There happens to be a precise set of exacting criteria that define brain death that has been in place for years, and which permits the procurement of desperately needed organs. These include: Cause must be appropriate (gunshot wound, severe brain hemorrhage, etc.); absence of intoxicants, poisoning, drugs, metabolic abnormalities; deep coma (no spontaneous movement or response to painful stimulus); absent brainstem reflexes; and apnea, the spontaneous absence of breathing. To test for apnea, there is an exact set of steps to follow, and if no breathing is demonstrated–and testing may be repeated multiple times over the next six hours if confirmation is needed for some reason–then the person is considered to have brain death, the family is counseled and the person may be considered a suitable organ donor.
There are also numerous confirmatory tests that may be used, if desired in the particular situation.
It would be ethically important for the doctor to have mentioned the brain health of the baby he writes about, having been saved from death after 39 minutes of a flat EEG. Near-drowning victims rarely if ever escape profound ischemic brain injury and require lifelong institutional care. There are some things worse than death. “Life” at any cost should take into account the quality of that life. Misleading statements that may impact the organ-procurement cause should be carefully considered before promulgation.
