Brain Death

Beyond Brain Death offers a provocative challenge to one of the most widely accepted conclusions of contemporary bioethics: the position that brain death marks the death of the human person. Eleven chapters by physicians, philosophers, and theologians present the case against brain-based criteria for human death. Each author believes that this position calls into question the moral acceptability of the transplantation of unpaired vital organs from brain-dead patients who have continuing function of the circulatory system. One strength of the book is its international approach to the question: contributors are from the United States, the United Kingdom, Liechtenstein, and Japan. This book will appeal to a wide audience, including physicians and other health care professionals, philosophers, theologians, medical sociologists, and social workers.

This text provides an overview of the processes of brain death, exploring the concepts and historical approach of human death, clinical examinations of brain-dead patients, ancillary tests in coma and brain death, bioethical discussions of brain death and its relationship with some consciousness disturbances, and the legal considerations of human death. Unlike other, narrow-focus reference this book encompasses a wide spectrum of issues including medical, legal, bioethical and historical aspects.

The death of a person refers to the permanent cessation of all integrated brain function. Brain death denotes a state where all brain function has permanently ceased, but the heart continues to beat. There is no global consensus in diagnostic criteria, and the guidelines and protocols regarding the confirmation of brain death vary from country to country. This article is based on the protocol applied in Finland. Declaration of brain death follows a certain set of tests that demonstrate the complete absence of brain function (brain stem function in the UK). Provided that the cause of the irremediable brain damage is known and the absence of all cranial nerve reflexes has been confirmed with clinical tests, death can be declared whilst the heart continues to beat. At least two physicians, of specified status and experience, are required to act together to diagnose brain death.

Although some decades have passed, there are still worldwide controversies about a concept of human death on neurological grounds. There are also disagreements on the diagnostic criteria for brain death, whether clinical alone or clinical plus ancillary tests. Moreover, some scholars who were strong defenders of a brain-based standard of death are now favoring a circulatory-respiratory standard. The study of coma is extremely important because lesions of the brain are responsible for quality of life in patients or cause of death. The main goal of Brain Death and Disorders of Consciousness is to provide a suitable scientific platform to discuss all topics related to human death and coma.

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Established in 1982 as the leading reference on electroencephalography, Drs. Niedermeyer's and Lopes da Silva's text is now in its thoroughly updated Fifth Edition. An international group of experts provides comprehensive coverage of the neurophysiologic and technical aspects of EEG, evoked potentials, and magnetoencephalography, as well as the clinical applications of these studies in neonates, infants, children, adults, and older adults. This edition includes digital EEG and advances in areas such as neurocognition. Three new chapters cover the topics of Ultra-Fast EEG Frequencies, Ultra-Slow Activity, and Cortico-Muscular Coherence. Hundreds of EEG tracings and other illustrations complement the text.

Addressing all aspects of brain death and thoroughly detailing how a potential organ donor should be maintained to ensure maximum use of the organs and cells, The Brain-Dead Organ Donor: Pathophysiology and Management is a landmark addition to the literature. This first-of-its-kind, multidisciplinary volume will be of interest to a large section of the medical community. The first section of the book reviews the historical, medical, legal, and ethical aspects of brain death. That is followed by two chapters on the pathophysiology of brain death as investigated in small and large animal models. This includes a review of the many hormonal changes, including the neuroendocrine- adrenergic ‘storm’, that takes place during and following the induction of brain death, and how they impact metabolism. The next section of the book reviews various effects of brain death, namely its impact on thyroid function, the inflammatory response that develops, and those relating to innate immunity. The chapters relating to assessment and management of potential organ donors will be of interest to a very large group of transplant surgeons and physicians as well as critical care and neurocritical care physicians and nurses. Neurologists, endocrinologists, neurosurgeons, and pathologists will also be interested, especially in the more basic science sections on various aspects of brain-death and hormonal therapy. Organ procurement organizations and transplant coordinators worldwide will also be interested in this title. Other chapters will be of interest to medical historians, medico-legal experts, and ethicists.

Compiled by internationally recognized experts in trauma critical care,this sourcediscusses the entire gamut of critical care management of the trauma patient and covers several common complications and conditions treated in surgical intensive care units that are not specifically related to trauma. Utilizing evidence-based guidelines where they ex

Neural grafting, virtual reality, gene therapy, psychotropic drugs ... As startling new treatments emerge for disorders of the brain, new concerns are arising along with them. In the first book to examine the implications of the full range of revolutionary interventions now possible in the human brain, Robert H. Blank warns that while these new techniques may promise medical wonders, they also raise profound political questions. Our rapidly unfolding knowledge about the brain and the accompanying applications have three main policy dimensions: funding research initiatives, controlling individual use, and assessing social consequences. But underlying these aspects, Blank argues, are more disturbing issues that pose fundamental challenges to our conceptions of equality, autonomy, freedom, responsibility, and human nature itself. Brain Policy makes the key facts from the technical literature readily accessible to social scientists and general readers and points out the implications for our society. Blank first explains the structure and function of the nervous system and current theories of brain operation; he then assesses the uses and potential abuses of various intervention techniques. He identifies the public policy issues raised by discoveries in the neurosciences and calls for intensified scrutiny of the advantages and disadvantages of new technologies. Warning that the risks and dangers of the dramatic developments in neuroscience are potentially large, Blank offers a means of understanding these scientific advances and the philosophical and political issues they entail. This book will be of interest to social scientists, policy analysts, policy makers, bioethicists, scientists who want to see the bigger picture, and the informed reader with an interest in the implications of neuroscience for themselves and society.

Basic Consumer Health Information about Acquired and Traumatic Brain Injuries, Infections of the Brain, Epilepsy and Seizure Disorders, Cerebral Palsy, and Degenerative Neurological Disorders, Including Amyotrophic Lateral Sclerosis (ALS), Dementias, Multiple Sclerosis, and More Along with Information on the Brain's Structure and Function, Treatment and Rehabilitation Options, Reports on Current Research Initiatives, a Glossary of Terms Related to Brain Disorders and Injuries, and a Directory of Sources for Further Help and Information.

Having been originally introduced as a term to facilitate discussion of a specific group of patients regarded as entering a state of unawareness following coma, the ‘Persistent Vegetative State’ (PVS) has established itself as an apparently discrete medical condition with clear-cut implications for ethicists and lawyers that exceed any scientifically based understanding. As a consequence of this upgrading, conclusions drawn about the status and hence the management of this uncommon condition have been increasingly extended to other patients with much more common forms of disability. This book traces the origins of prevailing perceptions about PVS and submits these to critical examination. In doing this it comes to the conclusion that inadequate attention has been paid to acknowledging what is not known about affected individuals and that assumptions have consistently come to be traded as facts. Re-examination of the basis of the PVS and the adoption of a more scientific approach is long overdue and is owed to the community at large which has generally been provided by many medical practitioners with a ‘dumbed-down’ account of the condition. The book will be of interest to philosophers, medical graduates and neuroscientists but is also intended to remain accessible to the general reader with an interest in the wider implications of trends in medical thinking for attitudes towards many classes of patient. It has an extensive bibliography and will be of specific interest to bioethicists and lawyers with professional interests in PVS.

Addressing key issues arising from the nature of death, 'Death, Dying and the Ending of Life' examines important topics relating to bioethics, philosophy and literature.

The first textbook on the subject, this is a practical, clinically comprehensive guide to ethical issues in surgical practice, research, and education written by some of the most prominent figures in the fields of surgery and bioethics. Discussions of informed consent, confidentiality, and advance directives--core concepts integral to every surgeon-patient relationship--open the volume. Seven chapters tackle the ethical issues in surgical practice, covering the full range of surgical patients--from emergency, acute, high-risk, and elective patients, to poor surgical risk and dying patients. The book even considers the special relationship between the surgeon and patients who are family members or friends. Chapters on surgical research and education address innovation, self-regulation in practice and research, and the prevention of unwarranted bias. Two chapters focus on the multidisciplinary nature of surgery, including the relationships between surgery and other medical specialties and the obligations of the surgeon to other members of the surgical team. The economic dimensions of surgery, especially within managed care, are addressed in chapters on the surgeons financial relationships with patients, conflicts of interest, and relationships with payers and institutions. The authors do not engage in abstract discussions of ethical theory; instead, their discussions are always directly relevant to the everyday concerns of practicing surgeons. This well-integrated volume is intended for practicing surgeons, medical educators, surgical residents, bioethicists, and medical students.

A comprehensive guide to traumatic brain injury, beginning with an introduction to epidemiology, biomechanics and pathology of head injury, then discussing resulting conditions, and the academic and clinical aspects of their management. Written by experts in the fields of neuropsychiatry, neurology and rehabilitation medicine, dedicated chapters also examine rarer aspects including post-traumatic basal ganglia haematoma, dural sinus thrombosis, CSF otorrhea and facial injuries. Fluid and electrolyte management are also discussed. Key Features Comprehensive guide to traumatic brain injury discussing numerous conditions resulting from head trauma, as well as basic epidemiology, biomechanics and pathology Includes chapters on rarer conditions, as well as fluid and electrolyte management Almost 300 colour images and illustrations

An introduction to issues and controversies surrounding organ transplantation and healthcare