BRAIN DEATH – YOUR QUESTIONS ANSWERED

Brain death, technically referred to as brain-stem death, occurs when the whole brain dies. It is the irreversible end of all brain activity. Brain-death usually results from a severe brain injury which causes all the brain activity to stop. This can happen after a major road accident, head injury, or a bleed in the brain due to a stroke. The human brain consists of two parts: – The Cortex – The large part stored in the skull that is used to depict the brain visually. – The Brain Stem – The part of the brain that connects the spinal cord to the cortex. When a person incurs a serious head injury, the cortex starts to swell up; however, it cannot expand much further because it is contained in the skull, which is made of hard bone.

As a result, the pressure in the brain can grow greater than the pressure of the heart. The heart is then unable to pump blood to the brain. This lack of blood flow to the brain causes the whole brain to die, due to lack of oxygen. The brain cells not only die, but also liquefy, which makes brain death irreversible.

Brain death is crucial to the process of organ retrieval and transplantation. That’s why it’s important to understand what exactly it is. It is a legal form of death. It’s just that no one has bothered to tell us about it, or explain what it is.

Watch this short video to completely understand what brain death is before you move ahead.

A person who is brain dead is not suffering from brain death; he or she is dead. A brain dead person can never wake up. There are a number of ways to determine whether a person is brain dead. If there is no blood flow to the brain, then brain cells have died due to lack of oxygen, and the brain is dead. Brain death can also be confirmed if the person – Is not conscious – Cannot breathe – Cannot swallow – Cannot cough, and – his or her pupils do not respond to light.

Brain death differs from a coma because it is an irreversible process; it is a form of death. A person who is in a coma is unconscious and does not respond to stimuli, but his or her brain is still partially active. A person who is brain dead has a brain with zero brain activity, and stops breathing. As a result, his or her heart and other vital organs die because they are deprived of oxygen.

If the body of a brain dead person is kept on a ventilator, the heart may continue to beat for 2-3 days, and keep vital organs such as the liver and kidney alive for this time period. These organs can be surgically removed for donation. The family or next of kin will be asked if they want to donate his/her organs. This is called a deceased donation, which means that the family has agreed to donate his/her organs. The family has the option of donating all or some of the organs. After the organs have been harvested (removed from the body for transplantation into someone else), the body of the patient is handed over to the family.

The process of declaring a person brain dead, so that his or her organs can be donated, in India is cumbersome. According to the Transplantation of Human Organs (THO) Act 1994, the person’s death has to be certified by a board of 4 medical experts before the person’s organs can be surgically removed. This board comprises: 1. The government-certified doctor who is in charge of the hospital. 2. An independent specialist nominated by the doctor who is in charge of the hospital. 3. A neurosurgeon nominated by the doctor who is in charge of the hospital. 4. The doctor who was treating the deceased. Arranging the logistics for this board to meet is obviously time consuming. Keeping in mind that the person’s organs may only be kept alive for a limited period of time, the initiative is often never undertaken by doctors. Unfortunately there is no organ donation network in most states in India which connects hospitals, or a centralized registry of recipients, which makes the task even more cumbersome for doctors