Understanding Brain Death

How does the physician determine if a patient has actually died?
The physician performs a series of tests to determine if death has occurred. Death is indicated if the patient:

• Cannot breathe without assistance
• Has no pupil response to light
• Has no response to pain

What does the term “brain dead” mean?
When someone is brain dead, it means there is no blood flow or oxygen to their brain and that their brain has ceased functioning in any capacity. It does not mean that other organs, such as the heart, kidneys, or liver are dead, although they may function for only a few days. Unless damaged by injury or disease, these organs may be donated to another individual for an organ transplant.

Why doesn’t the heart stop 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 a saline solution, given oxygen, and still continue to beat. Therefore, the brain can be dead and the heart may continue to beat.

What part does medication play in the body of the brain dead patient?
In case the family wishes to donate the organs and/or tissues, medications are usually continued until the time the patient is officially declared brain dead. These medications help keep the blood pressure and heart rate under control, and some reduce swelling in the brain.

Would removing the respiratory support equipment be the same as causing the death of my family member or not giving him or her all possible chances?
Once the patient is brain dead, he or she is already dead; consequently, you cannot cause death by removing respiratory support. The respiratory support equipment only keeps the heart beating.

What is the recorded time of death for a brain dead patient, when the patient is declared brain dead or when the heart actually stops beating?
The recorded time of death is when the physician actually pronounces the patient dead. The patient can be pronounced dead on the basis of brain death (with the heart still beating). Medically and legally, the patient is dead at that point.

Does the body of a brain dead patient sometimes start to deteriorate even if the patient is still on life support?
The failure of many organs begins to occur soon after brain death.

Are there any clinical documented cases where a patient was declared brain dead and later restored to a normal life?
No. When you hear about patients who were brain dead and recovered, they were not actually brain dead. They were in a deep coma or vegetative state with slight brain activity.