Susan L. Smith, MN, PhD


March 28, 2003

Brain Death

Brain death has been the subject of ethical debate for more than 3 decades. An understanding of brain death by all involved parties is essential to the successful recovery of organs. Brain death in the context of the historical perspective and clinical organ donation is described and discussed in detail in Chapter 5 of this book Policy and Practice in Organ Transplantation[4] and in another Medscape program, Donation and Transplantation: Into the New Millennium.[5]

Although the determination and pronouncement of brain death are the responsibility of the physician, the critical care nurse has several important responsibilities including early recognition of impending brain death, open communication with the physician regarding the patient's status, peer support of nurses caring for brain-dead patients, assisting in the testing for brain death criteria, and care of the patient's family. In this last role, the critical care nurse has the opportunity to provide the family with and reinforce factual information about brain death. Only if the family understands and accepts that brain death is death will they consent to donation.


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