There are two ways a person can die, cardiopulmonary death and brain death. Both are formal, legal definitions of death. Cardiopulmonary death is the irreversible loss of function in the heart and lungs. Persons who have suffered a non-survivable brain injury (i.e. head trauma, stroke, etc.) have the opportunity to be organ donors. In most cases, they are diagnosed with brain death which is “the irreversible cessation of all brain functions.”
This can be a difficult diagnosis for relatives and friends to understand and/or accept. These patients have a heart beat and are breathing. Although medications are given to maintain blood pressure and a ventilator is breathing for the person, it is common for loved ones to maintain hope for recovery even after they have been notified that there is nothing else that can be done to save the person’s life.
Frequently Asked Questions
How does the physician determine if a patient has actually died?
The physician performs a series of tests to determine if brain death has occurred. Tests are also conducted to rule out any other reason that could be causing the brain not to function, such as medical conditions, medications or extreme cold. Death is indicated if the patient cannot breathe without assistance, has no pupil response to light nor response to pain. Common tests for brain death include a blood flow (determines if blood is flowing into the brain) and an apnea test (determines if the person can breathe on their own).
Once brain death has been declared, there is no chance for recovery. The legal time of death is when the final diagnosis of brain death has been documented in the hospital chart. The discontinuation of the ventilator does not cause death.
What does the term brain death mean?
When someone is brain dead, there is no blood flow or oxygen to their brain. The brain (including the brain stem which controls breathing) has ceased functioning in any capacity. Because the ventilator is breathing for the person, the organs such as the heart and liver continue to receive oxygen and are able to function for a few days after the brain has died. Unless damaged by injury or disease, the organs may be donated to another individual for an organ transplant.
Why does the heart keep beating if a person is brain dead?
The heart has its own pacemaker independent of the brain. As long as it has oxygen, it continues to beat. The heart could actually be removed from the body, placed in saline solution, given oxygen, and still continue to beat. This is why although the brain is dead, the heart continues to beat.
It is possible that there will be jerking or movement of the extremities, but these are involuntary reactions and not related to brain function.