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September 3, 1982

Brain Death and Live Birth

JAMA. 1982;248(9):1101-1102. doi:10.1001/jama.1982.03330090071036

In this issue of JAMA, Dillon and colleagues (p 1089) describe two extraordinary cases. Both involved young pregnant, women who experienced profound neurological deterioration culminating in a clinical determination that they were both "catastrophically ill," with one patient meeting rigorous criteria of brain death. In both instances, the physicians responsible for these patients had to decide what their new obligations to them were. They had also to determine their obligations to the developing fetuses, whose chances for survival depended on the continuation of maternal circulation. These cases test our understanding of the nature and goals of medicine, of the responsibility of physicians, and even of the meaning of life and death. The authors should be praised for their clinical skills in successfully maintaining maternal circulation in case 2. They should also be commended for identifying the profound clinical-ethical quandaries, for resolving them according to their best clinical judgment, and, finally,