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Old 04-17-2012
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Medicolegal and Ethics Who can declare a patient brain dead?

Who can declare a patient brain dead? I just like to clarify. I have two sources that seem to have contradictory standpoints and both are from Kaplan.

In Kaplan's Medical Ethics, 100 Cases You Are More Likely To See On The Exam by Conrad Fischer:

-- Brain death does not specifically require determination by a neurologist if the physician managing the patient is comfortable with the criteria described and how to verify them. (Chapter 5, p. 40)

In Kaplan's Ethics Step 3 Videos, Dr. Alina Gonzalez-Mayo said:

-- The only people that can by themselves declare a patient brain dead are neurologists, neurosurgeons, and intensivists. If they're not available, hospitals can bypass this by having two individuals declare a patient brain dead. (Chapter 2 video. Ethical issue: brain death and declaration of death)

-- Dr. Gonzalez-Mayo specifically mentioned in an example that a Family Physician alone cannot declare a patient brain dead.


Am I missing something? Does anyone know any other reliable source that can resolve this? Thanks!
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Old 04-18-2012
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I believe.... The "neurologists, neurosurgeons, and intensivists" determine it.. But if they are not available then the 2 doctors (the family physician and another doc) have to sign it..
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Old 04-18-2012
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i just read fischer not long ago, i think he is right...

well (i am not 100%) sure.

But if only neurologist could do that, than you should provide every operating room with a neurologist...
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Old 04-18-2012
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Quote:
Originally Posted by DocSikorski View Post
i just read fischer not long ago, i think he is right...

well (i am not 100%) sure.

But if only neurologist could do that, than you should provide every operating room with a neurologist...
I agree. It doesn't seem logical for neurologists only to state someone is brain-dead.

However, the question that had been asked recognized that Dr. Conrad believes neurologists are not the only competent body in declaring death of the brain. The question also stated a source contradictory to Dr. Fischer's opinion. I don't know if there is a third book for Bio Ethics, but a third source supporting either argument would help put the matter to rest.
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The good thing about step 1 is that it doesn't go into shady areas...
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Old 04-19-2012
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Quote:
Originally Posted by DocSikorski View Post
But if only neurologist could do that, than you should provide every operating room with a neurologist...
Any physician can pronounce death... it's irreversible brain inactivity ("brain death", = "no family permission required to pull the plug") that requires a neurologist, neurosurgeon, intensivist or two other attending physicians (often with an outside read of an eeg) to confirm. As to the original question, I don't think the two citations are necessarily contradictory...
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Old 04-20-2012
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Quote:
Originally Posted by Mondoshawan View Post
Any physician can pronounce death... it's irreversible brain inactivity ("brain death", = "no family permission required to pull the plug") that requires a neurologist, neurosurgeon, intensivist or two other attending physicians (often with an outside read of an eeg) to confirm. As to the original question, I don't think the two citations are necessarily contradictory...
Just to clarify, the neurologist is needed to confirm brain death, not to declare it?
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