Brain Death

Brain death is when a person's brain has completely stopped working but the body is being kept alive by breathing machines and medicines.

• People who are brain dead are unaware and can't think or feel

• They can't move or breathe

• Their brain stops controlling automatic body functions such as heartbeat and blood pressure

• People with brain death are considered legally dead

Machines can breathe for someone who is brain dead, and medicines can keep the heart beating for a short time. However, eventually, all the person’s organs stop working. If a person wanted to be an organ donor, doctors may be able to use the person's organs for transplant. But the organ donation has to be done before the organs stop working.

No one who's brain dead ever recovers. Brain death is different from coma. People in a coma have some brain function and sometimes recover.

Brain death is caused by severe brain damage from:

• A head injury

• Lack of oxygen to the brain (such as from drowning or cardiac arrest)

Doctors first make sure the person doesn't have a medical problem that causes a deep coma similar to brain death. Such problems include:

• Overdose of certain kinds of drugs

• An extremely low body temperature (hypothermia)

If the person doesn't have one of those problems, doctors do a physical exam to look for signs of brain activity including:

• Trying to breathe if the ventilator is turned off

• Flinching or moving if the person is pinched or poked by a needle

• Gagging on something put in the back of the throat

• Blinking if something touches an eyeball

• Pupils narrowing in response to a flashlight

If there's no sign of brain activity, doctors sometimes test again 6 to 24 hours later to make sure the person again shows no response. After testing twice with no response, doctors know that the person is brain dead.

Instead of waiting a day to repeat the examination, doctors may do:

• Brainwave tests (EEG [electroencephalography]) to see if the brain has any electrical activity

• Blood flow tests to see if any blood is getting to the brain

People with no electrical activity or blood flow in the brain have brain death. But these tests aren't required.

Because brain death means someone is legally dead, the person's organs can be donated to someone in need of an organ transplant. Donation doesn't have to wait for the person's heart to stop beating. Organs are taken only if the person or family wishes to donate them. The ventilator and supportive medicines are kept going until this is done. The organs are removed carefully, and the body is treated with great respect. Then doctors:

• Turn off the ventilator

• Stop any medicines

• Release the body to the coroner's office or the funeral home