- Published: November 21, 2012
Last year, Carina Melchior was in a car crash and subsequently pronounced brain-dead. Her parents agreed to donate her organs, and she was taken off her respirator to wait for her body to shut down.1
Then, she began to wake up.
According to the American Academy of Neurology, brain death is defined as "the irreversible loss of function of the brain," with specific diagnostic criteria given, as well as potential complicating factors in diagnoses based on these criteria. A (mostly religious) group of dissidents like those at the Life Guardian Foundation continues to protest against the use of brain death as a medical definition.2 Such dissidents point to cases like that of Carina Melchior as reasons for discarding the idea of brain death as distinct from legal death, especially since the application of a brain death standard permits the practice of organ donation, which certainly would have killed someone like Melchior, had she not woken up.
One literature review found that, at least in adults, there are no published reports of recovery of neurologic function following a diagnosis of brain death according to the criteria detailed by the American Academy of Neurology.3 The perhaps improper application of guidelines by Melchior's attending physicians might have led to an unfortunate outcome, but that does not mean the guidelines themselves are flawed. Perhaps, to further assuage the fears of those uncomfortable with current definitions of brain death, a moratorium could be placed on organ donation by patients considered to be brain dead who would otherwise have their organs donated. Monitoring the outcome of those patients to see if any recovered neurologic function would explicitly illustrate whether or not the lives of those patients were being exchanged for the potential benefits of the organ recipients. However, it seems unlikely that this would pacify the religiously-motivated dissidents, while it is certain that many patients awaiting organ donations would suffer.