An interdisciplinary response to contemporary concerns about brain death determination

Ariane Lewis; James L Bernat; Sandralee Blosser; Richard J Bonnie; Leon G Epstein; John Hutchins; Matthew P Kirschen; Michael Rubin; James A Russell; Justin A Sattin; Eelco F M Wijdicks; David M Greer

doi:10.1212/WNL.0000000000005033

An interdisciplinary response to contemporary concerns about brain death determination

Neurology. 2018 Feb 27;90(9):423-426. doi: 10.1212/WNL.0000000000005033. Epub 2018 Jan 31.

Affiliations

¹ From the Departments of Neurology and Neurosurgery, Division of Neurocritical Care (A.L.), NYU Langone Medical Center, New York, NY; Department of Neurology (J.L.B.), Dartmouth-Hitchcock Medical Center, Lebanon, NH; Pittsburgh Critical Care Associates (S.B.), PA; Schools of Law, Medicine, and Public Policy (R.J.B.), University of Virginia, Charlottesville; Department of Pediatrics, Division of Neurology (L.G.E.), Northwestern University Feinberg School of Medicine, Chicago, IL; American Academy of Neurology Deputy General Counsel (J.H.), Minneapolis, MN; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Pediatrics (M.P.K.), The Children's Hospital of Philadelphia, PA; Departments of Neurology & Neurotherapeutics and Neurological Surgery (M.R.), UT Southwestern Medical Center, Dallas, TX; Department of Neurology (J.A.R.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurology (J.A.S.) University of Wisconsin, Madison; Department of Neurology, Division of Critical Care Neurology (E.F.M.W.), Mayo Clinic, Rochester, MN; and Department of Neurology (D.M.G.), Boston University School of Medicine, MA. ariane.kansas.lewis@gmail.com.
² From the Departments of Neurology and Neurosurgery, Division of Neurocritical Care (A.L.), NYU Langone Medical Center, New York, NY; Department of Neurology (J.L.B.), Dartmouth-Hitchcock Medical Center, Lebanon, NH; Pittsburgh Critical Care Associates (S.B.), PA; Schools of Law, Medicine, and Public Policy (R.J.B.), University of Virginia, Charlottesville; Department of Pediatrics, Division of Neurology (L.G.E.), Northwestern University Feinberg School of Medicine, Chicago, IL; American Academy of Neurology Deputy General Counsel (J.H.), Minneapolis, MN; Departments of Anesthesiology and Critical Care Medicine, Neurology, and Pediatrics (M.P.K.), The Children's Hospital of Philadelphia, PA; Departments of Neurology & Neurotherapeutics and Neurological Surgery (M.R.), UT Southwestern Medical Center, Dallas, TX; Department of Neurology (J.A.R.), Lahey Hospital and Medical Center, Burlington, MA; Department of Neurology (J.A.S.) University of Wisconsin, Madison; Department of Neurology, Division of Critical Care Neurology (E.F.M.W.), Mayo Clinic, Rochester, MN; and Department of Neurology (D.M.G.), Boston University School of Medicine, MA.

PMID: 29386276
DOI: 10.1212/WNL.0000000000005033

Abstract

In response to a number of recent lawsuits related to brain death determination, the American Academy of Neurology Ethics, Law, and Humanities Committee convened a multisociety quality improvement summit in October 2016 to address, and potentially correct, aspects of brain death determination within the purview of medical practice that may have contributed to these lawsuits. This article, which has been endorsed by multiple societies that are stakeholders in brain death determination, summarizes the discussion at this summit, wherein we (1) reaffirmed the validity of determination of death by neurologic criteria and the use of the American Academy of Neurology practice guideline to determine brain death in adults; (2) discussed the development of systems to ensure that brain death determination is consistent and accurate; (3) reviewed strategies to respond to objections to determination of death by neurologic criteria; and (4) outlined goals to improve public trust in brain death determination.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Death / diagnosis*
Brain Death / physiopathology*
Female
Guideline Adherence
Humans
Male
Neurology / standards*
Practice Guidelines as Topic*
Reproducibility of Results
Societies, Medical / organization & administration
Societies, Medical / standards*