Bioethics Blogs

“Reasonable Accommodation” for Families of ‘Brain Dead’ Patients

The NIB Forum is pleased to post a contribution from a board member, who comments on a case study from volume 1, issue 1.

“Reasonable Accommodation” for Families of ‘Brain Dead’ Patients


By Jeffrey Spike, PhD

Martin L. Smith and Ann Lederman Flamm published a Case Study in Narrative Inquiry in Bioethics’ first issue (Vol 1, No 1, Spring 2011, pp. 55-64): “Accommodating Religious Beliefs in the ICU: A Narrative Account of a Disputed Death.” It was a careful and detailed description of a woman, Sarah, in her mid-to-late 20s who is left dead by neurological criteria after an apparent un-witnessed cardiac arrhythmia at home. There have been a number of discussions of cases like this, including one I wrote with a colleague over 15 years ago (Jeffrey Spike and Jane Greenlaw, Journal of Clinical Ethics, Vol. 23, No. 3, Fall 1995): “Persistent Brain Death and Religion: Must a Person Believe in Death in order to Die?” The title was deliberately provocative, both in inventing a new term for these corpses that exist in limbo, dead but pink and breathing thanks to a ventilator and drugs to maintain blood pressure, and also deliberate in raising the question of the intersection between personal beliefs (including religious beliefs) and medical realities.

The outcome of the case in Smith and Flamm was described as a deus ex machina: another hospital accepted the transfer of the patient. Thus their article leaves it an open question for others to consider: what should be done in such cases?

Here then are some suggestions.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.