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from Dr David W Evans
The paper titled “Role of short latency potentials in the diagnosis of brain death” by Facco E, Munari M, Gallo F, Volpin SM, Behr AU, Baratto F & Giron GP, and published in Clinical Neurophysiology (2002) 113; 1855-66, offers irrefutable, genuinely scientific, evidence in support of the contention that the tests of brain stem function in general use for the diagnosis of “brain stem death” (or that element of “brain death”) lack the power to exclude remaining function in the brain stem.
The authors stress the necessity of certainty in the diagnosis of ‘BD’ (as a basis for the diagnosis and certification of human death) and report that 3 patients diagnosed ‘BD’ on the current Italian criteria - meeting “all EEG and clinical criteria of whole brain death” - still had detectable brain stem activity when more rigorously tested. As they say, “they were not yet dead”.
Since the tests of brain stem function listed as required in satisfaction of the Italian criteria (including the now-admittedly dangerous apnoea test) appear to be the same as those prescribed in the UK Code of Practice for the diagnosis of “brain stem death” (or “death for transplant purposes”), it can no longer be maintained that those simple bedside tests suffice for the certain diagnosis of death of the brain stem. That being so, arguments about the role of the brain stem in the generation of consciousness are seen as irrelevant.
David W. Evans