Understanding Brain Death

Brain death occurs when a person has an irreversible, catastrophic brain injury, which causes total cessation of all brain function (the upper brain structure and brain stem). Brain death is not a coma or persistent vegetative state. Brain death is determined by one or more physicians not associated with a transplantation team.

Some causes of brain death include (but are not limited to):

  • Trauma to the brain (i.e. severe head injury caused by a motor vehicle crash, a fall or blow to the head)
  • Cerebrovascular injury (i.e. stroke or aneurysm)
  • Anoxia (i.e. drowning or heart attack when the patient is revived, but not before a lack or blood flow/oxygen to the brain has caused brain death)
  • Brain tumor

If my loved one is brain dead, what does that mean?
Brain death means there is no activity in the brain. The brain is no longer functioning in any capacity and it never again will function. Because the brain is dead, the individual cannot feel pain.

What can cause brain death?
Death of the brain can occur from accidental injuries or illness. High blood pressure can also cause bleeding in the brain and result in death. A brain infection, a brain tumor or a traumatic injury may cause the brain to swell and lead to death as well.

How does the doctor determine brain death?
Doctors examining the patient will conduct numerous tests to determine whether any brain activity is present. If all brain activity is absent, the patient is dead.

I have understood that when an individual dies, that his/her heart stops beating. If my loved one is dead, why does the heart continue to beat?
The heart is part of the autonomic nervous system and thus has the ability to beat independently of the brain as long as it has oxygen. The heart will eventually stop beating as all bodily systems begin to stop working shortly after brain death. Once this process has begun, it cannot be reversed. At the time a physician declares brain death, the patient is dead. After authorization for organ donation has been obtained, mechanical support (a breathing machine) will be continued to keep oxygen going to the organs until they can be recovered for transplant. The machine is not keeping the patient alive (brain death is irreversible and is legally and medically recognized as death), it is merely keeping the organs viable until they can be recovered from the donor (after authorization for donation).

Would removing the breathing machine be the same as causing the death of my loved one or not giving him/her the chance to recover?
No. The brain will never recover when it dies. Since the patient has already been declared dead, removing the machine (which is artificially pumping air into the lungs) cannot cause further harm or death.

What is the legal time of death for a brain dead patient?
The legal time of death is the date and time that doctors determine that all brain activity has ceased. This is the time that is noted on the patient’s death certificate.

Are there any proven cases where patients were declared brain dead and later were restored to a normal life?
No. Often the general public views brain death and coma as the same. They are NOT! Brain death is always irreversible. Brain death is death.