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Ghibaudo V, Bado J, Garcia S, Berthiller J, Rithzenthaler T, Gobert F, Bapteste L, Carrillon R, Bodonian C, Dailler F, Haegelen C, Dumot C, Rheims S, Berhouma M, Balança B. Lessons to Learn from Multimodal Neuromonitoring of Brain Death with Electrophysiological Markers of Cortical and Subcortical Loss of Functions. Neurocrit Care 2024:10.1007/s12028-024-02049-4. [PMID: 38982002 DOI: 10.1007/s12028-024-02049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 06/13/2024] [Indexed: 07/11/2024]
Affiliation(s)
- Valentin Ghibaudo
- Centre de recherche en neurosciences de Lyon, Inserm U1028, CNRS UMR 5292, Lyon, France
| | - Jules Bado
- Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France
| | - Samuel Garcia
- Centre de recherche en neurosciences de Lyon, Inserm U1028, CNRS UMR 5292, Lyon, France
| | | | | | - Florent Gobert
- Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France
| | | | | | | | | | | | - Chloé Dumot
- Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France
| | - Sylvain Rheims
- Centre de recherche en neurosciences de Lyon, Inserm U1028, CNRS UMR 5292, Lyon, France
- Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France
| | | | - Baptiste Balança
- Centre de recherche en neurosciences de Lyon, Inserm U1028, CNRS UMR 5292, Lyon, France.
- Hospices Civils de Lyon, 59 Bd Pinel, 69500, Bron, France.
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Lewis A. An Update on Brain Death/Death by Neurologic Criteria since the World Brain Death Project. Semin Neurol 2024; 44:236-262. [PMID: 38621707 DOI: 10.1055/s-0044-1786020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
The World Brain Death Project (WBDP) is a 2020 international consensus statement that provides historical background and recommendations on brain death/death by neurologic criteria (BD/DNC) determination. It addresses 13 topics including: (1) worldwide variance in BD/DNC, (2) the science of BD/DNC, (3) the concept of BD/DNC, (4) minimum clinical criteria for BD/DNC determination, (5) beyond minimum clinical BD/DNC determination, (6) pediatric and neonatal BD/DNC determination, (7) BD/DNC determination in patients on ECMO, (8) BD/DNC determination after treatment with targeted temperature management, (9) BD/DNC documentation, (10) qualification for and education on BD/DNC determination, (11) somatic support after BD/DNC for organ donation and other special circumstances, (12) religion and BD/DNC: managing requests to forego a BD/DNC evaluation or continue somatic support after BD/DNC, and (13) BD/DNC and the law. This review summarizes the WBDP content on each of these topics and highlights relevant work published from 2020 to 2023, including both the 192 citing publications and other publications on BD/DNC. Finally, it reviews questions for future research related to BD/DNC and emphasizes the need for national efforts to ensure the minimum standards for BD/DNC determination described in the WBDP are included in national BD/DNC guidelines and due consideration is given to the recommendations about social and legal aspects of BD/DNC determination.
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Affiliation(s)
- Ariane Lewis
- Division of Neurocritical Care, Department of Neurology and Neurosurgery, NYU Langone Medical Center, New York
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Simons JN, van der Graaf R, van Delden JJ. Cardiac organoids do not warrant additional moral scrutiny. BMC Med Ethics 2024; 25:61. [PMID: 38773517 PMCID: PMC11106857 DOI: 10.1186/s12910-024-01064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/15/2024] [Indexed: 05/24/2024] Open
Abstract
Certain organoid subtypes are particularly sensitive. We explore whether moral intuitions about the heartbeat warrant unique moral consideration for newly advanced contracting cardiac organoids. Despite the heartbeat's moral significance in organ procurement and abortion discussions, we argue that this significance should not translate into moral implications for cardiac organoids.
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Affiliation(s)
- Jannieke N Simons
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Rieke van der Graaf
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Johannes Jm van Delden
- Department of Bioethics and Health Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Wilkinson D, Miller C, Turner SW. Informed non-dissent for brain death testing in children: ethical and legal perspectives. Arch Dis Child 2024; 109:359-360. [PMID: 38367980 DOI: 10.1136/archdischild-2023-325635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2024]
Affiliation(s)
- Dominic Wilkinson
- Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
- Centre for Biomedical Ethics, National University of Singapore Yong Loo Lin School of Medicine, Singapore
- Newborn Care, John Radcliffe Hospital, Oxford, UK
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Greer DM, Lewis A, Kirschen MP. New developments in guidelines for brain death/death by neurological criteria. Nat Rev Neurol 2024; 20:151-161. [PMID: 38307923 DOI: 10.1038/s41582-024-00929-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 02/04/2024]
Abstract
The declaration of brain death (BD), or death by neurological criteria (DNC), is medically and legally accepted throughout much of the world. However, inconsistencies in national and international policies have prompted efforts to harmonize practice and central concepts, both between and within countries. The World Brain Death Project was published in 2020, followed by notable revisions to the Canadian and US guidelines in 2023. The mission of these initiatives was to ensure accurate and conservative determination of BD/DNC, as false-positive determinations could have major negative implications for the medical field and the public's trust in our ability to accurately declare death. In this Review, we review the changes that were introduced in the 2023 US BD/DNC guidelines and consider how these guidelines compare with those formulated in Canada and elsewhere in the world. We address controversies in BD/DNC determination, including neuroendocrine function, consent and accommodation of objections, summarize the legal status of BD/DNC internationally and discuss areas for further BD/DNC research.
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Affiliation(s)
- David M Greer
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
- Boston Medical Center, Department of Neurology, Boston, MA, USA.
| | - Ariane Lewis
- NYU Langone Medical Center, Departments of Neurology and Neurosurgery, New York, NY, USA
| | - Matthew P Kirschen
- The Children's Hospital of Philadelphia, Department of Anaesthesiology and Critical Care Medicine, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Martin D, Díaz-Cobacho G, Hannikainen IR. The Brain Death Criterion in Light of Value-Based Disagreement Versus Biomedical Uncertainty. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:123-126. [PMID: 38236880 DOI: 10.1080/15265161.2023.2278566] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Pope TM. Time for Federal Standards on Death Determination: The National Determination of Death Act. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:111-113. [PMID: 38236883 DOI: 10.1080/15265161.2023.2278563] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Lewis A. Response to Open Peer Commentaries Re: Medicolegal Challenges to Death by Neurologic Criteria in the United Kingdom and USA. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:W1-W3. [PMID: 38236884 DOI: 10.1080/15265161.2023.2284289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Padela AI, Suleman M. Interests and Choices in Determining Death by Neurological Criteria. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:118-121. [PMID: 38236860 DOI: 10.1080/15265161.2023.2278585] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Thumma SA, Weeks E, Farahany NA. By Statute or by Common Law? The Legal Determination of Death. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:1-2. [PMID: 38236861 DOI: 10.1080/15265161.2024.2291988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Lyons B, Donnelly M. Consent, Consultation, or Authorization Is Required for DNC Testing in the UK. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:126-128. [PMID: 38236891 DOI: 10.1080/15265161.2023.2278576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Barry Lyons
- Trinity College Dublin
- Children's Health Ireland
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McGee A, Gardiner D. Brainstem Death Is Dead. Long Live Brainstem Death! THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:114-116. [PMID: 38236886 DOI: 10.1080/15265161.2023.2278572] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Joffe AR. Ethical Issues in Death by Neurologic Criteria Require Critical Scrutiny: Lack of Engagement with Sound Arguments to Save Medical Dogma. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:121-123. [PMID: 38236863 DOI: 10.1080/15265161.2023.2278550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Omelianchuk A. No Country for Old Laws: Why the Effort to Revise the UDDA Reveals the Social Weakness of Medicine in the US. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:108-110. [PMID: 38236875 DOI: 10.1080/15265161.2024.2279437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Sarbey B. The Advantages of the Higher Brain Criterion for Determining Death. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:116-118. [PMID: 38236856 DOI: 10.1080/15265161.2023.2278548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Paquette E. Medicolegal Challenges to Death by Neurologic Criteria in the United Kingdom and the United States: Lessons Learned from the Case of Archie Battersbee and a Suggestion for Mid-Level Principles to Enhance an Ongoing Dialogue. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:97-100. [PMID: 38236876 DOI: 10.1080/15265161.2024.2279438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Erin Paquette
- Northwestern University Feinberg School of Medicine
- Ann & Robert H. Lurie Children's Hospital of Chicago
- Northwestern University Pritzker School of Law (by courtesy)
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Bernat JL. The Brainstem Criterion of Death and Accurate Syndromic Diagnosis. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:100-103. [PMID: 38236869 DOI: 10.1080/15265161.2023.2278554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Ross LF. Parents Don't Know Best in the United Kingdom. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2024; 24:103-106. [PMID: 38236885 DOI: 10.1080/15265161.2024.2279439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Abstract
Although the fundamental principle behind the Uniform Determination of Death Act (UDDA), the equivalence of death by circulatory-respiratory and neurologic criteria, is accepted throughout the United States and much of the world, some families object to brain death/death by neurologic criteria. Clinicians struggle to address these objections. Some objections have been brought to court, particularly in the United States, leading to inconsistent outcomes and discussion about potential modifications to the UDDA to minimize ethical and legal controversies related to the determination of brain death/death by neurologic criteria.
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Affiliation(s)
- Danielle Feng
- Department of Neurology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA
| | - Ariane Lewis
- Department of Neurology, NYU Langone Medical Center, 530 First Avenue, Skirball-7R, New York, NY 10016, USA; Department of Neurosurgery, NYU Langone Medical Center, 530 First Avenue, Skirball-7R, New York, NY 10016, USA.
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