Diagnosis of death by neurological criteria (DNC) is a construct which has been part of the British medico-legal landscape for nearly half a century. This book examines the factors behind its emergence, and discusses the various changes that took place in the last few decades that culminated in the current definition and clinical criteria for determining brain-based death. It highlights the continuities and discontinuities in practice, and the impact they have on the issue of withdrawal of mechanical ventilation in intensive care units and on the field of organ transplantation. The book also explores the law’s response to the introduction and development of DNC in clinical practice. It demonstrates how the legitimacy of the definition and criteria used by the medical profession were forged in the courtroom rather than in Parliament. It documents why case law were introduced in court, and assesses whether organ donation was a consideration in the deliberations. It will be emphasised that courts have given insufficient consideration to requests made in recent cases to consider a broader range of methods to determine death. Those pleas were made on the grounds that the definition and criteria used in the UK are dissimilar to those used in other jurisdictions that also adopt DNC; and that faith communities have a different understanding of death. By taking a close look at those other approaches before highlighting the inherent limitations of the courtroom as the forum that confers DNC its legitimacy, the book puts forward the argument that the democratic process should be engaged.

Diagnosis of death by neurological criteria (DNC) is a construct which has been part of the British medico-legal landscape for nearly half a century. This book examines the factors behind its emergence, and discusses the various changes that took place in the last few decades that culminated in the current definition and clinical criteria for determining brain-based death. It highlights the continuities and discontinuities in practice, and the impact they have on the issue of withdrawal of mechanical ventilation in intensive care units and on the field of organ transplantation. The book also explores the law's response to the introduction and development of DNC in clinical practice. It demonstrates how the legitimacy of the definition and criteria used by the medical profession were forged in the courtroom rather than in Parliament. It documents why case law were introduced in court, and assesses whether organ donation was a consideration in the deliberations. It will be emphasised that courts have given insufficient consideration to requests made in recent cases to consider a broader range of methods to determine death. Those pleas were made on the grounds that the definition and criteria used in the UK are dissimilar to those used in other jurisdictions that also adopt DNC; and that faith communities have a different understanding of death. By taking a close look at those other approaches before highlighting the inherent limitations of the courtroom as the forum that confers DNC its legitimacy, the book puts forward the argument that the democratic process should be engaged.

This book discusses the common principles of morality and ethics derived from divinely endowed intuitive reason through the creation of al-fitr' a (nature) and human intellect (al-‘aql). Biomedical topics are presented and ethical issues related to topics such as genetic testing, assisted reproduction and organ transplantation are discussed. Whereas these natural sources are God’s special gifts to human beings, God’s revelation as given to the prophets is the supernatural source of divine guidance through which human communities have been guided at all times through history. The second part of the book concentrates on the objectives of Islamic religious practice – the maqa' sid – which include: Preservation of Faith, Preservation of Life, Preservation of Mind (intellect and reason), Preservation of Progeny (al-nasl) and Preservation of Property. Lastly, the third part of the book discusses selected topical issues, including abortion, assisted reproduction devices, genetics, organ transplantation, brain death and end-of-life aspects. For each topic, the current medical evidence is followed by a detailed discussion of the ethical issues involved.

Laws are imposed on facts. But what is the law to do when its rules for establishing facts do not—because they cannot—produce a satisfactory answer? Scenarios that raise this intractable uncertainty problem have been treated as isolated concerns, but are in fact endemic across legal systems. They can cross jurisdictional and doctrinal boundaries, have recurred throughout history, and demand creative thinking from those faced with them. This book explores the law’s understandings of and responses to such situations from a comparative historical perspective. It investigates how the law has framed these most difficult problems of uncertainty; dealt with uncertainty’s often unclear boundaries; and developed a broad range of different responses to solve or avoid it, across doctrine, time, and jurisdiction. The work examines a selection of key uncertainty problems across private law as elements of a singular uncertainty issue endemic in legal systems. This analysis will be of interest to historians and comparatists, but also to doctrinal, theoretical, and other scholars and practitioners. The analysis leaves us better informed and better equipped for dealing with future scenarios where uncertainty arises, including insights beyond national and doctrinal confines.

This text provides an overview of the processes of brain death, exploring the concepts and historical approach of human death, clinical examinations of brain-dead patients, ancillary tests in coma and brain death, bioethical discussions of brain death and its relationship with some consciousness disturbances, and the legal considerations of human death. Unlike other, narrow-focus reference this book encompasses a wide spectrum of issues including medical, legal, bioethical and historical aspects.

Core Topics in Neuroanesthesia and Neurointensive Care is an authoritative and practical clinical text that offers clear diagnostic and management guidance for a wide range of neuroanesthesia and neurocritical care problems. With coverage of every aspect of the discipline by outstanding world experts, this should be the first book to which practitioners turn for easily accessible and definitive advice. Initial sections cover relevant anatomy, physiology and pharmacology, intraoperative and critical care monitoring and neuroimaging. These are followed by detailed sections covering all aspects of neuroanesthesia and neurointensive care in both adult and pediatric patients. The final chapter discusses ethical and legal issues. Each chapter delivers a state-of-the art review of clinical practice, including outcome data when available. Enhanced throughout with numerous clinical photographs and line drawings, this practical and accessible text is key reading for trainee and consultant anesthetists and critical care specialists.

The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.

Brain death-the condition of a non-functioning brain, has been widely adopted around the world as a definition of death since it was detailed in a Report by an Ad Hoc Committee of Harvard Medical School faculty in 1968. It also remains a focus of controversy and debate, an early source of criticism and scrutiny of the bioethics movement. Death before Dying: History, Medicine, and Brain Death looks at the work of the Committee in a way that has not been attempted before in terms of tracing back the context of its own sources-the reasoning of it Chair, Henry K Beecher, and the care of patients in coma and knowledge about coma and consciousness at the time. That history requires re-thinking the debate over brain death that followed which has tended to cast the Committee's work in ways this book questions. This book, then, also questions common assumptions about the place of bioethics in medicine. This book discusses if the advent of bioethics has distorted and limited the possibilities for harnessing medicine for social progress. It challenges historical scholarship of medicine to be more curious about how medical knowledge can work as a potentially innovative source of values.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.