enerbol and Brain-Injuries

An accident or a catastrophic disease may occasionally lead to brain death (BD) during pregnancy. Management of brain-dead pregnant patients needs to follow special strategies to support the mother in a way that she can deliver a viable and healthy child and, whenever possible, also be an organ donor. This review discusses the management of brain-dead mothers and gives an overview of recommendations concerning the organ supporting therapy.. To obtain information on brain-dead pregnant women, we performed a systematic review of Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). The collected data included the age of the mother, the cause of brain death, maternal medical complications, gestational age at BD, duration of extended life support, gestational age at delivery, indication of delivery, neonatal outcome, organ donation of the mothers and patient and graft outcome.. In our search of the literature, we found 30 cases reported between 1982 and 2010. A nontraumatic brain injury was the cause of BD in 26 of 30 mothers. The maternal mean age at the time of BD was 26.5 years. The mean gestational age at the time of BD and the mean gestational age at delivery were 22 and 29.5 weeks, respectively. Twelve viable infants were born and survived the neonatal period.. The management of a brain-dead pregnant woman requires a multidisciplinary team which should follow available standards, guidelines and recommendations both for a nontraumatic therapy of the fetus and for an organ-preserving treatment of the potential donor.

Topics: Brain Death; Brain Injuries; Delivery, Obstetric; Female; Humans; Life; Pregnancy; Pregnancy Complications; Tissue and Organ Procurement

The dominant conception of brain death as the death of the whole brain constitutes an unstable compromise between the view that a person ceases to exist when she irreversibly loses the capacity for consciousness and the view that a human organism dies only when it ceases to function in an integrated way. I argue that no single criterion of death captures the importance we attribute both to the loss of the capacity for consciousness and to the loss of functioning of the organism as a whole. This is because the person or self is one thing and the human organism is another. We require a separate account of death for each. Only if we systematically distinguish between persons and human organisms will we be able to provide plausible accounts both of the conditions of our ceasing to exist and of when it is that we begin to exist. This paper, in short, argues for a form of mind-body dualism and draws out some of its implications for various practical moral problems.

Topics: Beginning of Human Life; Brain; Brain Death; Brain Diseases; Brain Injuries; Cognition; Comprehension; Death; Embryo, Mammalian; Euthanasia; Euthanasia, Active; Euthanasia, Passive; Humans; Individuality; Life; Persistent Vegetative State; Personhood; Philosophy; Self Concept

Detection of fetal hydrocephalus with head enlargement in the third trimester raises questions concerning the extent of the physician's obligations to the fetus and to the mother. Here Strong develops and defends an approach to these questions that he discussed in an earlier essay ("Ethical conflicts between mother and fetus in obstetrics," Clinics in Perinatology 1987 Jun; 14(2): 313-328), dividing the ethical issues involved into two main topics. He first explores under what circumstances a physician is ethically justified in draining fluid from the fetal cranium to reduce head size. This procedure, which usually causes fetal death, facilitates vaginal delivery. A cesarean section, which is less stressful for the fetus, exposes the woman to the risks of surgery. Secondly, Strong applies this discussion to the issue of how the physician should counsel the woman, and what recommendations, if any, the physician should make concerning the method of delivery.

Topics: Beginning of Human Life; Brain Diseases; Brain Injuries; Cesarean Section; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Counseling; Decision Making; Disclosure; Embryonic and Fetal Development; Ethical Analysis; Ethics; Fetus; Homicide; Human Rights; Humans; Hydrocephalus; Individuality; Infant, Newborn; Infant, Premature; Infanticide; Informed Consent; Labor, Obstetric; Liability, Legal; Life; Maternal Welfare; Methods; Moral Obligations; Morbidity; Mortality; Patient Care; Personhood; Physician's Role; Physicians; Policy Making; Pregnancy; Pregnant Women; Prognosis; Risk; Risk Assessment; Self Concept; Social Responsibility; Treatment Refusal; Value of Life

The connection between brain life and brain death is neither as simple nor as defensible as it might at first appear. The problem rests with the two dominant competing definitions of death:...the loss of that which is necessary for the organism to continue to function as a whole;....the loss of that which is essentially significant to the nature of the organism... If death is understood as the loss of that which is necessary for the continued functioning of the organism as whole, then the apparent symmetry breaks down. If...death could be understood as the loss of that which is essentially significant to the nature of the organism....consciousness, then the symmetry would hold. However, that definition of death is indefensible. Therefore...statements about the status of anencephalic infants and early human embryos based upon a connection between brain death and brain life are unfounded.

Topics: Adult; Anencephaly; Beginning of Human Life; Brain; Brain Death; Brain Diseases; Brain Injuries; Death; Embryo, Mammalian; Embryonic and Fetal Development; Human Characteristics; Humans; Individuality; Infant; Life; Persistent Vegetative State; Personhood; Philosophy; Self Concept

Kuhse and Singer, the editors of this special issue of Bioethics, introduce seven articles on conflicting concepts, public policies, and standards for the determination of cardiorespiratory and brain death and the relationship of brain death to the beginning of "brain life" and to organ donation, especially from anencephalic infants. The articles are "Consciousness, the brain and what matters," by Grant Gillett; "Brain death and the anencephalic newborn," by Robert D. Truog and John C. Fletcher; "Brain death and brain life: rethinking the connection," by Jocelyn Downie; "A plea for the heart," by Martyn Evans; "The importance of knowledge and trust in the definition of death," by Bo Andreassen Rix; "Death, democracy and public ethical choice," by Reid Cushman and Soren Holm; and "Misunderstanding death on a respirator," by Tom Tomlinson.

Topics: Anencephaly; Attitude; Beginning of Human Life; Brain; Brain Death; Brain Diseases; Brain Injuries; Cognition; Community Participation; Comprehension; Death; Decision Making; Denmark; Embryo, Mammalian; Embryonic and Fetal Development; Ethics; Heart; Humans; Individuality; International Cooperation; Internationality; Life; Life Support Care; Nurses; Persistent Vegetative State; Personhood; Physicians; Public Opinion; Public Policy; Reference Standards; Self Concept; Tissue and Organ Procurement; Tissue Donors; United States; Withholding Treatment

Topics: Abortion, Induced; Adult; Beginning of Human Life; Bioethical Issues; Bioethics; Brain Death; Brain Diseases; Brain Injuries; Death; Dementia; Ethicists; Ethics; Euthanasia, Passive; Fetus; Human Characteristics; Humans; Individuality; Infant; Infanticide; Life; Moral Obligations; Persistent Vegetative State; Personhood; Philosophy; Reference Standards; Self Concept; Social Responsibility; Value of Life

If phenylketonuria is diagnosed during the first few weeks of life, a special diet can be given to prevent the brain damage that otherwise will occur.A simple, cheap, accurate laboratory test has been developed to diagnose the condition in infants two to four days old before they leave the hospital. At the Donald N. Sharp Memorial Community Hospital in San Diego routine testing of all newborn infants has been done with this technique since August 26, 1963. Mass screening programs in the newborn nursery are already being carried out by large numbers of hospitals across the United States.

Topics: Blood; Brain Injuries; Clinical Laboratory Techniques; Hospitals; Hospitals, Community; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Laboratories; Life; Mass Screening; Nurseries, Hospital; Phenylalanine; Phenylketonurias

Topics: Brain; Brain Damage, Chronic; Brain Injuries; Discrimination Learning; Humans; Intellectual Disability; Life

Topics: Brain; Brain Injuries; Child; Humans; Infant; Learning; Life

Topics: Brain; Brain Injuries; Death; Humans; Life