Brain death determination

A while back I read an article about laxity in determining brain death, with an eye toward organ harvesting. As I recall the article centered around young drivers in vehicular accidents. One example I recall was a test of splashing water on patients' faces. 

I know a doctor who wouldn't let his son check the donor option on his driver's license.

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"Are hospitals doing everything they should to make sure they don't make mistakes when declaring patients brain-dead? A provocative study finds that hospital policies for determining brain death are surprisingly inconsistent and that many have failed to fully implement guidelines designed to minimize errors.

..."The worst-case scenario would be if we were to pronounce somebody brain-dead and then they recovered some neurological function," Greer says. "That would be horrific if that were the case."

To see how well the guidelines have been adopted, Greer and his colleagues analyzed policies at 492 hospitals and health care systems across the country. While most have adopted the guidelines, the researchers report Monday in the journal JAMA Neurology that there are significant differences in how the key parts of the guidelines have been accepted.

More than 20 percent of the policies don't require doctors to check that patients' temperatures are high enough to make the assessment, as the guidelines call for. "If somebody has a low temperature then their brain function can actually be suppressed based on that," Greer says.

Almost half of policies don't require doctors to ensure patients' blood pressure is adequate for assessment of brain function. And some say doctors can skip tests that the guidelines recommend.

In addition, most of the policies don't require that a neurologist, neurosurgeon or even a fully trained doctor make the call. "In some hospitals they actually allowed for a nurse practitioner or a physician assistant to do it," Greer says.""

http://www.npr.org/sections/health-shots/2015/12/28/460940576/researchers-find-lapses-in-hospitals-policies-for-determining-brain-death

1. "Clinical diagnosis is suppose to be done 6-24 hours after injury then repeated, they determined my daughter within two hours, and prescribed the treatment of a donor for her.
2. ...All available treatments are to be done on you even if you are grave, my daughter got mannitol, oxygen, elevation of head, three out of many. These are the less aggressive. My daughter was acute: acute measures should have been done on her behalf. Treatments for brain injury are oxygen therapy, elevation of the head, mannitol, CSF drain, sedation, hypothermia therapy, nutrition, DE compressive craniotomy.
3. The donor operation is horrific and not dignified.
4. The donor is rolled into the surgical suite hooked up to a ventilator.
5. He is breathing, and his heart is beating
6. He is not give anesthesia, he is only given a neuron (brain) muscular blocking agent in his tummy to keep him from tightening it to the approaching knife. He is also given this drug to paralyze him so he can not move his limbs.
7. ...The number one donor will be a 24 year old male that just happens to be uninsured. How can only an uninsured person be the number one donor? Don’t insured people have brain injury to?
8. The government demands the hospitals notify the local donor bank of a potential donor.
9. The government demands the local donor store to maintain a quota. How can you put a quota on organs?
10. UNO’S says,“ they will make the little hospital come up to identifying the potential donor with carrots or sticks, carrots are incentives, the sticks are legislation.”" (my bolding and the author's bolding)
11. http://www.organfacts.net/braindeath/brain-death-controversy/index.php