News: Recent tragedy highlights need to clarify brain death diagnosis

January 30, 2014

Careful use of terminology may help alleviate miscommunication in situations of potential tragedy. Following the recent death of 33-year-old Marlise Muñoz, who was declared brain dead at a Fort Worth hospital, facilities may want to take the opportunity to review their internal guidelines for defining the condition and clarify definitions for similar diagnoses such as coma or persistent vegetative state, according to a January article in Modern Healthcare magazine.

The American Academy of Neurology provides guidelines provide clarity on the diagnosis of brain death, and includes a checklist to guide clinicians on proper use of the diagnosis.

Muñoz was kept alive by the hospital following a brain embolism which left her clinically brain dead due a 14-week-old fetus she was carrying and a Texas law which required the hospital to do so, according to a report published on CBS news.

Although not specifically related to Muñoz’s case, families may misunderstand the physician’s diagnosis after hearing the words “life-support” and fail to internalize the underlying reality of their loved-ones’ death, Art Caplan, a professor of bioethics at NYU Langone Medical Center told Modern Healthcare. Furthermore, non-specialized physicians need to work with neurologists to correctly identify the most appropriate diagnosis and to consistently document that diagnosis in the record for everyone’s peace of mind.

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