Talk:Brain death

message: Right now, this article has a tautology: "permanent" cessation of EEG activity is not reversible:  well, that's true by definition.
Question: can brain electrical activity ever cease reversibly? What about deep anaesthesia, or hypothermia? The Anome
:See the ECT article for one possible answer: does anyone have a cite for this? — Preceding unsigned comment added by 217.158.106.57 (talk) 12:48, 27 March 2003
::Propofol brings about a dose-dependent diminution of cerebral blood flow, decreases global cerebral metabolic rate, and is potent enough to create a flat electroencephalogram in high doses. This state is rapidly reversible with no neurologic change thereafter. 
::"Brain death" cannot be diagnosed (by EEG) in the presence of such EEG-dampening drugs. - Nunh-huh 19:19, 31 Mar 2004 (UTC)
thread_title: February 2003

message: I revised the page fairly extensively, no offense intended.  I am a practicing transplant surgeon and know quite a lot about the topic.  The key point I would like to make is that brain dead individuals not only have lack of brain function, they have actual necrosis (death) of all brain tissue.  Thus, profoundly hypothermic people can have flat EEGs but are not brain dead, at least as clinicians use the term.  Assessing cerebral blood flow with radionuclide scanning (or, historically, arteriography) is extremely useful and eliminates any uncertainty about whether recovery is possible.
Another important point is that anyone with a neurologic injury severe enough to have any question of being brain dead has a negligible chance of meaningful recovery, even if they still have some respirations or other brain stem function. — Preceding unsigned comment added by 216.202.124.223 (talk) 19:16, 31 March 2004
:Necrosis, now that's irreversible. Should we emphasize that as the "true" definition of brain death, with the various types of tests as a way of detecting the absence of necrosis? (ie "brain life") -- The Anome 06:10, 1 Apr 2004 (UTC)
replies: text: It is incorrect that brain death indicates true death.  Zach Dunlap was found brain dead, even according to a PET scan, yet recovered successfully, without lasting impairment more severe than memory loss.   —Preceding unsigned comment added by 68.183.229.168 (talk) 04:01, 25 March 2008 (UTC)
replies: text:  I think the Zach Dunlap story is incorrect, or at the very least unsubstantiated. All references to it seem to draw from the same feelgood newspaper story (light on medical detail). It is not unlikely that a doctor or, more likely, a journalist made a mistake, so it is weak evidence against brain death being true death. I suggest that the reference is removed until/if a report appears in a peer reviewed form (if he really recovered from brain death there is bound to be a case report soon!) Anders Sandberg (talk) 03:00, 26 March 2008 (UTC)
replies: text:  Possibly, but the father specifically remembers seeing a PET scan that showed no blood flow.  According to Professor Bruce Brew, head of the Department of Neurology at St. Vincent's Hospital in Sydney, "It can be difficult to diagnose brain death. There is no absolute diagnostic tests. [sic] ... perhaps one in several hundred thousand [are mispronounced dead]. If not even rarer. By and large when people are pronounced brain dead, they unfortunately, are."   —Preceding unsigned comment added by 68.183.229.168 (talk) 18:47, 26 March 2008 (UTC)
replies: text: I tend to agree with Anders Sandberg on this one. The newspaper story is light on medical detail, and there hasn't been any more substantiation of a true false positive on the brain death study in this case. To add additional nuance, both the news story and the cited blog from the Neurologist refer to the study as a 'PET' scan, when in fact brain death studies are usually scintigraphic or SPECT imaging, not PET. 107.203.117.55 (talk) 03:30, 11 October 2022 (UTC)
thread_title:  irreversibility of brain death 

message: Another ambiguity is the use of the term "brain dead individual."  If someone is brain dead they are legally dead.  Once a person dies they are then a corpse and no longer an individual.  This is not a trivial matter as the entire concept of brain death does not at all address the issue of what it means to be alive or dead, but is just a list of criterion to determine irreversible loss of entire brain function.  It is clear to me that society has not accepted the concept of brain death as equivalent to dead because of the use of phrases such as this one.
This article needs a complete rewrite. — Preceding unsigned comment added by Drsyme (talk • contribs) 21:48, 6 December 2005
: One can have an individual chair, or an individual shirt. The term seems fine for reffering to living or dead or non-animate things. HighInBC 06:36, 2 March 2006 (UTC)
thread_title: Confusing Term

message: My little cousin was involved in a serious motorbike crash and was rushed to the hospital straight after the acccident. They saved his life although he has lost his eyesight and sense of smell.  He was concious and abled to communicate with us by kicking his legs.  We were told that his chance of surviving was good as he was only young.  He was 18 at the time.  Sadly, 11 days after the accident, he was pronouned brain dead.  The doctors kept him breathing and his heart beat for another day so family members from abroad could come and see him for the last time.  We all watched his heart beat dropped to zero by his bedside.  
I am so confused and curious... my understanding was that his brain was functioning when he was at hospital, what has changed?  What has made his brain decided to stop working? — Preceding unsigned comment added by 219.79.23.105 (talk) 12:42, 20 April 2006
-A reply-
Without knowing the exact circumstances of the case it is difficult to be specific, however, brain death (or brain stem death) can be caused by a whole variety of things, including trauma, bleeding into the brain or brainstem, infection or lack of oxygen/blood supply to the brain or brainstem. I appreciate that he was conscious and communicative for some days before his death, but some of the above factors can cause brain death even weeks after the original accident. If you really want to find out more I suggest you speak to the doctor(s) caring for your cousin, they are usually very approachable and understanding. I am sorry for your loss.Mmoneypenny 21:09, 21 September 2006 (UTC)
thread_title:  Can somebody explain this to me? 

message: In earlier times cessation of respiration and heartbeat used to tell dead or not and a common man could determine that too. Now with science all of this support the various definitions of death make it almost impossible to conclude whether the LIFE is there or not. — Preceding unsigned comment added by 210.7.132.72 (talk) 07:00, 29 August 2006
:It's because there is no such thing as "life". There is only a collection of parts that fail. Defining death is a matter of picking which failed parts, typically the heart or the brain, justify giving up and letting everything else fail. 76.169.201.183 21:53, 14 January 2007 (UTC)
replies: text: A.K.A. you can keep cells alive while certain parts of the body are dead, it's the sum of the whole that makes "conscious life" possible. However without the brain this isn't possible while the body can still be kept alive by machines performing the tasks the brain normally does, the individual is no longer the person they were when they were consciously alive. They're technically alive, although their brain is dead, this is the subject of debate on whether or not people should be kept alive or not because the recovery of brain cells and such is very poorly understood as it is a very long and complex process. The irreversibility factor is difficult to assess but severely extensive damage is usually justification enough. Just some thoughts... 70.162.43.130 06:58, 20 March 2007 (UTC)
thread_title: Other thoughts

message: Wow, yeah we need a springclean here. Now if only I can find some time... I'll come back end of December and see if I can't lend a hand.Mmoneypenny 21:36, 21 September 2006 (UTC)
thread_title:  Springclean 

message: This paragraph could be confusing to the lay-person: "Note that brain electrical activity can stop completely, or apparently completely (a "flat EEG") for some time in deep anaesthesia or during cardiac arrest before being restored. Brain death refers only to the permanent cessation of electrical activity. Numerous people who have experienced such "flat line" experiences have reported near-death experiences, the nature of which is controversial."
 
The typical use of "flat-line" refers to the ECG or the lectrical activity of the heart not the brain (EEG). In the vast majority of anaesthetic cases one monitors the heart and not the brain.
Also, in the ICU I work in the diagnosis frequently goes to a 4 vessel cerebral angiogram to make fully sure that there is an absense of flow. This is the "gold standard" of brain death. Frequently a person which such massive injuries as to cause brain death will have multiple cranial nerve palsies which makes cranial nerve testing unreliable.
One final thought - I think it should be made more obvious that pronouncing a patient "brain dead" is only required to allow for legal organ donation. If donation is not an option then life-support can be withdrawn without confirming brain death if the hope of any meaningful recovery is lost.
Sorry I have no idea how to edit this myself! 220.245.182.82 11:45, 7 October 2006 (UTC)
thread_title:  Just some thoughts post a long day in ICU! 

message: Could the next competent medic (preferably British or with an understanding of the British criteria) to check this page please have a look at the Brain Stem Death page too. At the moment, half of it still reads like a rant from the "cardiovascular death only" lobby. 11:02, 4 May 2008 (UTC)
thread_title: May 2008

message: Critics of the notion of brain death have sometimes argued that it could be invalidated by the futuristic existence of artificial brains, given that death in its broadest definition involves the entire body and that it happens on the cellular level, and not on any peculiar mnemonic level. Hence, if your brain unexpectedly dies, it might be replaced by one of these organic computer brains that would maintain your previous state of psychological consciousness, as one would store information on a computer disk. ADM (talk) 07:07, 25 August 2009 (UTC)
thread_title: Artificial brain

message: This article needs to include criticism of the "brain death" criteria and discussion of alternative criteria for death. One prominent author here is Dr. Alan Shewmon. Also, in the religious section, I'm reading about "the lord Buddha" and just imagining the outcry if someone wrote "the lord Jesus Christ" in a Wikipedia article, so I've removed "lord" and cleaned up those sentences a bit. JKeck (talk) 01:51, 11 July 2013 (UTC)
thread_title:  NPOV 

message: This page currently uses both "brain dead" and "brain-dead". Which is more correct, and if neither, can we standardize. Zargulon (talk) 16:16, 6 December 2013 (UTC)
replies: text: Neither is incorrect, but we can standardize on the hyphenated style (brain-dead) for the reasons that are explained at English compound > Hyphenated compound modifiers regarding permanent compounds versus temporary compounds, because both AHD4 and M-W Collegiate online enter both hyphenated brain-dead (adj) and open compound brain death (noun). I'll go edit to suit. Done. Quercus solaris (talk) 20:58, 6 January 2014 (UTC)
thread_title:  Spelling of "brain dead": with or without hyphen 

message: The section on religious views is a discussion on religious views with respect to organ donation, not brain death. I think this section needs to be re-worked to add religious views on brain death and remove the organ transplantation discussion but I don't really have the knowledge to make this change. Also, I'm a newbie and while I know I should be bold in my edits, I'm reluctant to make such a big change on a section that's been around this long. Ca2james (talk) 17:42, 20 February 2014 (UTC)
replies: text: Since no one has commented, I moved the religious views subsection to the organ donation section and reworked the first sentence. This maintains the text but stops it from being WP:COATRACK in the Legal history section. The entire organ donation section may still be coatrack text but now it can all be considered together. Ca2james (talk) 15:51, 4 March 2014 (UTC)
thread_title:  Religious views  

message: The entire section pertains to religious views on organ donation. Even the sub-heading of the section says that. I think it should go or be re-written. There are religious views on brain death but I don't want to go there myself/too complicated.24.0.133.234 (talk) 02:19, 8 March 2014 (UTC)
replies: text: Yes, and it's a sub-section of the Organ donation section. I moved it there because it was about organ donation and not brain death, as I described above. I agree that it needs to be rewritten to better summarize the main article. Ca2james (talk) 02:27, 8 March 2014 (UTC)
thread_title:  Religious Views section 

message: Is there anyone credible who believes that absolute brain death isn't synonymous with death? There have been people who turned around from this condition, as is mentioned in the article, but I think the very notion is discouraged in the public. Such views are linked with extremism, families desperately hoping against hope, and links to the anti-euthanasia movement. But is there anyone with theories about people returning from 'brain dead' state, or otherwise innovative or explanative thoughts on the problems associated with this concept? --IronMaidenRocks (talk) 12:54, 1 May 2014 (UTC)
replies: text: Sorry to answer this so late but what i think you are referring-to would be considered a misdiagnoses. At this point, "brain death" is considered to be a final-permanent, irreversible loss of consciousness along-with physical signs and test-results to confirm. People's other vital organs "return" from brain death through transplantation I guess you could say, but although there is debate about misdiagnoses and tests used to determine brain death, (because any repairable or recoverable condition labeled as brain death would be a misdiagnoses)--an irreversible loss of consciousness is what it is.24.0.133.234 (talk) 16:23, 5 September 2014 (UTC)
thread_title: Not relatable to actual death?

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thread_title:  External links modified 

message: Now that the Jahi McMath case is back in the news, I think a mention of the New Jersey Declaration of Death Act (https://muse.jhu.edu/article/245624) is useful. However I don't know how to present it in context of other states' viewpoints, so someone more versed in these topics should add it in. Wqwt (talk) 19:19, 29 June 2018 (UTC)
thread_title:  Legality