Brain stem death: managing care when accepted medical guidelines and religious beliefs are in conflict

Commentary : Delay in stopping treatment can become unreasonable and unfair

What should doctors do when a patient in intensive care is declared brain stem dead, but according to their family's religious beliefs is still alive and must continue to be given treatment? In the Education and Debate section of this week's BMJ, two UK paediatric intensive care specialists describe how they resolved the difficulty by limiting rather than withdrawing intensive care, allowing their patient, an orthodox Jew, to remain on mechanical ventilation until she died. The former Chief Rabbi, the late Lord Jakobovits, explains the Jewish position in more detail. However, in a commentary, two Australian intensive care specialists argue that unreasonable delay in stopping treatment serves neither the interests of the patient, nor those of society and can be difficult for staff.

Contact : David Inwald, Portex Department of Anaesthesia, Intensive Care and Respiratory Medicine, Institute of Child Health, London WC1N 1EH Email: [email protected]