Addressing Ethical Challenges in Determining Brain Death/Death by Neurological Criteria

Speakers: Margy McCullough-Hicks, MD, Joel Wu, JD, MPH, MA, HEC-C, and Benjamin Miller, MD. The determination of a person’s death is an important process involving both medical and societal considerations. Controversy and confusion regarding the determination of death by neurologic criteria persist at the bedside, in the community, and within broader policy discussions. This leads to ethical dilemmas, narrative misunderstandings, and a lack of clarity that can result in both medical and moral harms. How can clinicians ensure death by neurologic criteria is determined ethically, accurately, and consistently? How should clinicians respond to patients’ and families’ unfamiliarity with the process of determining death? Specifically, how should clinicians approach the concept of death by neurological criteria when patients and families may not be aware of, or open to the concept? This session will review prevailing legal and medical standards for determining death, and offer practical strategies for how to ethically approach conflict when death by neurological criteria is at issue. Learning Objectives: After this webinar, attendees will be able to: -Describe the social importance of the meaning and determination of death, and the two current legal standards for the determination of death, either: 1) Circulatory or, 2) Brain Death/Death by Neurological Criteria. -Describe the procedures for the determination of death by neurological criteria. -Identify strategies to address common ethical issues that arise in the determination of death by neurological criteria. Unpacking Bedside Bioethics is a quarterly professional development seminar series delivered by the Center for Bioethics. Speakers discuss foundational bioethics concepts, identify ethical dilemmas in clinical cases, & explain how to apply bioethical frameworks to resolve those dilemmas. This interprofessional series is designed for professionals who work in health related fields and health professions students. This is an event of the Office of Academic Clinical Affairs (OACA), hosted by the Center for Bioethics. Certificate of Attendance will not be given for watching the recording; it will only be given to those attending the Zoom webinar. Margy McCullough-Hicks, MD, is an Assistant Professor of Neurology at the University of Minnesota and Affiliate Faculty at the Institute for Health Informatics. She is a vascular neurologist specializing in cerebrovascular disease and stroke neuroimaging and has a strong interest in clinical and research ethics. Dr. McCullough-Hicks earned her BA in Philosophy from Columbia University and her MD from Georgetown University. She completed a Neurology residency at Yale and a Vascular Neurology fellowship at Stanford. She is a member of the UMN Department of Neurology Diversity Equity and Inclusion Committee, the University of Minnesota Medical Center Ethics Committee, and the American Academy of Neurology Ethics, Law, and Humanities Committee. Joel Wu, JD, MPH, MA, HEC-C, is a Center for Bioethics Clinical Ethics Assistant Professor and a senior lecturer in the Division of Health Policy and Management at the University of Minnesota’s School of Public Health. He is a co-chair of the University of Minnesota Medical Center's Ethics Committee, co-lead for the clinical ethics consultation service for MHealth Fairview system hospitals, and member of the MHealth Fairview Ethics Council. Professor Wu earned his BS in Biochemistry, Genetics and Cell Biology, and Microbiology, and his MPH in Epidemiology from the University of Minnesota, and his Masters in Bioethics and JD from Case Western Reserve University. He completed fellowships in Bioethics and Professionalism at the Mayo Clinic and in Clinical Ethics and Children’s Minnesota and Abbott Northwestern Hospital. He is a member of the Organ Procurement and Transplant Network Ethics Committee. Benjamin Miller, MD, is an Associate Professor of Neurology at the University of Minnesota, division head for neurocritical care, and medical director of the Neurocritical Care Unit at the University of Minnesota Medical Center. He is a neurointensivist specializing in the care of critically ill patients who have a significant neurological injury with an interest in the area of neuroprognostication following cardiac arrest. Dr. Miller earned his BS in Psychology, Biochemistry, and Microbiology from the University of Iowa and his MD from The Roy J. and Lucille A. Carver College of Medicine at the University of Iowa. His neurology residency and fellowships in neurocritical care and vascular neurology were completed at Case Western Reserve University at University Hospital Cleveland Medical Center.