Maternal brain death: medical, ethical and legal issues
- 727 Downloads
We present the case of a pregnant woman who experienced a cerebral venous sinus thrombosis resulting in brain death at 13 weeks gestation. We discuss the management of the mother and foetus following this tragic event. We also discuss the complex medical, legal and ethical issues that arose following maternal brain death. The central question is whether continuing maternal organ supportive measures in an attempt to prolong gestation to attain foetal viability is appropriate, or whether it constitutes futile care.
Successful maintenance of maternal brain somatic function to facilitate foetal maturation in utero has been reported. While the gestational age of the foetus is central to resolving this issue, there is no clear upper physiological limit to the prolongation of somatic function following brain death. Furthermore, medical experience regarding prolonged somatic support is limited. Finally, the legal rights conferred on the foetus may vary significantly depending on the jurisdiction in which the maternal brain death occurs and may have important implications.
A consensus building approach, involving the family, is essential to resolving these potentially conflicting issues.
KeywordsMaternal Brain death Brainstem death Foetus Ethics Legal
The authors wish to acknowledge the legal assistance and advice provided by Padraic Brennan, David Barniville B.L. and Donal O’Donnell S.C.
- 1.Pallis C, Harley DH (1996) From brain death to brainstem death. In: Pallis C, Harley DH (eds) ABC of brainstem death. BMJ, London, pp 8–12Google Scholar
- 5.Bernstein IM, Watson M, Simmons GM, Catalano PM, Davis G, Collins R (1989) Maternal brain death and prolonged fetal survival. Obstet Gynecol 74:434–437Google Scholar
- 9.Sheikh AA, Cusack DA (2001) Maternal brain death, pregnancy and the foetus: The medicolegal implications. Medico-Legal J Ir 7:75–85Google Scholar