J Pediatr Intensive Care 2017; 06(04): 240-244
DOI: 10.1055/s-0037-1604012
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Ethics and Brain Death in Pediatrics: Recent Controversy and Practical Suggestions

Trevor M. Bibler
1   Center for Medical Ethics and Health Policy, Houston, Texas, United States
Kyle L. Galbraith
2   Human Subject Protection, Carle Foundation Hospital, Urbana, Illinois, United States
Kyle B. Brothers
3   Department of Pediatrics, University of Louisville School of Medicine, Louisville, Kentucky, United States
› Author Affiliations
Further Information

Publication History

02 May 2017

28 May 2017

Publication Date:
27 June 2017 (online)


Who decides when a child is dead? The story of Jahi McMath has brought this question into focus for pediatric intensivists, ethicists, and the American public. In this article, we address this question by arguing that medical professionals do not have an obligation to acquiesce when families insist upon postmortem therapies. To do so may harm the dignity of the child by subjecting him or her to procedures that objectify the body, damage the child's reputation, and violate his or her privacy. Applying this answer to the real world of pediatric intensive care, we suggest practices meant to preserve the dignity of the child while accepting that the family is struggling to understand the tragedy. Muddled communication or an unyielding attitude will fail to help the family understand and cope with the death of their young loved one. Clear and honest communication—in conjunction with an empathetic disposition—can improve pre- and postmortem care for both patient and family.