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Does Personhood Begin at Conception?
Published in Christopher Kaczor, The Ethics of Abortion, 2023
A critic might argue that if brain death really counts as death, then why should the human fetus prior to the development of the brain also not be considered dead? As indicated earlier (Section 4.6), even if one accepts neurological criteria as the basis for determining death, an important difference between the human fetus and the case of brain death would be that of irreversibility. In brain death, brain function is irreversibly lost: a temporary loss is not considered brain death. A brain-dead patient has irreversibly lost neurological function; a human fetus has not irreversibly lost neurological function but will, if all goes well, function like the rest of us.
Pathophysiology of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Glucose is a molecule made up of six carbons. It is a very efficient form of fuel for the body. When metabolized in the presence of oxygen, it is broken down to form carbon dioxide and water. The brain and nervous tissues use glucose as the source of most of their required energy. Other tissues and organ systems use fatty acids and ketones as fuel. The brain is unable to synthesize or store sufficient glucose to last for more than several minutes. A continual glucose supply from the systemic circulation is required for the cerebrum to function normally. Brain death can be due to severe and prolonged hypoglycemia. Significant brain dysfunction occurs because of only moderate hypoglycemia. Glucose is obtained from the circulation by tissues. Hypoglycemia is extremely dangerous in comparison to hyperglycemia. There is rigid control of blood glucose levels while fasting, and they remain between 70 and 99 mg/dL, which is equivalent to between 4.0 and 5.5 mmol/L. After eating, blood glucose levels rise. Insulin is released from the beta cells of the pancreas, allowing glucose to be transported into the body cells. Approximately 66% of the glucose contained in each meal is removed from the blood, and stored in the liver or skeletal muscles as glycogen. When the liver and skeletal muscles become saturated with glycogen, remaining glucose is converted into fatty acids by the liver. These are stored as triglycerides in the adipose tissue’s fat cells.
Introduction
Published in David Lamb, Death, Brain Death and Ethics, 2020
Criteria for the diagnosis of brain death are being continually refined by clinical and experimental research. Yet confusion persists partly because of the use of ambiguous terms like ‘irreversible coma’ and ‘cerebral death’, and partly because people confuse questions related to the determination of death with other tangentially related problems. It is most important to avoid confusing the identification of brain death with (1) criteria for diagnosing the vegetative state; (2) questions concerning then need for cadaver transplants; (3) cost-benefit arguments related to the employment of artificial life-support systems; (4) decisions to terminate artificial life support, with a view to facilitating various forms of ‘allowing to die’.
The history of organ transplantation
Published in Baylor University Medical Center Proceedings, 2022
Kristen D. Nordham, Scott Ninokawa
Regulation and organization has helped transplant become widely accepted with the public. The first significant governmental involvement in transplant was the National Uniform Anatomical Gift Act, drafted in 1967. This allowed individuals or next-of-kin to donate organs and/or tissue for transplantation at the time of death and created the uniform donor card. The medical community itself had to make decisions on aspects unique to the field of transplant. Although Alexandre had performed a transplant from a coma dépassé patient 5 years earlier, official criteria for brain death were established in 1968 by a committee at Harvard Medical School. The report aimed to define irreversible coma as a criterion for death in order to lessen burdens of permanently comatose patients on families and hospitals and clear up controversy in obtaining organs for transplantation. Donation after brain death has become the most common form of donation.
Factors affecting organ donation rate during devastating brain injuries: a 6-year data analysis
Published in Acta Chirurgica Belgica, 2021
Reyhan Arslantas, Banu Eler Çevik
The current population-based cohort study identified ICH (37%) as the leading cause of brain death, followed by TBI (22%) and SAH (22%). In contrast to other studies [7,8], the most frequent cause of brain death in our hospital was ICH. However, the most common reasons for brain death in Çekirge City Hospital, Bursa/Osmangazi [9] and a tertiary university hospital in Izmir [10] were ICH and intracranial hemorrhage, respectively. Unlike these results, Kompanje et al. [8] reported that only 5% of patients who died due to ICH progressed to brain death. Differences in the most common reasons for brain death among various studies may be attributed to the use of different classifications for the cause of brain death. Some countries, like Spain, generally admit all patients with devastating ICH to critical care in order to provide adequate care and assess for the possibility of donation. In such countries, the most common cause of brain death has been ICH [1].
Requiring Consent for Brain-Death Testing: A Perilous Proposal
Published in The American Journal of Bioethics, 2020
A medical treatment provides medical interventions that are intended to cure specific ailments, improve biological abnormalities, or alleviate symptoms in a patient. Differently, an assessment is aimed at attaining specific information that can inform and guide the medical team toward appropriate next steps for the patient. For example, a decision-making capacity assessment is not performed to be therapeutic or to alleviate any symptoms; rather, it is intended to assess the patient’s level of cognition and determine who the appropriate decision-making agent for a specific medical decision should be. Similarly, brain-death testing is not performed to be therapeutic or to alleviate any symptoms; it is intended to assess the functioning of the brain and determine whether the patient meets the criteria for clinical death. This distinction between treatments and assessments in their purpose and goals is crucial, because these factors help form the ethical obligations and boundaries associated with each concept.