title: Signs of life and signs of death: brain death and other mixed messages at the end of life.
abstract: Brain death is a medical, legal and cultural category constructed to fill an important need created by evolving medical technologies and practices. However, managing life and death via organ transplants and brain death criteria is not without controversy; there remains much confusion and ambivalence in both lay and medical populations regarding both organ donation and the diagnostic category of brain death. By way of a case study of cranial trauma taken from a larger study of bereaved parents, this article discusses how, from a parent's perspective, brain death and organ donation are neither morally nor medically straightforward concepts. The case study presented in this article demonstrates the necessity for more research and clinical training in communication issues regarding brain death and end-of-life care with families in critical care situations.
authors.affiliation: Insituttes of Health Research New Emerging Team: Family Caregiving in Palliative and End-of-life Care, Montreal, Canada. mary.macdonald@mcgill.ca
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Macdonald
authors.forename: Stephen
authors.initials: S
authors.lastname: Liben
authors.forename: Franco A
authors.initials: FA
authors.lastname: Carnevale
authors.forename: S Robin
authors.initials: SR
authors.lastname: Cohen
mesh_terms: D001293:Attitude to Death; D001294:Attitude to Health; D001601:Bereavement; D001926:Brain Death / Q000175:diagnosis* / Q000331:legislation & jurisprudence; D002170:Canada; D002648:Child; D003142:Communication; D006259:Craniocerebral Trauma / Q000175:diagnosis; D003422:Critical Care / Q000523:psychology; D005260:Female; D005639:Frustration; D006301:Health Services Needs and Demand; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric; D015404:Nursing Methodology Research; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000941:ethics / Q000458:organization & administration