Since not all the hospitals in the U.S. have adopted the same guidelines for declaring brain death, some dead people might not be dead in reality.
When it comes to brain death it is very difficult to call a certain moment as being the moment of death since it is not quite a moment but rather a process. When people die of other causes, like heart attacks it is much easier to define the moment from which things are irreversible and the vital organs have shut down.
One of the cases that show how tricky it can be to declare someone brain dead is the case of Colleen Burns, 41. After she overdosed intentionally on a cocktail of toxic drugs she seemed more dead than alive. Oxygen didn’t seem to be flowing through her lungs anymore and scans of her brain showed poor electrical activity. Her family decided to donate her organs.
However the doctors were very surprised when they got in the operating room and their patient opened her eyes wide. Burns was neither brain dead and not even unconscious anymore. And yet she had almost been killed by the ones who were trying to save her life.
Stories like this one are the nightmare of every doctor and also the reason why the American Academy of Neurology issued a set og guidelines in 2010 which should help hospitals determine brain death.
David Greer from Yale University, one of the neurologists who worked on the guidelines claims that the role of this set of rules is to make sure that no patient is declared brain dead if there is even the slightest hope of recovery.
However, a new study recently published in JAMA Neurology and lead by Dr. Greer shows that not even five years after the national guidelines have been issued not all hospitals have adopted them.
Greer and his team surveyed almost 500 hospitals over a period of three years and discovered that many of them did not require a neurologist or someone with expertise in neurology to determine brain death. Worse than that, about 50 percent of the hospitals did not even require the presence of the patient’s attending physician to make the call. Among these hospitals some of them also didn’t require hypotension or hypothermia tests which can both supress the functions of the brain and appear like brain death.
By not following the guidelines these hospitals risk killing people with small chances of survival and they also appear unworthy of the trust of patient’s families who might not take the decision to stop the life supporting machines or donate the organs of their loved ones with the hope that doctors have made a mistake and they will wake up.
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