RT Book, Section
A1 Towns, Jacob S.
A1 Whitaker, Nash
A1 Ellender, Timothy J.
A2 Farcy, David A.
A2 Chiu, William C.
A2 Marshall, John P.
A2 Osborn, Tiffany M.
SR Print(0)
ID 1135702370
T1 Brain Death
T2 Critical Care Emergency Medicine, 2e
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9780071838764
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1135702370
RD 2024/04/18
AB Brain  death  is  defined  as  the  complete  and  irreversible  loss  of  both  cerebral  cortical  function  and  involuntary  activity  (brainstem  function)  necessary  to  sustain  life.1  The  concept  of  “death”  can  be  nebulous  because  it  contains  biological,  moral,  and  legal/political  connotations.  Brain  death,  although  defined  inconsistently,  is  used  as  an  indicator  of  legal  death  by  many  authorities.1–8  Clinically,  injury  and  illness  may  irreversibly  injure  various  parts  of  the  brain  causing  neuronal  death  while  other  parts  of  the  brain  may  remain  alive;  thus,  historically,  the  term  “brain  death”  has  been  used  (sometimes  incorrectly)  to  refer  to  various  combinations  of  dysfunction.9–11  Brain  death  is  not  the  same  as  persistent  vegetative  state,  in  which  the  person  retains  involuntary  activity  necessary  for  life  and  is  therefore  “alive.”  To  provide  clarity,  a  President's  Commission  study  on  brain  death  drafted  the  Uniform  Determination  of  Death  Act  (UDDA)  in  1980,  which  was  approved  by  both  the  American  Medical  Association  (AMA)  and  the  American  Bar  Association  (ABA).12–14  The  UDDA  outlines  two  ways  of  determining  death:  the  first  is  “irreversible  cessation  of  circulatory  and  respiratory  functions,”  and  the  second  is  brain  death.13  The  UDDA  is  grounded  upon  the  philosophy  that  an  organism,  as  a  whole,  need  not  suffer  total  organ  failure  to  be  declared  dead;  only  the  organ  responsible  for  integration  of  the  whole  system  needs  to  have  failed.2,9,15  This  principle  is  fundamental  to  our  current  practice  of  organ  donation  and  thus  allows  procurement  to  occur  legally.12