PEDIATRICS Vol. 81 No. 2 February 1988, pp. 301-303
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New Brain Death Guidelines in Children: Further Confusion

John M. Freeman MD1 and Peggy C. Ferry MD1

1 From the Division of Pediatric Neurology, Johns Hopkins University School of Medicine, Baltimore, and the Section of Child Neurology, Departments of Pediatrics and Neurology, University of Arizona Health Sciences Center, Tucson

Virtually the only reason brain death criteria are needed for children is for organs transplantation. We do not need to diagnose brain death to terminate care, to discontinue ventilator support, or to withhold further medical interventions. For these decisions we have the long tradition of doing what is best for the child (and family), which was reaffirmed by the recent Baby Doe regulations.1 To paraphrase these regulations: It is not medical neglect to withhold medically indicated treatment when, in the treating physician's reasonable medical judgement, the infant is (1) chronically and irreversibly comatose, (2) treatment could only prolong dying and not be effective in ameliorating or correcting all of the infant's life-threatening conditions, or (3) would be futile or virtually futile.




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