This semester we heard a talk by Dr. Joe Vukov. During his talk he discussed brain death and much of the conversation surrounding the topic. Dr. Vukov took time to clarify the difference between brain death, coma, and being in a vegetative state. Brain death includes 3 essential findings: coma, loss of brain stem reflexes, and apnoea. In addition, it occurs when a person has irreversible, traumatic brain injury that results in the cessation of all brain function. Dr. Vukov emphasized the irreversibility of brain death. People who suffer brain death cannot breathe on their own and they will not recover from their injury. A person who suffers brain death is deceased. This can be often hard for family and friends of loved ones with brain death to process because the person (while on the ventilator) typically looks like themselves. In addition, Dr. Vukov mentioned that many of the accidents that result in brain death (car crashes, motorcycle and bike accidents, and other trauma) often occur in younger people. The age of the victim can make their death even more impossible for the family to process.
Many confuse the terms coma and vegetative state with brain death. According to Dr. Vukov, a coma is a state of deep and prolonged unconsciousness as a result of injury or illness. In the article "Understanding brain death vs. states of consciousness" the author iterates the difference between a coma, vegetative state, and brain death. Patients in a coma are "alive, but in a state of eyes-closed, depressed consciousness from which they cannot be aroused." unlike brain death, coma patients have brain stem responses, spontaneous breathing and/or non purposeful motor responses. In addition, coma patients have the possible outcome of "progression to brain death, recovery of consciousness, or evolution to a state of chronically depressed consciousness." Patients in a vegetative state are alive, but have severely limited and/or impaired consciousness.
Although, brain death has been distinguished from coma and vegetative state, it continues to be an area of confusion for many people. Dr. Vukov mentioned that some of the confusion arises from the legal definition and categorization of brain death. One of the most confusing of these cases is the story of Jahi McMath. Jahi McMath and her family have been at the center of a debate on brain death since 2013. McMath was declared brain dead in December 2013 when she was 13 years old. However, her mother refused to believe this. For this reason, her mother moved her to New Jersey, a state that accommodates religions that do not recognize brain death, so that she could remain on life support. This case sparked the debate on ethics of religious refusal surrounding brain death. Dr. Vukov discussed this during his talk. Regardless of New Jersey’s legislation or religious beliefs, brain death is still medically considered death. Dr. Vukov explored this by reiterating the medical implications of brain death. Brain death is death. Hopefully, brain death will continue to be more widely understood.
“Mother: Girl at Center of Debate Over Brain Death Dies.” U.S. News & World Report, U.S. News & World Report, www.usnews.com/news/us/articles/2018-06-28/girl-at-center-of-debate-over-brain-death-dies-after-surgery.
Szabo, Liz. “Understanding Brain Death vs. States of Consciousness.” USA Today, Gannett Satellite Information Network, 10 Jan. 2014, www.usatoday.com/story/news/nation/2014/01/09/brain-death-states-of-consciousness/4397515/.
Dr. Vukov talk 4/02/2019
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