Brainstem Death

Holly is 35 years old. She had been trying to conceive over the past 5 years and was successful after three cycles of IVF. At 23 weeks gestation, she was discovered unconscious at home by her husband. She was rushed to hospital but deteriorated further in the A&E department. She required intubating and was transferred to ITU. Over the next few days multiple tests are performed to try and determine the cause of collapse. She is found to have suffered a catastrophic intracranial hemorrhage. Despite multiple attempts to wean ventilation and see if she could breathe alone, there was no return of spontaneous respiration. Review by two independent consultants confirms that she has suffered brainstem death and that there is no chance of recovery. The review and scan by the obstetricians show that she has a healthy 23-week live fetus. Her husband pleads that the life support machine is not switched off in order to nurture the baby to a viable gestation. He feels that this is what Holly would have wanted.

• What tests are performed to diagnose brainstem death?
• Does a person who is declared dead have any interests?
• Is it lawful and ethical for somatic support to be continued until viability of the fetus?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)