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Old 02-21-2011
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Medicolegal and Ethics When to stop treatment if the patient has brain death?

I am studying medical ethics from Kaplan Lecture Notes ...I am confused with rule #8 the physician decides when the patient is dead..

1- If there are no more Rx options (the patient is cortically dead) and the family insists on Rx. There's nothing the physician can do. Rx must stop

2- If the physician thinks continued Rx is futile (the patient has shown no improvement) but the surrogate wants to continue. Rx must continue

what is cortical death

can some1 help me with this ..pls .....
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Old 02-21-2011
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Cortical death is persistent vegetative state, so irreversible loss of mental activity and consciousness.

1. The example given by Dr. Daughtery is that you have diagnosed the patient as dead (no pulse, breathing etc.) and the family insists on giving them drugs , or insists on referring to another physician, or when they have called in another physician to access the situation, even though the patient is already dead. Treatment must stop.

2. Although the doctor has knowledge of treatments and their effectiveness, it is ultimately WHAT THE PATIENT WANTS, if he / she unable to express whether they want to be continued treatment or not, a surrogate is elected who "decides what is to be done based on WHAT THE PATIENT WOULD WANT" not what the surrogate wants.

Hope that's made things clear
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Old 02-21-2011
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I would suggest Dr. Conrad Fischer's 100 cases book for ethics. Its very well written and you can finish it in 2-3 days.
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