Hospitals Don’t Always Agree On What “Brain-Dead” Means

Brain death — the total loss of all brain function — accounts for 1-2% of all deaths in the U.S. every year. But a recent study suggests that hospitals aren't always on the same page when it comes to diagnosing the condition. For the study, published online last month in JAMA Neurology, researchers wanted to know the degree to which hospitals around the U.S. had adopted the American Academy of Neurology's latest guidelines for determining whether a patient is brain-dead. To find out, they analyzed brain death policies of 492 hospitals. Their results showed that, although most of the hospitals had adopted the new guidelines, there was an uncomfortable amount of variability in the way they were actually implemented. For instance, only about a third of those policies required a neurologist or neurosurgeon to be the doctor making the call. Some of the other inconsistencies are a little more worrying: While more than 90% of hospital policies in the study require the patient to not have a pupil response, only about 60% require an absence of spontaneous breathing, and only 22.6% require an absence of jaw reflexes. So, while someone may be considered "brain-dead" at one hospital, they might not be at another. And, in the absolute worst-case scenario, reports NPR, that misdiagnosed "brain-dead" patient may regain some brain function. If you're declared brain-dead, then you're dead. And at that point, your organs may be up for donation. So getting the diagnosis right can be a matter of life-or-death — and not just for you.