LifeCenter Northwest

There are two ways that people die: cardiopulmonary death and brain death. Both brain death and cardiopulmonary death are formal, legal definitions of death.

Cardiopulmonary death is the irreversible loss of function of the heart and lungs. Brain death is the irreversible loss of function of the brain and brain stem. Brain death occurs when brain function ceases because the flow of blood to the brain is stopped permanently due to a severe injury to the brain.

When this happens, all brain function stops, including the most primitive life-sustaining reflexes, such as the ability to breathe, gag, or respond to pain. The ventilator (a device for maintaining artificial respiration) is all that keeps the heart beating and oxygen flowing.

Determination of Brain Death

A physician performs a series of tests to determine if brain death has occurred. The doctor also performs tests to rule out any other reason that could be causing the brain to not function, such as medical conditions, medications, or extreme cold.

Once a patient has been declared brain dead, there is no chance for recovery. They no longer have any sensations and can feel no pain. They have normal color and warm skin only because of the ventilator. The chest continues to move up and down with artificial breath because of the ventilator.

If a patient is not on a ventilator, breathing and the beating of the heart will stop. It is possible that there will be jerking or movement of the extremities, but these are not related to brain function.

Time of Death

The legal time of death is when the doctor has written their diagnosis of brain death on the medical chart. The discontinuation of the ventilator does not cause death.

Donation after Cardiac Death

Some people with non-survivable injuries to the brain never become brain dead because they retain some minor brain stem function. In these circumstances donation after cardiac death might be an option. The option of donating organs after cardiac death may be presented to these families after it is clear that their loved one cannot survive. Donation in such cases entails taking the patient off ventilated support. Once the patient’s heart stops beating, the physician declares the patient dead and organs can be removed for transplant.