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Signs of life and signs of death: brain death and other mixed messages at the end of life

School of Nursing, McGill University, Department of Oncology, McGill University, Montreal, Canada, mary.macdonald{at}mcgill.ca

Stephen Liben, MD

Pediatric Palliative Care Programme, Montreal Children's Hospital, Pediatrics, McGill University, Montreal, Canada

Franco A. Carnevale, RN, PhD

Montreal Children's Hospital, School of Nursing, McGill University, Montreal, Canada

S. Robin Cohen, PhD

Division of Palliative Care, Department of Oncology and Department of Medicine, McGill University, and Jewish General Hospital, Montreal, Canada

Brain death is a medical, legal and cultural category constructed to fill an important need created by evolving medical technologies and practices. However, managing life and death via organ transplants and brain death criteria is not without controversy; there remains much confusion and ambivalence in both lay and medical populations regarding both organ donation and the diagnostic category of brain death. By way of a case study of cranial trauma taken from a larger study of bereaved parents, this article discusses how, from a parent's perspective, brain death and organ donation are neither morally nor medically straightforward concepts. The case study presented in this article demonstrates the necessity for more research and clinical training in communication issues regarding brain death and end-of-life care with families in critical care situations.

Key Words: bereavement • brain death • end-of-life care • organ donation • parental perception

Journal of Child Health Care, Vol. 12, No. 2, 92-105 (2008)
DOI: 10.1177/1367493508088546


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