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The Meaning of Brain Death A Different View

Robert D. Truog, MD1,2; Franklin G. Miller, PhD3
[+] Author Affiliations
1Division of Critical Care Medicine, Boston Children’s Hospital, Boston, Massachusetts
2Division of Medical Ethics, Harvard Medical School, Boston, Massachusetts
3Department of Bioethics, National Institutes of Health, Bethesda, Maryland
JAMA Intern Med. 2014;174(8):1215-1216. doi:10.1001/jamainternmed.2014.2272.
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The recent case of Jahi McMath, a teenager in Oakland, California, was extensively publicized in the news media and led to prominent commentaries in medical journals on the meaning of brain death.1,2 McMath is a 14-year-old adolescent who in December 2013 experienced devastating neurological damage following complications from a tonsillectomy. McMath met criteria for the diagnosis of brain death. She continues, however, to receive mechanical ventilation, tube feedings, and supportive care at an undisclosed location, with her treatment financed by private funds, according to the most recent reports.

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Words and their meanings
Posted on August 4, 2014
Madhusree Singh, MD
Veteran's Medical Center / UCSD, San DIego
Conflict of Interest: None Declared
I find the viewpoint about brain death carefully worded and informative. I think one of the main reasons we continue to have such public conflicts about issues brain death is related to problems that we have communicating these complex ideas amongst each other and to the lay public, as well. The other gargantuan problem is our closed attitudes about these discussions- culturally we are uncomfortable talking about death (although, this is changing- slowly) and the pervasive "us versus them" attitude that we have in health care. This damages an already difficult conversation. In the case discussed, it is likely that very little communication occurred between the family and clinicians after the disastrous operation. I think that it is key to address life and death issues early and often as no matter what decisions are made, there is long term suffering for the family.
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