Brain Death Essay Assignment

The concept, definition, and understanding of death and brain death in the modern society are overlapping. Before the introduction of modern, sophisticated instruments, death has always been defined as the cessation of life which is as a result of stoppage of circulation of blood and vital functions of the body like respiration and pulsation. However, a new definition of death has now been developed based on the functions of these machines.Brain Death Essay Assignment The machines can maintain the respiration and heartbeat of a patient that is unresponsive to electrical activities of the brain. In modern medicine, this condition is called brain death; critical care physicians face challenges of how to care for a severely brain-damaged patient as all therapy is based on preservation and restoration of neuronal functions (Goila & Powar, 2009). If they are unsuccessful in achieving these, the patient becomes brain dead. The brain dies before any other organ of the body due to its sensitivity to injury and its inability to restore tissue after a severe injury. Irreversible death of the brain would, therefore, lead to the death of other organs because the brain is the command and control center of other body functions. This creates the definition of brain death as the “irreversible loss of all functions of the brain, including the brainstem” (Goila & Powar, 2009). Another definition based on artificial respiration defines brain death as “a state of cessation of cerebral function with preservation of cardiac activity and maintenance of somatic function by artificial means” (Longo et al., 2012. p. 2253).Brain Death Essay Assignment

The diagnosis of the brain death is based on several sets of criteria endorsed by the local medical community. Therefore, a patient cannot be confirmed brain dead until he/ she has met all of these criteria and they include: (1) widespread cortical destruction, reflected by deep coma and unresponsiveness to all forms of stimulation, (2) global brainstem damage that can be shown by absence of pupillary reaction to light, and loss of oculovestibular and corneal reflexes (3) destruction of the medulla, manifested by complete apnea (Longo et al., 2012).Brain Death Essay Assignment The causes of brain death are numerous as it was explained earlier that it is due to severe damage to the brain in which the doctors are unable to restore the neurological status of the patient. It is important that the physician understands the etiology of the brain damage because it would help in the process of certifying that a patient is brain dead. A few of the numerous causes of brain damage include hypertensive intracerebral hemorrhage, aneurysmal subarachnoid hemorrhage, hypoxic-ischemic brain insults and fulminant hepatic failure. The test for medullary destruction, which is manifested by apnea requires that PCO2 be high enough to stimulate respiration during spontaneous breathing. “Apnea testing can be done safely by use of diffusion oxygen prior to removal of a ventilator” (Longo et al., 2012. p. 2253). This can be achieved by preoxygenation with 100 percent oxygen; the oxygen is then sustained by administering through a tracheal cannula. The CO2 pressure increases between 2-3 mmHg during apnea, this pressure is then observed, at the end of the period of observation PCO2 has to increase to about 50-60 mmHg for the test to be valid. Apnea is, therefore, confirmed if no respiratory effort was observed in the presence of a high enough PCO2. Other tests that can be done are isoelectric EEG to confirm the total cerebral damage, Radionuclide brain scanning, and other features. Some period of observation usually between 6-24 hours is needed to see if the clinical signs of brain death hold. Therefore, it is necessary that the physician delay “clinical testing for at least 24 hours if a cardiac arrest has caused brain death or if the inciting disease is not known” (Longo et al., 2012. p. 2253).Brain Death Essay Assignment

ORDER A FREE PAPER HERE

Physicians are faced with the responsibility of determining brain death. The diagnosis of brain death is clinical. Brain death cannot be diagnosed and confirmed in the absence of these confirmatory tests. Furthermore, the physician has to inform the next of kin or family members about the next step that should be taken regarding the patient, most of what is mainly advised is organ donation. A patient can be certified brain dead by a single physician that is experienced with brain death determination (Goila & Powar, 2009). However, before a patient can be an organ donor, the requirement stated by the New York law has to be met. This requirement says “that the time of brain death must be certified by the physician who attends the donor at his death and one other physician, neither of whom shall participate in the process of transplantation” (Guidelines for determining brain death, 2011). This requirement ensures that all medical standards were met and the decision to certify a patient brain dead was not influenced by external factors or the need of the organs by potential recipients, this gives the participants confidence.

In the western world, it is accepted that the respirator can be disconnected based on good communication with the family members, poor communication and inadequate preparation of the family members by the physician can create problems. Ethical problems have arisen as a result of brain death and organ donation. According to Joffe (2010), he argues that until there is clarification that death is equivalent to brain death, brain death should not be accepted as death. He further went on to say that if “brain death is not death, then the implications of this conclusion is significantly enormous” (Kuhse, Schuklenk & Singer, 2015).Brain Death Essay AssignmentHe further stated that since brain death is not death, the action of removing the organs, including the heart is such a devastating state to be in, because it means that it is acceptable to kill a living innocent man (Kuhse, Schuklenk & Singer, 2015). This brings to light the ethics of “do no harm.” Harvesting organs have been identified as the motivator for brain death diagnosis that is why Singer pointed out in one of his books that brain death is accepted as a convenient fiction because it serves as a practical benefit of organ transplantation. even though, transplantation of organs serves as a benefit to many people,  there are still social fears and distrusts towards brain death and organ donation. Ethical foundations of organ transplantation are being reviewed. Regardless of the fact that organ transplantation is accepted medically, legally, and religiously today, it is still necessary that the medical community and the society come together to be educated about these matters so that traditional concepts that cannot be changed can be fully understood. Furthermore, as it has been stated earlier, organ harvesting, ICU costs, and research serves as a driving force for brain death criteria even though there is no universal consensus of these criteria as it varies from country to country.Brain Death Essay Assignment