“As good as dead” and is that good enough? Public attitudes toward brain death

Requests for somatic support after neurologic death determination: Canadian physician experiences

“…1 Once death has been declared using neurologic criteria, routine practice is to discontinue organ support (e.g., mechanical ventilation and vasopressors) unless deceased organ donation is planned. While NDD has been part of clinical practice for 50 years, 2 it remains subject to misunderstandings [3][4][5][6][7][8][9] due to philosophical and religious disagreements about what constitutes human death, 10,11 complexities in the clinical practice of death determination, 12,13 inconsistencies in terminology and language used to describe NDD, 10 and cognitive dissonance involved in declaring as dead a person that continues to have some degree of biologic function. [14][15][16][17] Finally, despite legal precedent supporting acceptance of neurologic criteria for determining death, NDD remains legally undefined in most provinces.…”

What Should We Do About the Mismatch Between Legal Criteria for Death and How Brain Death Is Diagnosed?

“…Doing so might help respond to current public skepticism and lack of understanding of BD 54,55,56,57 and acknowledge lay tendencies to care more about prognosis than abstractions. 54,57,58,59 Such a change could obfuscate determinations of a time of death and require a refinement of the dead donor rule, 60 which expresses general clinical and ethical consensus that a person must be dead before their organs can be retrieved. When one acknowledges that current testing can only imperfectly approximate BD, the question of whether to abandon the dead donor rule will also need to be carefully considered.…”

Refinements in the Organism as a Whole Rationale for Brain Death

“…This stage features a physiological understanding that the brain controls and regulates many bodily functions and its loss signals death. People operating at this level of understanding consider the brain-dead patient to be dead and others “as good as dead” (Kilcullen 2014). The latter concept is distinct but often is conflated with the former.…”