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The Outpatient Management of a Brain Dead Child

Published online by Cambridge University Press:  29 July 2009

Gregory L. Stidham ,
Amnon Goldworth ,
Gail Joralemon ,
David A. Bennahum  and
Alexander Ivanjushkin
Gregory L. Stidham
Affiliation:
Associate Professor of Pediatrics and Anesthesiology and Director, Critical Care, University of Tennessee, Memphis, and chairs the Bioethics Committee at Le Bonheur Children's Medical Center
Amnon Goldworth
Affiliation:
Stanford University, Stanford, California
Gail Joralemon
Affiliation:
University of New Mexico Hospital, St. Joseph Health System's Institutional Review Board, and the New Mexico Department of Human Services Task Force on Healthcare Reform
David A. Bennahum
Affiliation:
Professor of Medicine & Family and Community Medicine, University of New Mexico, Albuquerque, and serves as Chair of the Biomedical Ethics Committee of the University of New Mexico Hospital
Alexander Ivanjushkin
Affiliation:
Professor in the Department of Philosophy, Russian Medical Academy of Science, Moscow
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Extract

The patient, a 27-month-old girl, presented to Hospital B by ambulance in acute respiratory failure due to bilateral pneumothoraces.

At 41 weeks, the patient had been delivered by Cesarean section for failure to progress at Hospital A in the same city. Three days after birth she suffered a respiratory arrest. Resuscitation and ventilator support were initiated promptly but the child did poorly, and shortly after this first arrest, the parents were told by the child's physician that she had no chance of recovery. Nevertheless, the mother continued to insist that the child be kept on a respirator and aggressive support be maintained.

Type
Ethics Committees at Work
Information
Cambridge Quarterly of Healthcare Ethics , Volume 2 , Issue 3 , Summer 1993 , pp. 359 - 370
Copyright
Copyright © Cambridge University Press 1993

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References

Notes

page 363 note 1 National Institutes of Neurological Diseases and Stroke Collaborative Study Group. An appraisal of the criteria of cerebral death: a summary statement. Journal of the American Medical Association 1977;237:982.CrossRefGoogle Scholar

page 363 note 2 Grigg, MM, Kelly, MA, Celesia, GG, et al. Electroencephalographic activity after brain death. Archives of Neurology 1987;44:948.CrossRefGoogle ScholarPubMed

page 363 note 3 Boutros, AR, Henry, CE. Electrocerebral silence associated with adequate spontaneous ventilation in a case of fat embolism: a clinical and medicolegal dilemma. Archives of Neurology 1982;39:314.CrossRefGoogle Scholar

page 363 note 4 Pallis, C. ABC of brain stem death: the arguments about the EEG. British Medical Journal 1983;286:284.CrossRefGoogle ScholarPubMed

page 363 note 5 Ashwal, S, Schneider, S. Brain death in children. Pediatric Neurology 1987;3:5.CrossRefGoogle Scholar

page 363 note 6 Special Task Force. Guidelines for the determination of brain death in children. Pediatrics 1987;80:298.Google ScholarPubMed

page 363 note 7 Ad Hoc Committee on Brain Death, The Children's Hospital, Boston. Determination of brain death. Journal of Pediatrics 1987; 110:15.Google ScholarPubMed

page 363 note 8 Freeman, JM, Ferry, PC. New brain death guidelines in children: further confusion. Pediatrics 1987;81:301.Google ScholarPubMed

page 363 note 9 Ashwal, S, Schneider, S. Brain death in the newborn. Pediatrics 1989;84:429.Google ScholarPubMed

page 363 note 10 Ashwal, S, Schneider, S. Failure of electroencephalography to diagnose brain death in comatose children. Annals of Neurology 1979; 6:512.CrossRefGoogle ScholarPubMed

page 363 note 11 Fackler, JC, Rogers, MC. Is brain death really cessation of all intracranial function? Journal of Pediatrics 1987; 110:84.CrossRefGoogle ScholarPubMed

page 363 note 12 Schneider, S. Usefulness of EEG in the evaluation of brain death in children: the cons. Electroencephalography and Clinical Neurophysiology 1989;73:276.CrossRefGoogle Scholar

page 363 note 13 See note 12. Schneider, , 1989;73:276.Google Scholar

page 363 note 14 Lynch, J, Eldadah, MK. Brain-death criteria currently used by pediatric intensivists. Clinical Pediatrics 1992;31:457.CrossRefGoogle ScholarPubMed

page 363 note 15 Tomlinson, T, Brody, H. Futility and the eth- ics of resuscitation. Journal of the American Medical Association 1990; 264:1295.Google Scholar

page 363 note 16 Jecker, NS, Jonsen, AR. Medical futility: its meaning and ethical implications. Annals of Internal Medicine 1990; 112:949.Google Scholar

page 363 note 17 Lantos, JD, Singer, PA, Walker, RM, et al. The illusion of futility in clinical practice. American Journal of Medicine 1989;87:81.CrossRefGoogle Scholar

page 363 note 18 Truog, RD. Triage in the ICU. Hastings Center Report 1992;22(3):13.CrossRefGoogle ScholarPubMed

page 363 note 19 Waller, DA, Todres, ID, Cassena, NH, Anderten, A. Coping with poor prognosis in the pediatric ICU: the Cassandra prophecy. American Journal of Diseases of Children 1979; 133:1121.CrossRefGoogle ScholarPubMed

page 370 note 1 American College of Physicians. Ethics manual. Annals of Internal Medicine 117:947–60.CrossRefGoogle Scholar

page 370 note 2 Andereck, WS. Development of a hospital ethics committee: lessons from five years of case consultations. Cambridge Quarterly of Healthcare Ethics 1992;1:41–50.CrossRefGoogle ScholarPubMed