On April 11, 2024, the National Catholic Bioethics Center (NCBC) issued a landmark position statement, acknowledging that at least half of patients diagnosed as “brain dead” still have partial brain function. The NCBC statement was prompted by the 2023 updated guideline for the diagnosis of “brain death” published by the American Academy of Neurology (AAN) together with the American Academy of Pediatrics, the Child Neurology Society, and the Society of Critical Care Medicine.
According to the NCBC, the 2023 AAN updated guideline marks “a decisive breakdown in a shared understanding of brain death” and “a formal breach in a longstanding consensus in law and public policy” because this guideline does not conform to the current legal standard for “brain death” under the Uniform Determination of Death Act (UDDA). The UDDA requires the “irreversible cessation of all functions of the entire brain, including the brain stem.” But a part of the brain called the hypothalamus continues to provide neuroendocrine function in most patients declared “brain dead.” Is the hypothalamus important? According to the NCBC:
The hypothalamus can be understood as a kind of ‘smart’ coordinating center in the brain which is involved in regulating temperature, salt-water balance, sex drive, and sleep. Recent studies show that it may play a role in phenomenal awareness and pain detection.