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Perhaps dying but certainly not dead:
Brainstem failure patients (wrongly
referred to as brainstem dead)
retain all signs of life which include:
(1)
Neuromuscular activity, muscle twitches,
complex movements of the
limbs and trunk, as if struggling to
breath during apnoea testing
(Lazarus
sign ) (
51).
(2)
Alteration of pulse and blood pressure
which commonly occur in
response to the apnea challenge and in
response to surgical stimuli
during organ harvesting(52,53)This
strongly suggests viability of
brainstem
vasomotor area.
(3)
Serum levels of hypothalamic and
pituitary hormones were found to
be
inconsistently high in brainstem donors
suggesting that some parts
of the hypothalamus and hypophysis may still be viable after "brainstem
death"(54,55).
(4)
A brain dead subject can sustain his
body temp. within near normal
range, clearly denoting metabolic
activity. The body temp. can rise
and
leucocytosis may occur in response to
infection(56).
(5)
A case reported in 1988 of a 27-year old
primigravida who was in her 24th week of
gestation suffering from brainstem
death. In order to
deliver a viable baby, the mother was
kept alive (on a life support) for
a
whole nine weeks. When the baby was
delivered alive by caesarian
section, the mother was sacrificed( 13).
How
could a cadaver endorse a living fetus
for nine weeks? How
could a cadaver sustain her blood gas levels near the normal range even
if on
a respirator. It is well known that
a cardiac pace-maker can never
initiate a cardiac contraction when a
patient dies. How was that patient
sustained alive for nine whole
weeks if' she were already a cadaver?
From all the above data it could be
realised that assuming patients
with brainstem insult to be dead is a
great mistake. Actually suchL_
patients are suffering from brainstem
failure. Like any other
vital-organ failure, if its function is
not promptly substituted for by
machines until these patients are
effectively treated, they will
eventually
die.
Unfortunately, brainstem failure
patients are never granted that
right(13)
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