The hospital ensures that the patient is physiologically maintained until LifeNet Health has evaluated the patient as a potential candidate to donate and the family has been informed of the option for donation.
Declaration of Death by Neurological Criteria (Brain Death)
The primary role of the physician is to care for the critically ill patient, continually assessing the patient’s neurological status and, when appropriate, declare death by neurological criteria.
Hospital policies will guide the declaration process and are framed around the American Academy of Neurology’s evidence-based Guidelines for Determining Brain Death.
State law dictates the number of neurological examinations required to determine brain death as well as the physician specialties allowed to legally declare by neurological criteria. Many hospitals utilize brain death checklists for documentation of the examination, apnea test and any ancillary testing, and require a time, date, and signature of the performing physician(s).
Virginia Code of Law
§ 54.1-2972. When person deemed medically and legally dead; determination of death; nurses' or physician assistants' authority to pronounce death under certain circumstances.
A. A person shall be medically and legally dead if:
- In the opinion of a physician duly authorized to practice medicine in this Commonwealth, based on the ordinary standards of medical practice, there is the absence of spontaneous respiratory and spontaneous cardiac functions and, because of the disease or condition which directly or indirectly caused these functions to cease, or because of the passage of time since these functions ceased, attempts at resuscitation would not, in the opinion of such physician, be successful in restoring spontaneous life-sustaining functions, and, in such event, death shall be deemed to have occurred at the time these functions ceased; or
- In the opinion of a physician, who shall be duly licensed and a specialist in the field of neurology, neurosurgery, electroencephalography, or critical care medicine, when based on the ordinary standards of medical practice, there is the absence of brain stem reflexes, spontaneous brain functions and spontaneous respiratory functions and, in the opinion of such specialist, based on the ordinary standards of medical practice and considering the absence of brain stem reflexes, spontaneous brain functions and spontaneous respiratory functions and the patient's medical record, further attempts at resuscitation or continued supportive maintenance would not be successful in restoring such reflexes or spontaneous functions, and, in such event, death shall be deemed to have occurred at the time when these conditions first coincide.