Amrita Journal of Medicine

EDITORIAL
Year
: 2020  |  Volume : 16  |  Issue : 2  |  Page : 41-

Brain stem death


Zubair Umer Mohamed 
 Consultant, Organ Transplant Anaesthesia and Critical Care, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

Correspondence Address:
Dr. Zubair Umer Mohamed
Consultant, Organ Transplant Anaesthesia and Critical Care, Amrita Institute of Medical Sciences and Research Centre, P. O, Ponekkara, Kochi - 682 041, Kerala
India




How to cite this article:
Mohamed ZU. Brain stem death.Amrita J Med 2020;16:41-41


How to cite this URL:
Mohamed ZU. Brain stem death. Amrita J Med [serial online] 2020 [cited 2022 Jul 2 ];16:41-41
Available from: https://ajmonline.org.in/text.asp?2020/16/2/41/292424


Full Text



Not many concepts in medicine have stirred up as much controversies as brain stem death. In this special edition, we have endeavored to explore the breadth and depth of this topic and summarize the various facets of the concept of brain stem death in a series of 10 articles.

The words 'brain dead' and 'brain stem death' are often used interchangeably, the reasons for which are described later in this issue, by Dr Shabala Paul and Dr Mathew George. In this issue, we have aligned with the use of the term 'brain stem death' as that is what is used in the Transplantation of Human Organs and Tissues Rules, 2014, which forms the basis of legislation and nomenclature in India.

From its origin to the present day, people across the globe – from medical professionals to ethicists to the general public – have been vociferously passionate and opinionated about this diagnosis. While some embrace and acknowledge it as the eventual inevitable culmination of an irreversible damage and disease process, others view it as a precursor to “real death” or even a pseudodiagnosis. Theologians, some linking it with the concept of “gift of life” (if organ donation ensues), have also given their myriad opinions based on their respective religious definitions of death.

India, in general, and Kerala, in particular, are going through a phase in history where brain stem death certification and organ donation are under immense public and professional scrutiny, not only in terms of its appropriateness and utility but also in terms of the legality, intent, and transparency. History teaches us that other countries too, have traversed this path, be it around the introduction of the Harvard Criteria in the US in the 1960s or after the Panorama Series in the BBC, in the UK in the 1980s. These events sparked an intense scientific and impassioned ethical discussion and debate that led to a series of societal and legislative steps both at the regional and national levels, that helped to structure and establish the treatment pathways in their respective societies. The recent order from the Government of Kerala that clarifies the legal and medical options after the declaration of brain stem death has been applauded by the medical fraternity and has also been adopted by other Indian states. We hope that the current discourse in India will lead to a scientifically and ethically acceptable conclusion that is best for the society, which encompasses the views of all stakeholders and allows the people to make an informed and collected decision.

Let the ignorant be educated, the willing facilitated, and the averse not coerced.