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October 1, 2008

Request for Complementary Medicine After Brain Death

JAMA. 2008;300(13):1517-1518. doi:10.1001/jama.300.13.1517-b

To the Editor: Dr Applbaum and colleagues1 present a case of a request for complementary medicine after determination that death has occurred using brain function criteria. Applbaum analyzed the ethical issues in this case using the method of analytic isolation, but this was not necessary because the ethics of this case are straightforward.

A cadaver is not a patient, making the use of the word in the presentation by the authors and by the ethics consultants in this case conceptually flawed at its core. Cadavers cannot be disconnected from “life support,” and the use of such language can promote confusion in the public. The ethical standard of care for a cadaver that is not to be maintained for purposes of obtaining tissues or organs for transplantation is prompt discharge to the hospital morgue—both for public health reasons and to prevent unacceptable opportunity costs that arise when patients are denied or delayed access to a bed that will clinically benefit them.