MNeagle
24th September 2011, 08:44 PM
Recent cases of people being declared brain dead, then recovering contradict what doctors and organ procurement groups having been telling the public since 1968.
"Brain dead is dead. There is no 'recovery,'" one organ procurement organization says on its website (http://www.organtransplants.org/understanding/death/). It's a familiar refrain, but one that savvy medical consumers would do well to investigate before agreeing to become organ donors.
The "Dead" Awaken
In July, a woman diagnosed as "brain dead" did the supposedly impossible. Madeleine Gauron woke up. (http://www.journalexpress.ca/Soci%C3%A9t%C3%A9/Sant%C3%A9/2011-06-30/article-2624757/Un-mal-de-dent-qui-a-failli-virer-en-don-dorganes/1) Transplant folks had already sought consent to harvest her organs, but fortunately for her, her family refused, demanding proof she was really dead.
That case follows on the heels of a similar "miracle" in Australia in March. Doctors declared Gloria Cruz, 56, brain dead. She regained consciousness (http://www.foxnews.com/health/2011/05/11/husband-celebrates-miracle-brain-dead-wife-wakes-hospital/) three days later.
Lydia Paillard revived after a diagnosis of brain death (http://www.metro.co.uk/weird/844692-cancer-patient-wakes-up-in-hospital-after-being-pronounced-dead) in October. Sebastien Paillard was considering consenting to turning off his mother's ventilator at the doctor's recommendation when staff members noticed signs of brain activity in the "dead" woman.
Three woman in a single year, first they were irrevocably dead, and then they weren't. Before them, there was Zack Dunlap.
Zack Dunlap, Brain Dead or Living?
Zack Dunlap was declared brain dead in 2008. Organ harvesters were at the ready and actually began the process (http://theness.com/neurologicablog/index.php/brain-dead/), according to NeuroLogica. An impulsive decision by Dunlap's cousin to make a final check of his vital signs saved his life (http://www.healthzone.ca/health/article/413962).
After his ordeal, Dunlap remembered being declared brain dead (http://today.msnbc.msn.com/id/23775873/ns/today-today_people/) and feeling "ticked off" at the doctor, he told the TODAY Show.
But the hospital treating Dunlap insists he was really dead (http://www.thestar.com/sciencetech/Science/article/413962), according to the Toronto Star. Dr. Leo Mercer said there was no blood flow to Zack's brain,
therefore, "He was dead. He (met) the legal, medical requirements for declaring a patient brain dead."
Dr. Steven Novella analyzed the Dunlap case based on media reports for NeuroLogica. He found the diagnosis timing problematic. Dunlap suffered trauma to the brain and was declared brain dead 36 hours later. Novella says that swelling during that period would interfere with accurate diagnosis.
Problems with Brain Death Standard
An ad hoc committee of Harvard doctors introduced brain death in 1968. Their push for the adoption of this new legal standard for determining death was significantly motivated by a desire to increase the supply of organs (http://www.life.org.nz/euthanasia/euthanasiakeyissues/brain-death/) for transplant.
Doctors Truog and Miller recognized a distinction between legal death and actual death when they posited in the New England Journal of Medicine in 2008 that the standard is unconvincing because many patients declared brain dead retain some essential neurological function (http://www.nejm.org/doi/full/10.1056/NEJMp0804474).
"Many will object that transplant surgeons cannot legally or ethically remove vital organs from patients before death, since doing so will cause their death.
However, if the critiques of the current methods of diagnosing death are correct, then such actions are already taking place on a routine basis," those doctors argue.
Truog and Miller advocate a new standard allowing for explicit organ harvesting from living patients when the death is imminent due to ventilator removal plans.
Brain Death Determinations in Practice
Doctors are not consistent in declaring brain deaths. "Determining Brain Death," published by the American Association of Critical-Care Nurses in 1999, cited a study demonstrating that only 35% of 165 doctors likely to have to assess brain death could accurately describe the legal standard. Only 42% were consistent in applying their concept of death.
So were Dunlap, Gauron, Cruz and Paillard victims of mistaken diagnoses? Or were they "brain dead" yet still alive and capable of recovery? To medical consumers, it may not matter. Either way, if you're a potential organ donor, you could end up giving someone else the gift of life with the sacrifice of your own.
http://news.yahoo.com/brain-dead-doctors-said-yes-patients-proved-otherwise-221600587.html
"Brain dead is dead. There is no 'recovery,'" one organ procurement organization says on its website (http://www.organtransplants.org/understanding/death/). It's a familiar refrain, but one that savvy medical consumers would do well to investigate before agreeing to become organ donors.
The "Dead" Awaken
In July, a woman diagnosed as "brain dead" did the supposedly impossible. Madeleine Gauron woke up. (http://www.journalexpress.ca/Soci%C3%A9t%C3%A9/Sant%C3%A9/2011-06-30/article-2624757/Un-mal-de-dent-qui-a-failli-virer-en-don-dorganes/1) Transplant folks had already sought consent to harvest her organs, but fortunately for her, her family refused, demanding proof she was really dead.
That case follows on the heels of a similar "miracle" in Australia in March. Doctors declared Gloria Cruz, 56, brain dead. She regained consciousness (http://www.foxnews.com/health/2011/05/11/husband-celebrates-miracle-brain-dead-wife-wakes-hospital/) three days later.
Lydia Paillard revived after a diagnosis of brain death (http://www.metro.co.uk/weird/844692-cancer-patient-wakes-up-in-hospital-after-being-pronounced-dead) in October. Sebastien Paillard was considering consenting to turning off his mother's ventilator at the doctor's recommendation when staff members noticed signs of brain activity in the "dead" woman.
Three woman in a single year, first they were irrevocably dead, and then they weren't. Before them, there was Zack Dunlap.
Zack Dunlap, Brain Dead or Living?
Zack Dunlap was declared brain dead in 2008. Organ harvesters were at the ready and actually began the process (http://theness.com/neurologicablog/index.php/brain-dead/), according to NeuroLogica. An impulsive decision by Dunlap's cousin to make a final check of his vital signs saved his life (http://www.healthzone.ca/health/article/413962).
After his ordeal, Dunlap remembered being declared brain dead (http://today.msnbc.msn.com/id/23775873/ns/today-today_people/) and feeling "ticked off" at the doctor, he told the TODAY Show.
But the hospital treating Dunlap insists he was really dead (http://www.thestar.com/sciencetech/Science/article/413962), according to the Toronto Star. Dr. Leo Mercer said there was no blood flow to Zack's brain,
therefore, "He was dead. He (met) the legal, medical requirements for declaring a patient brain dead."
Dr. Steven Novella analyzed the Dunlap case based on media reports for NeuroLogica. He found the diagnosis timing problematic. Dunlap suffered trauma to the brain and was declared brain dead 36 hours later. Novella says that swelling during that period would interfere with accurate diagnosis.
Problems with Brain Death Standard
An ad hoc committee of Harvard doctors introduced brain death in 1968. Their push for the adoption of this new legal standard for determining death was significantly motivated by a desire to increase the supply of organs (http://www.life.org.nz/euthanasia/euthanasiakeyissues/brain-death/) for transplant.
Doctors Truog and Miller recognized a distinction between legal death and actual death when they posited in the New England Journal of Medicine in 2008 that the standard is unconvincing because many patients declared brain dead retain some essential neurological function (http://www.nejm.org/doi/full/10.1056/NEJMp0804474).
"Many will object that transplant surgeons cannot legally or ethically remove vital organs from patients before death, since doing so will cause their death.
However, if the critiques of the current methods of diagnosing death are correct, then such actions are already taking place on a routine basis," those doctors argue.
Truog and Miller advocate a new standard allowing for explicit organ harvesting from living patients when the death is imminent due to ventilator removal plans.
Brain Death Determinations in Practice
Doctors are not consistent in declaring brain deaths. "Determining Brain Death," published by the American Association of Critical-Care Nurses in 1999, cited a study demonstrating that only 35% of 165 doctors likely to have to assess brain death could accurately describe the legal standard. Only 42% were consistent in applying their concept of death.
So were Dunlap, Gauron, Cruz and Paillard victims of mistaken diagnoses? Or were they "brain dead" yet still alive and capable of recovery? To medical consumers, it may not matter. Either way, if you're a potential organ donor, you could end up giving someone else the gift of life with the sacrifice of your own.
http://news.yahoo.com/brain-dead-doctors-said-yes-patients-proved-otherwise-221600587.html