The death 'Of a child, 'One wh'Ose vulnerability and unfilled promise c'Omp'Ounds the tragedy 'Of any death, t'Ouches us deeply. When that death 'Occurs due t'O the generally unexpected and sudden loss 'Of brain functi'On, it is particularly P'Oignant. And yet, when death c'Omes, it sh'Ould be diag­ nosed expediti'Ously. The professi'Onal resP'Onsibilities 'Of the physician require that he b'Oth rec­ 'Ognize brain death and inf'Orm the family 'Of its occurrence. In additi'On, since recent advances in transplantati'On provide the P'Ossibility 'Of using the 'Organs 'Of a brain-dead child t'O save the lives 'Of 'Other children, the c'Oncepts 'Of beneficence an~ charity further c'Ompel physicians t'O facilitate such transplantati'Ons by inf'Orming the family about this P'Ossibility. Criteria 'Of brain death have been refined 'Over about 30 years since the term coma depasse (bey'Ond c'Oma) was coined by M'Ollaret and G'Oulon in 1957 (Kaufman and Lynn, 1986). The last maj'Or criteria ev'Olved 'On a nati'Onal level were th'Ose 'Of the President's C'Ommissi'On in 1981. H'Owever, studies t'O date have c'Oncentrated 'On adults, and relatively little work has been rep'Orted ab'Out devel'Oping brain death criteria f'Or the y'Oung. Indeed, the advis'Ors t'O the President's Com­ missi'On suggested that there are significant-although n'Ot well defined~ifferences in the ability of the brains 'Of th'Ose under five years 'Of age t'O rec'Over from clinical states that W'Ould be accepted as indicative 'Of c'Omplete and irreversible l'OSS of brain functi'On in adults.

Springer Book Archives

Background: Including Historical, Ethical, Legal, and Practical Considerations.- 1 · Death-Defining Acts: Historical and Cultural Observations on the End of Life.- 2 · A Jewish Approach to Ethical Issues in Brain Death and Organ Transplantation.- 3 · Catholic Considerations of Brain Death and Organ Retrieval.- 4 · Protestant Perspectives on Organ Donation.- 5 · The Legal Status of Brain-Based Determinations of Death.- 6 · Brain Death: Historical Perspectives and Current Concerns.- Criteria for the Declaration of Brain Death in Children.- 7 · Brain Death in Children: Guidelines and Experience at the Massachusetts General Hospital.- 8 · Brain Death in Children: the Philadelphia Experience.- 9 · Pediatric Brain Death and Organ Transplantation.- 10 · Pediatric Brain Death and Organ Transplantation: The Los Angeles Experience.- 11 · Clinical Criteria for Pediatric Brain Death: The Washington Experience.- 12 · Brain Death in Infants and Children: The Atlanta Experience.- 13 · Brain Death in Children: The Loma Linda Experience.- 14 · Brain Death in Children: Task Force Guidelines.- 15 · Validity of Radionuclide Cerebral Angiography for Diagnosing Brain Death in Infants.- 16 · Detection of Blood Flow to the Brain by Radionuclide Cerebral Imaging.- 17 · The Eeg in the Determination of Brain Death in Pediatric Patients: The NIH Study.- 18 · Role of EEG in Brain Death Determination in Children: The Bronx Experience.- Issues in Brain Death Related to Organ Donation.- 19 · Estimation of Organ and Tissue Donor Pool from Multiple Cause of Death Statistics.- 20 · Use of Anencephalic Infants as Organ Donors: Crossing a Threshold.- 21 · Relaxing the Death Standard for Organ Donation in Pediatric Situations.- 22 · The Definition of Death: Unresolved Controversies.- Needs and Possibilities in Transplantation.- 23 · Developments in Immunosuppression: The Secret to the Success of Organ Transplantation.- 24 · Pediatric Transplantation: Needs and Potential Donors.- 25 · Developments in Tissue Transplantation.- Other Topics in Organ Retrieval and Donation.- 26 · Organ and Tissue Retrieval and Donation: The Ethical Imperative.- 27 · Attitudes toward Clinical and Social Issues in Organ Procurement.- 28 · Effect of Organ Donation on Families of Brain-Dead Patients.- 29 · Legal Aspects of Organ Transfer.- 30 · Anatomical Gifts Effective at Death.- 31 · Fragile Trust: The Success and Failure of Required Request Laws and the Procurement of Organs and Tissues from Children and Adults.- 32 · Reconsidering the Ban on Financial Incentives.- Funding of Transplantation.- 33 · Funding of Transplantation: The Health Care Financing Administration.- 34 · Medical Technology Evaluation and Coverage.- 35 · The Private Insurer Response to Advanced Health Care Technology: The Case of Organ Transplants.- 36 · Federal Efforts to Improve the Organ Procurement System.