Dr. Bowton is Professor, Section on Critical Care, Department of Anesthesiology, Wake Forest Baptist Health, Winston-Salem, North Carolina. Read previous Critical Care Commentaries online.
Commentary
Critical Care Commentary: Brain death – patient, law, and family
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In this thorough and somber commentary, Dr. Bowton clearly points out how much gray remains in a world that demands black and white certainty.
Brain death, and its implication, is not an exact diagnosis, which impacts the family, society, and the care-giving team, but most of all, the patient.
As there are times that brain death cannot be truly determined, we must be mindful that our primary goal is always the patient, then the families, society, and others. As a practitioner in New York, where family discussion is the law, I have not found this to be a great impediment; with palliative care and pastoral support, most issues can be resolved. As we progress in our knowledge, a more global unified approach would be welcomed.
Dr. Peter Spiro, FCCP Section Editor