Extended somatic support for a pregnant woman with brain death from metastatic malignant melanoma: A case report

Abstract

This is the first known case of extended somatic support beyond viability for a pregnant woman with brain death resulting from metastatic malignant melanoma, resulting in a live birth.

Homage to Henry Beecher (1904-1976)

“…Perhaps the most striking challenge to the proposition that the brain death diagnosis constitutes death were case reports of brain dead pregnant women who were able to gestate fetuses for up to 3 months, albeit with intensive life support measures (Souza et al 2006;Yeung, McManus, and Tchabo 2008). In the language that Thomas Kuhn (1970) developed to characterize the progress of science, the brain death paradigm faces a state of crisis, driven by anomalous evidence regarding the biological functioning that remains possible despite irreversible apneic coma.…”

Decapitation and the definition of death

“…Perhaps the most striking challenge to accepting ‘brain death’ as death of the organism as a whole is the known capability of pregnant women diagnosed with this condition to gestate a viable fetus for a considerable period of time, followed by successful birth of a living infant 10 11. How can a dead body possible accomplish this feat?…”

Assessment of Somatic Support Process for Pregnant Brain Death Patients Occurring in a Transition Country Between Asia and Europe from Medical, Ethical, Legal and Religious Aspects

“…Though support of patients developing BD who are organ donors until the organ transplant procedure is a common situation encountered by organ transplant professionals, the support of pregnant patients developing BD until the birth of the baby is an extreme situation (Esmaeilzadeh et al 2010;Wawrzyniak 2015;Gopčević et al 2017). Since 1982, 24 patients with brain death in pregnancy have been reported in the literature (Dillon et al 1982;Heikkinen et al 1985;Field et al 1988;Bernstein et al 1989;Antonini et al 1992;Anstötz 1993;Nettina et al 1993;Béguin 1993;Wuermeling 1994;Iriye et al 1995;Vives et al 1996;Catanzarite et al 1997;Lewis and Vidovich 1997;Beca et al 1998;Spike 1999;Lane et al 2004;Hussein et al 2006;Souza et al 2006;Mejia et al 2008;Yeung et al 2008;Said et al 2013;Wawrzyniak 2015;Gopčević et al 2017;Holliday and Magnuson-Woodward 2017). However, with the increase in awareness and necessity of organ transplantation, the number of applications of BD procedures in intensive care units has increased, with a resulting increase in both 24 pregnant BD cases (Table 1).…”