Wednesday, November 19, 2008
Brain stem death
Brain Stem Death was first formally introduced in 1976 and has been ratified by the Department of Health and Medical Royal Colleges on several occasions since, most recently in October 2008. Its equation with human death is based on the concept that when essential elements of the brain stem - the stalk of the brain which connects its bulk (the cerebral hemispheres and mid-brain) to the spinal cord - are permanently out of action it is reasonable to disregard continuing activity (life) elsewhere in the brain, e.g. in the thalamus and "higher centres", because there can never again be consciousness or spontaneous breathing. That concept has not found acceptance in the USA (and many other countries) where the irreversible cessation of all functions of the entire brain must be established for the legal certification of death on neurological grounds. ( taken from wikipedia )
How do you tell the family that this is the condition that your son/daughter is having now ? How do you think the family will accept that their child is considered dead ? Is it easy to accept that nothing can be done anymore when you see your child helpless with all the machines making noises assuming to function and regulate ?
Identification of this syndrome was held, by the Conference of the Medical Royal Colleges in 1976, to require withdrawal of "further artificial support" - particularly fruitless mechanical ventilation of the comatose patient - thus "sparing relatives from the further emotional trauma of sterile hope". The diagnostic criteria being accepted by this authoritative body as "sufficient to distinguish between those patients who retain the functional capacity to have a chance of even partial recovery and those where no such possibility exists", no legal problems with this withdrawal of life-support measures, in the sole interests of the patient and his relatives, were likely to be encountered.
How do you tell the spouse that you need to pull the plug and within minutes ; she will die ? How scientific can one be losing one's dear heart and soul ? Are you sure that nothing more can be done ? How do you show your empathy and actually tell the family there is nothing can be done now and it will be over soon ?
After 4pm today , the 2nd brain stem function test will be performed ; and the fate of the unconscious lovely innocent mother who is still breastfeeding her child will be determined.