fact (Site not responding. Last check: 2007-11-06)
		Brain death is confusing because it's an artificial distinction constructed, more than thirty years ago, on a conceptual foundation that is unsound.
		Consent rates are tied directly to knowledge of brain death: families who think that donation is actually going to kill the patient refuse more often than families who believe that their relative is already dead.
		The neurologist James Bernat, a professor at Dartmouth Medical School and the author of the chapters on brain death in several neurology textbooks, is one of the defenders of the whole-brain concept.
	newyorker.com /fact/content/articles/010813fa_FACT (4443 words)

	What is brain death? (Site not responding. Last check: 2007-11-06)
		Brain death is defined as the irreversible loss of all functions of the brain.
		Ischemia - Blockage of an artery leading to the brain or in the brain, heart attack (stoppage of the heart for a period of time), bleeding in the brain.
		Because the brain is enclosed in the skull, it does not have room to swell, thus pressure within the skull increases (this is "intracranial pressure").
	www.transweb.org /qa/asktw/answers/answers9509/braindeath.html (327 words)

	Wired News: Brain Dead Means Dead
		Brain dead people often still have a heartbeat, and their chests may rise and fall with the help of a ventilator, sometimes giving hope to grieving families that the person may suddenly wake up.
		If a brain death situation is explained clearly, and a family decides to donate, up to seven lives can be saved by one person's organs.
		But most of Sharon's family did not know the definition of brain death, except Colleen who is a registered nurse.
	www.wired.com /news/technology/0,1282,42847,00.html (1107 words)

	Brain Death vs. Cardiac Death
		Brain death means there is no blood flow or oxygen to the brain, therefore the brain cannot function in any capacity and never will again.
		Once the patient is brain dead, he or she is dead because the brain will not recover.
		The recorded time of death is when the patient is declared dead, not when the heart actually stops beating.
	www.unyts.org /braindeath.htm (388 words)

	American Life League - Euthanasia (Site not responding. Last check: 2007-11-06)
		Legislation to establish "brain-related" criteria for death has uniformly confounded irreversible cessation of all functions of the entire brain with death of the human person.
		For the brain, "destruction" implies such damage to the neurons that they disintegrate physically both individually and collectively.) The converse, of course, is obvious: the total destruction of the entire brain does imply irreversible cessation of every kind of brain function.
		Brain waves were recorded only once and at the time the determination of brain death was made, a therapeutic -level of phenobarbital was still in his blood.
	www.all.org /issues/ie12.htm (4804 words)

	Questions and Answers about Donation After Death: Brain Death (Site not responding. Last check: 2007-11-06)
		When someone is brain dead, it means there is no blood flow or oxygen to their brain and that their brain is no longer functioning in any capacity and never will again.
		Once the patient is brain dead, he or she is already dead.
		When brain death is declared, there is no hope, and it is time to let go.
	www.transweb.org /qa/qa_don/br_death.htm (1327 words)

	Consortium Ethics Program (Site not responding. Last check: 2007-11-06)
		On the contrary, it used the idea of “brain-death” to emphasize that, except for heartbeat, all of the traditional bedside criteria for diagnosing death (namely, general unresponsiveness, pupillary non-reactivity and apnea) directly implicated brain functions and that heartbeat, because of its dependence on breathing, implicated brain function indirectly.
		Nevertheless, the physician should recognize that “disclosing the death of a patient to the patient’s family is a duty which goes to the very heart of the physician-patient relationship.
		The emotional needs of the family and the integrity of the physician-patient relationship must at all times be given foremost consideration.”2 The timing of the order to stop treatment of a patient pronounced dead on the basis of neurological criteria should reflect the physician’s judgment how best to respect these values.
	www.pitt.edu /~cep/41-3.html (1248 words)

	Brain Death Criteria MEDSTUDENTS-NEUROLOGY (Site not responding. Last check: 2007-11-06)
		Brain death is the cessation and irreversibility of all brain function, including brain stem.
		Nowadays, modern ressucitative devices and technics can maintain the function of the heart, lungs and visceral organs for a period of time(hours or days) after the life-maintaining centers of the brain stem tissue have stopped function, which results in a medical dilema of a dead brain in a otherwise living body.
		In 1981, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (USA) developed standards for the determination of brain death which with some modifications are accepted worlwide.
	www.medstudents.com.br /neuro/neuro5.htm (513 words)

	Brain Death and Organ Transplantation: current ethical issues, debate
		Under this law before a “legal brain death diagnosis” and “organ removal” can occur, both the “donor's prior declaration” and “family consent” must be obtained.
		While agreeing that the law allows a choice in defining when death begins, critics argue that the “donor's prior declaration” principle is too strict.
		Brain Dead Person (1989) "human relationship oriented analysis" of the issue of brain death.
	www.lifestudies.org /specialreport01.html (306 words)

	The Truth About "Brain Death"
		"If brain death and death were identical and equivalent, there would be no need to coin 'brain death.'...
		Brain death is not based on data that would be considered valid for any other scientific purpose.
		Brain death is not the truth, but someday the truth will have to be told."
	www.geocities.com /eappleby/braindeath.html (198 words)

	Bioethics for clinicians: 24. Brain death -- Lazar et al. 164 (6): 833 -- Canadian Medical Association Journal
		Brain death is defined as the absence of all brain function
		the acceptance of brain death as a criterion for declaring death.
		the diagnosis of brain death and consents to organ donation.
	www.cmaj.ca /cgi/content/full/164/6/833 (2328 words)

	Brain Death
		He has been declared "brain dead" by a neurologist and a neurosurgeon who examined him on two occasions 24 hours apart.
		When the patient was temporarily taken off the ventilator, he became hypercarbic, acidemic and did not breathe spontaneously.
		states that brain death is legal definition of death.
	wings.buffalo.edu /faculty/research/bioethics/brain.html (787 words)

	MIR Teaching file case br002 (Site not responding. Last check: 2007-11-06)
		The exact standards for determination of brain death vary depending on state and hospital policy, but typically no single test is used as the single diagnostic test to determine brain death.
		The cerebral edema accomanying necrosis of brain tissues results in increased intracranial pressure, since the skull is a relatively closed cavity.
		Note that the brain stem and cerebellum is not well evaluated on this study, hence the diagnosis of "lack of effective cerebral perfusion".
	gamma.wustl.edu /br002te117.html (346 words)

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