AAN calls for uniform determination of brain death

  • Russell JA & al.
  • Neurology
  • 2 Jan 2019

  • curated by Susan London
  • Clinical Essentials
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Takeaway

  • A new American Academy of Neurology (AAN) position statement calls for uniformity in brain death laws, policies, and clinical practices.

Why this matters

  • Determination of brain death is used to inform counseling and decision-making about withdrawal of supportive technology, and for legal purposes.

Key results

  • 2 standards for brain death are widely accepted by the medical profession:
  • To the best of AAN's knowledge, there have not been any cases in which compliant application of these guidelines has led to incorrect determination of brain death, with a patient regaining brain function.
  • However, only Nevada has adopted legislation requiring use of these guidelines as the medical standard for determination of brain death.
  • The new position statement:
    • Calls for each state to develop legislation modeled after the Nevada statute;
    • Calls for uniform policies in medical facilities across the country to ensure compliance with the brain death guidelines;
    • Supports development of programs to train and credential physicians who determine death by neurologic criteria, and to provide public and professional education about brain death and its determination;
    • Provides guidance to medical professionals when a family may not accept a determination of death because of religious, moral, or cultural reasons, and requests continued life support.

Expert comment

  • “The AAN believes that a specific, uniform standard for the determination of brain death is critically important to provide the highest quality patient-centered neurologic and end-of-life care,” position statement author James Russell, DO, MS, says in prepared comments. “The AAN supports the development of legislation in every state modeled after the Nevada statute, which specifically defers to these current adult and pediatric brain death guidelines and any future updates.”