“What Does It Mean To Die?” – An Article From The New Yorker

What Does It Mean to Die? from the Feb 5, 2018 issue of the New Yorker is an important article.

A 13 year old girl went into the hospital for a tonsillectomy and experienced severe post-operative bleeding that lead to a prolonged cardiac arrest from which she was ultimately resuscitated.

[For the emergency management of post tonsillectomy bleeding, please see my post A Link To The Treatment of Major Post Tonsillectomy Bleeding From Peds EM Morsels
Posted on February 4, 2015.]

However, the clinicians determined that she was clinically dead based on widely accepted brain death criteria. Her heart continued to beat because she was on a ventilator.

The whole article deals with the question of what is brain death.

And it indirectly deals with – what are in the best interests of the patient with massive brain injury (which the article suggests might be an an appropriate term in some cases of brain death).

These complex questions are thoughtfully addressed.

As I started to read this article, I assumed that the patient might have locked in syndrome if in fact she had meaningful consciousness [See Recovery From Locked-in Syndrome from  July 2015 JAMA Neurology]. The syndrome is not specifically addressed in the article. I would be interested in a physician-centric review of this case by a neurologist.

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