To the Editor. —
Field et al1 report the maintenance of a brain dead woman who achieved successful delivery of what was initially a previable fetus. We applaud their efforts and concur with their conclusion that the guidelines we proposed in an earlier article need to be modified.2 We do not concur with the guidelines that they have substituted.The authors place ultimate authority with the family given that the family has "traditional authority about the disposal of the body" and that it "is generally assumed that they have their children's best interests in mind." We agree that the families' decision-making authority is derived from their status as maternal and fetal surrogates, not as spokespersons for their own interests, which are "unlikely to be decisive." Practically, the husband-father usually will be the "appropriate decision maker on both counts," and, "in most cases, it is ethically appropriate to respect
Wear S, Dillon WP, Lee RV. Maternal Brain Death During Pregnancy. JAMA. 1989;261(12):1728–1729. doi:10.1001/jama.1989.03420120060015
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