The process of withdrawal of ventilatory support was also explained to the parents. However they did not want the ventilatory support to be withdrawn till the patient's sister had arrived from Canada in 48 hrs. Despite further explanations regarding the concept of brain stem death, the family threatened legal action for withdrawal of ventilatory support . The following day a senior consultant and senior nurse in the ICU came into the unit and were informed of the situation and intervened. After lengthy discussions with the parents, ventilatory support was withdrawn. The heart stopped beating shortly after.
The reason for examining these features in the case study is to gain an insight into the errors in the system and clarify human error in the cause of such incidents. This is a key characteristic of critical incident reporting (Buckley, Short, Rowbottom & Oh, 1997). A review of these features helps in highlighting the problems and paves the way for quality assurance through implementation of preventative measures to control such incidents. By analysing these key features, the critical incident analysis assists in identifying areas of improvement within the ICU.
Brain stem death has been accepted as death of the individual in the United Kingdom since 1976, when the royal colleges published criteria for making a diagnosis of what was then called brain death (Royal Colleges, 1976). With advances in life support, the line between who is alive and who is dead has become blurred (Capron ,1995).Life support technologies introduced in the 20th century have produced a new kind of patient - one whose brain does not function, but whose heart and lungs continue to work (Center for Bio Ethics, 2005). Trachtman (2003) states that "technological advances in sustaining life might increase the difficulty in making the diagnosis of death". And, while medicine diagnoses brain stem death as death, it may still be difficult for family to accept the death while the heart is still beating and their loved one is still breathing.
In the case being examined, the parents were explained by the Jr. consultant and Jr. nurse the concept of brain stem dead and had also appeared to understand it. The parents' roman catholic faith also perhaps helped them accept this diagnosis since in the roman catholic faith even the pope concedes that it is for the doctor and especially the anaesthesiologist to give a clear and precise definition of "death" and