Concerned with the development of practices and attitudes to several categories of severely disabled subjects, their use as sources of tissues and organs for transplantation as well as an assessment of the ethical and social implications. Considers the topic of brain death and the changes in approach over three decades. Discusses the current status regarding the use of fetal brain tissue.
The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.
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 book discusses the common principles of morality and ethics derived from divinely endowed intuitive reason through the creation of al-fitr' a (nature) and human intellect (al-‘aql). Biomedical topics are presented and ethical issues related to topics such as genetic testing, assisted reproduction and organ transplantation are discussed. Whereas these natural sources are God’s special gifts to human beings, God’s revelation as given to the prophets is the supernatural source of divine guidance through which human communities have been guided at all times through history. The second part of the book concentrates on the objectives of Islamic religious practice – the maqa' sid – which include: Preservation of Faith, Preservation of Life, Preservation of Mind (intellect and reason), Preservation of Progeny (al-nasl) and Preservation of Property. Lastly, the third part of the book discusses selected topical issues, including abortion, assisted reproduction devices, genetics, organ transplantation, brain death and end-of-life aspects. For each topic, the current medical evidence is followed by a detailed discussion of the ethical issues involved.
The concept of brain death is often difficult for families to come to terms with when dealing with a tragic loss. Brain death occurs when a person has an irreversible, catastrophic brain injury, which causes total cessation of all brain function (the upper brain structure and brain stem). Doctors examining the patient will some tests to determine whether no brain activity is present. If all brain activities are absent, the patient is dead. Brain death is irreversible. Brain death is death. Brain death can be confusing for families who are confronted with the sudden death of someone they love. This book which is arranged in nine chapters studies in details, the systems and definition of brain death , the fundamentals of persuading families in donation, the body organs which are usable, etc. This book is suggested not to medical students but to every individual of societies.
This book offers valuable guidance to neurointensivists, other neurocritical care staff, and those desiring to develop a neurocritical care unit via a thorough discussion of neurological emergencies and neurocritical care unit organization. This comprehensive volume begins with a review of acute neurological emergencies as managed clinically in the neurocritical care unit. Topics include acute cerebrovascular, neurological, and neurosurgical disorders. The unique aspect of this book is its description of the organization of the neurocritical care unit. We focus on how other services in the hospital interact with and assist neurocritical care operations, telemedicine/telestroke, and neurocritical care personnel and their roles. A review of expected outcomes of neurocritical care conditions is also included. Neurointensivists, neurocritical care unit staff leadership, hospital administrators, and those interested in developing a neurocritical care unit will find Neurointensive Care Unit: Clinical Practice and Organization to be an invaluable guide.
In the 1980s, following the recommendation of a presidential commission, all fifty states replaced previous cardiopulmonary definitions of death with one that also included total and irreversible cessation of brain function. The Definition of Death: Contemporary Controversies is the first comprehensive review of the clinical, philosophical, and public policy implications of our effort to redefine the change in status from living person to corpse. Edited by Stuart J. Youngner, Robert M. Arnold, and Renie Schapiro, the book is the result of a collaboration among internationally recognized scholars from the fields of medicine, philosophy, social science, law, and religious studies. Throughout, the contributors struggle to reconcile inconsistencies and gaps in our traditional understanding of death and to respond to the public's concern that, in the determination of death under current policies, patients' interests may be compromised by the demand for organ retrieval. Their questions about the philosophical and scientific bases for determining death lead, inevitably, to more profound questions of social policy. Acknowledging that the definition of death is as much a social construct as a scientific one, the authors, in their analysis of these issues, provide a comprehensive and provocative source of information for students and scholars alike.
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.
New technologies and medical treatments have complicated questions such as how to determine the moment when someone has died. The result is a failure to establish consensus on the definition of death and the criteria by which the moment of death is determined. This creates confusion and disagreement not only among medical, legal, and insurance professionals but also within families faced with difficult decisions concerning their loved ones. Distinguished bioethicists Robert M. Veatch and Lainie F. Ross argue that the definition of death is not a scientific question but a social one rooted in religious, philosophical, and social beliefs. Drawing on history and recent court cases, the authors detail three potential definitions of death -- the whole-brain concept; the circulatory, or somatic, concept; and the higher-brain concept. Because no one definition of death commands majority support, it creates a major public policy problem. The authors cede that society needs a default definition to proceed in certain cases, like those involving organ transplantation. But they also argue the decision-making process must give individuals the space to choose among plausible definitions of death according to personal beliefs. Taken in part from the authors' latest edition of their groundbreaking work on transplantation ethics, Defining Death is an indispensable guide for professionals in medicine, law, insurance, public policy, theology, and philosophy as well as lay people trying to decide when they want to be treated as dead.
What is brain death? At what point does a human life begin or end? Thomas Russell presents his concept of death, viewing death as death of the organism as a whole and answering the question what is death? with an examination of what constitutes life. Drawing on philosophical arguments, Russell argues that all current concepts of brain death are conceptually inadequate, but a new concept of death, applicable to all living entities, can encompass the traditional criteria and tests for death and does not entail any significant operational changes in the way in which death is diagnosed. From an historical review and examination of concepts of death, Russell considers key topics including: different brain states; conditions for life; biological concepts; and the moment of death.
