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May 12, 1978

Brain Death

JAMA. 1978;239(19):1958. doi:10.1001/jama.1978.03280460026006

To the Editor.—  The discussion of brain death by Veith et al (238:1651, 1977) was interesting.

  1. It is worrisome whenever bioscientists determine that any proposed criteria are infallible, especially with respect to such an ultimate decision as initiating a death certificate.

  2. The authors must be aware that the original EEG criteria for silence were modified to account for complete and incomplete recoveries in heavily sedated or hypothermic patients. Such patients may satisfy the electrical criteria for brain death. In the 1969 Harvard study such patients totaled three, or more than one in a thousand.1 Are there no subtle environmental poisons that also dampen brain waves? Will there not be any synthetic reversible brain poisons discovered in 1982 or 1991? Which committee would add the new caveats? How would a new exception come to light in Kansas, for example, where the choiceless physician shall, under present law, pronounce death