unlicensed practice of medicine, and would they in fact do so, thus admitting suspension to be a medical procedure? What would it require for a suspension team to be "medically qualified," in a legal sense? And might laws relating to emergency first aid have any bearing here? My gut feeling is that the biostasis community needs to move from a pseudo-mortuary status to a medical or paramedical status, and the sooner the better. A large part of the battle involves the use of accurate language (which Brian Wowk has described so well), and a stance backed by appropriate legal theories (whatever those may be). But these are mere armchair observations by a theoretician stepping outside his field. I toss them out for consideration by those whose backgrounds in law and by those on the firing line of practical experience and legal responsibility. The soundness of Brian's recommendations, I believe, stands regardless of the additional issues i have raised in this letter. His recommendations can be justified on the narrower grounds of clear, positive communication. My more tentative suggestions are aimed at longer-range goals, such as being able to bring a malpractice suit for failure to treat ischemic coma. The first creditable suit could make a world of difference. Sincerely yours, K. Eric Drexler *
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Dear Editors, I was interested in your article, "Less Restrictive Criteria For Brain Death" (July, 1988). Please note that the originator of the concept of "brain death" was Dr. R. S. Schwab, chief of the EEG lab at Massachusetts General Hospital in boston. The criteria were as follows: "In a patient where cardiac function is present, there should be: 1) Complete unresponsiveness and unreceptivity to external stimuli. 2) No muscle activity (except cardiac muscle). 3) No reflexes (including tendon jerks, vestibular reflexes, corneal or pupillary responses, etc.). 4) No spontaneous respiration (patient is on a respirator). 5) There should be no hypothermia (exact temperature not mentioned), and 6) No history of drug ingestion. ----------------------------------------------------------------------(8)
(Numbers 5) and 6) are included because patients with these conditions can recover from so-called "brain death.") 7) All these criteria should be present for at least 24 hours. 8) An EEG showing electro-cerebral silence (ECS) is confirmatory, but not essential for the diagnosis of "brain death." This statement was made by a physician (the late Dr. Schwab) who was the originator of EEG's in the U.S., and who had devoted an academic lifetime to its study. I had worked with Dr. Schwab, and the findings were published in 1968. "Flat EEGs -- Clinical and Pathological Correlation."