OneLegacy’s hospital partners frequently receive and care for patients with head injuries, a brain tumor, bleeding into the brain or brain infections. Sometimes these conditions cause the brain to stop functioning. In such cases, the patient is declared brain dead.
While the patient’s family will feel a sense of overwhelming pain, the nurses of OneLegacy will help families face the tragic loss of their loved one by helping them better understand what is happening and by giving them an opportunity through donation to help others, a step which can start them on the road to grieving and recovery.
Understanding brain death is an important first step in this process. Following are answers to some common questions about brain death.
What is brain death?
When someone is brain dead, it means that there is no blood or oxygen flow to his or her brain. Thus, the brain is no longer functioning in any capacity and never will again.
What causes brain death?
Brain death results from swelling or bleeding resulting from a major trauma to the brain. Frequent causes include:
- Lack of oxygen to the brain from drowning, respiratory diseases, or drug overdose.
- Irregular blood flow to the brain caused by a blocked artery, heart attack or bleeding in the brain.
- A blow to the head or a ruptured aneurysm.
- A gunshot wound to the head
- The ballooning of a blood vessel supplying the brain.
- Car accidents
When any of the above occur, they cause swelling of the brain. Because the brain is enclosed in the skull, it does not have room to swell, thus pressure within the skull increases and can stop blood flow to the brain, killing brain cells. When brain cells die, they do not grow back, thus any damage caused is permanent and irreversible.
How does a physician determine if a patient is brain dead?
The physician performs a series of tests to determine the severity of the brain injury and if brain death has occurred. Unlike a coma, signs of brain death include:
- Cease of blood flow to the brain.
- The patient's inability to breathe without a ventilator or breathing machine.
- The patient's pupils do not respond to light.
- No reponse to pain
California state law requires that two physicians must independently examine and declare the patient brain dead.
If my loved one is brain dead, why does the heart continue to beat?
The heart has its own pacemaker independent of the brain. As long as it has oxygen and glucose, it continues to beat and give blood and oxygen to other organs, such as the kidneys, liver or pancreas. Unless damaged by injury or other disease, these organs may be used to help another individual through an organ transplant.
Would removing the respiratory support equipment be the same as causing the death of my family member?
No. Once the patient is brain dead, he or she is legally dead. The brain will never recover. The respiratory support equipment keeps oxygen flowing to the organs in order to help keep the heart beating, which gives the appearance that your family member is living. When the ventilator is discontinued, the heart will stop beating after several minutes without oxygen.
Are there any documented cases where a patient was declared brain dead and later restored to a normal life?
No. If you have heard about a person who was supposedly brain dead and recovered, they were actually in a deep coma or vegetative state with slight brain activity—not brain dead.
Are all families approached about the opportunity to donate organs and tissue?
Federal law requires hospitals to report all brain deaths (or imminent deaths) and cardiac deaths to OneLegacy. The families of all deceased patients whom OneLegacy determines to be medically suitable for donation should be offered the opportunity to donate.
Are the hospital staff and organ procurement staff adding insult to injury by asking for organ/tissue donation at such a time of loss?
That is not our intention. For many families, the gift of organ and/or tissue donation is the only positive experience in the tragic chain of events surrounding the loss of their loved one. It can help give meaning to an otherwise senseless event.
Would my family member feel any pain if his or her organs were donated?
No. As with all organ and tissue donors, he or she is deceased and no longer feels pain.