A senior medical official said yesterday that rules are
currently being drawn up by the Ministry of Health to regulate who
is qualified to determine when patients are brain dead.
Li Shunwei, professor of neuropsychiatry at Peking Union Medical
College Hospital and member of the drafting committee, said it is
likely that only doctors in intensive care, anaesthesia, internal
and surgical neuropsychiatry departments will be empowered to
determine brain death.
Although patients' families and their loved ones have the final
say on whether to accept such a diagnosis, Li said: "We still need
to be most cautious when announcing someone is brain dead."
In order to be able to diagnose brain death, doctors will have
to be working at higher level medical institutions and have at
least 10 years' experience treating severe brain injuries.
The concept of brain death, defined as complete and irreversible
cessation of brain activity, is internationally accepted, but the
establishment of agreed criteria has been troublesome and current
procedures are not always followed.
"In many of the 40 cases I have overseen procedures are other
than standard," said Chen Zhonghua, professor at Wuhan Tongji
Hospital in central China's Hubei Province.
Chen said that in some cases, families gave up hope although not
all criteria had met the standard of brain death. There are also
cases in which exhausting efforts are made to save a patient who is
already brain dead.
Li said clinical research and statistical analysis had shown
that it's impossible for a brain dead patient to recover. But
patients can still breathe with an artificial respirator, and in
one case in the US, a patient was kept breathing for 14 years.
China's first reported diagnosis of brain death was in 2003, and
there have been many more since. The first regulation on organ
transplantation, which sanctioned transplantation from brain dead
patients, was also passed recently.
The concept of brain death was first introduced by two French
medical scholars observing patients in deep coma. Currently, around
80 countries have adopted brain death criteria for adults.
(China Daily, China.org.cn June 21, 2005)