A senior medical official said yesterday that rules are currently being drawn up by the Ministry of Health to regulate who is qualified to determine when patients are brain dead.
Li Shunwei, professor of neuropsychiatry at Peking Union Medical College Hospital and member of the drafting committee, said it is likely that only doctors in intensive care, anaesthesia, internal and surgical neuropsychiatry departments will be empowered to determine brain death.
Although patients' families and their loved ones have the final say on whether to accept such a diagnosis, Li said: "We still need to be most cautious when announcing someone is brain dead."
In order to be able to diagnose brain death, doctors will have to be working at higher level medical institutions and have at least 10 years' experience treating severe brain injuries.
The concept of brain death, defined as complete and irreversible cessation of brain activity, is internationally accepted, but the establishment of agreed criteria has been troublesome and current procedures are not always followed.
"In many of the 40 cases I have overseen procedures are other than standard," said Chen Zhonghua, professor at Wuhan Tongji Hospital in central China's Hubei Province.
Chen said that in some cases, families gave up hope although not all criteria had met the standard of brain death. There are also cases in which exhausting efforts are made to save a patient who is already brain dead.
Li said clinical research and statistical analysis had shown that it's impossible for a brain dead patient to recover. But patients can still breathe with an artificial respirator, and in one case in the US, a patient was kept breathing for 14 years.
China's first reported diagnosis of brain death was in 2003, and there have been many more since. The first regulation on organ transplantation, which sanctioned transplantation from brain dead patients, was also passed recently.
The concept of brain death was first introduced by two French medical scholars observing patients in deep coma. Currently, around 80 countries have adopted brain death criteria for adults.
(China Daily, China.org.cn June 21, 2005)
