Personal Injury Law

Brain Death

Our Atlanta based lawyers are constantly involved in cases involving brain injury and brain death. As tragic as these cases are, the families and loved ones are many times faced with the decision whether to cease life support after there has been a medical determination of brain death.

In general, brain death is considered to be the irreversible loss of brain function. The exact definition has changed throughout the years and is still subject to debate. The brainstem controls brain function and is responsible for regulating breathing, heart rate, reflexes, withdrawal from pain. Thus, diagnosing brain death requires the absence of brainstem function.

Most states have adopted a version of the Uniform Determination of Death Act thereby establishing a definition of brain death. The Uniform Act defines brain death as follows:
Determination of Death. An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.

The Georgia legislature has enacted O.C.G.A. §31-10-16 which defines brain death as folows:
(a) A person may be pronounced dead by a qualified physician, or by a registered professional nurse authorized to make a pronouncement of death under Code Section 31-7-176.1, if it is determined that the individual has sustained either (1) irreversible cessation of circulatory and respiratory function, or (2) irreversible cessation of all functions of the entire brain, including the brain stem. (b) A person who acts in good faith in accordance with the provisions of subsection (a) of this Code section shall not be liable for damages in any civil action or subject to prosecution in any criminal proceeding for such act. (c) The criteria for determining death authorized in subsection (a) of this Code section shall be cumulative to and shall not prohibit the use of other medically recognized criteria for determining death

Brain death is usually determined in the Intensive Care Unit of a hospital or in the Emergency Department. The determination usually involves three steps. First, unconsciousness is verified. To do this, a Glasgow score of 3 is required. The Glasgow scale is neurological scale which aims to give a reliable, objective way of recording the conscious state of a person, for initial as well as continuing assessment. Secondly, the patient is clinically checked for brainstem reflexes. If all brainstem reflexes are absent the third and last step is taken. This is the performing of an apnea test. Apnea is the cessation of breathing. This test is to ensure that the patient has no drive to breathe and confirms brain death.

Full post as published by Georgia Injury Lawyer Blog on May 18, 2009 (boomark / email).