The diagnosis of brain death is coming under scrutiny in England after a "brain-dead" baby spontaneously began breathing on his own.  According to Sky News, the four-month-old baby had been declared brain-dead but continued on ventilator support because there was an ongoing legal dispute.  A senior doctor was described as "shocked" when a nurse noticed the baby breathing rhythmically and independently two weeks later.  The doctor said the wording of the brain death test might be changed to include a warning about the test's reliability.

In the USA, newspaper reporting on the recent tragic death of actress Anne Heche revealed confusion about whether a diagnosis of brain death means that you are actually dead.  According to news reports, after Heche's car accident of August 6, she was conscious and communicating with medical personnel.  By August 11, a spokesperson said she was not expected to survive, and she was declared brain-dead by doctors later that evening.  But because she had expressed a desire to be an organ donor, she was kept alive on life support until her organs could be harvested on August 14.

Interestingly, because brain death means "legally dead" in the state of California, the L.A. Times published her obituary August 12.  But the Washington Post and the New York Times waited until after her death by organ-harvesting to publish their obituaries.  Here's the quote from the Washington Post:

The Post's obituaries editor, Adam Bernstein, said the newspaper doesn't recognize brain death, which is sometimes partial, as a clear marker of death.

"It's black and white. There's no gray area here. If you're on life support, you're still alive," Bernstein said. "Other publications can make their own judgment about when they're comfortable publishing. I'm comfortable when someone is actually dead."

In 1968, an ad hoc committee at Harvard Medical School proposed a redefinition of death: people in an irreversible coma could be declared dead by the stroke of a pen.  Because viable organs for transplant can come from only a heart-beating, living donor, this redefinition was key to obtaining organs for transplant.  The recommendation of the ad hoc committee was codified into law in 1981 as the Uniform Determination of Death Act, or UDDA.  Now brain-injured people could be declared legally dead, their rights to ongoing medical care withdrawn, and they could be used as means — a source of spare parts.

But are doctors really able to predict "irreversibility" with any certainty?  The case reported by Sky News suggests that they are not.  In Oklahoma in 2007, Zack Dunlap was declared brain-dead and scheduled for organ-harvesting.  He recalls being unable to move or sign to his family and caregivers as they discussed harvesting his organs.  Thankfully, Zack managed to move before he was taken to the operating room to undergo death by organ-harvesting.

Most people are surprised to learn that even though the UDDA requires "irreversible cessation of all functions of the entire brain, including the brain stem" for a diagnosis of brain death, in routine practice, only a bedside examination of just the brain stem is performed.  The law does not require any special tests such as an EEG, MRI, or cerebral perfusion scan.  Doctors look for any reactions to pain, stick a cotton swab in your eye to see if you blink, and check whether your eyes move when cold water is flushed into your ears.  If you don't breathe on your own when the ventilator is withdrawn, they conclude that your brain stem isn't working.  And if the brain stem isn't working, they assume the rest of your brain isn't working, either.  But if that's true, how could Zack Dunlap hear the discussion about making him an organ donor after he had failed all his brain stem tests?  Obviously, his entire brain was not irreversibly dead!

Dr. Alan Shewmon, professor emeritus of pediatric neurology at UCLA medical school, has documented over 175 people who continued to live after a diagnosis of brain death, some for over twenty years.  Shewmon writes, "Just as cigarette ads are required to contain a footnote warning of health risks, ads promoting organ donation should contain a footnote along these lines: 'Warning: It remains controversial whether you will actually be dead at the time of removal of your organs.'"

Brain death is a legal fiction.  We are dead not when we lose certain abilities, but when our spirit departs to return to the God who gave it.  The brain death diagnosis removes legal rights from brain-injured patients so that they may be used as a source of spare parts.  Brain death is vigorously debated in the medical literature, and books have been written declaring that these donors are not actually dead.  But meanwhile, the public is kept in the dark and propagandized with continued campaigns to "give the gift of life."  How many people taken for organ-harvesting would have recovered if only their doctors had waited a little longer?  It is time for the public to be made aware of these facts and demand accountability from the transplant industry.  In the meantime, don't sign that donor card!

Dr. Heidi Klessig is a retired anesthesiologist and pain management specialist who writes and speaks about organ donation.  Her work may be found at respectforhumanlife.com.

Image: ElisaRiva via Pixabay, Pixabay License.