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Medical and Ethical Issues

David R. Field, MD; Elena A. Gates, MD; Robert K. Creasy, MD; Albert R. Jonsen, PhD; Russell K. Laros, Jr, MD

JAMA. 1988;260(6):816-822.

Abstract
We present in detail a case of a 27-year-old primigravida who was maintained in a brain-dead state for nine weeks. An apparently normal and healthy male infant weighing 1440 g was delivered. The newborn did well and was found to be growing and developing normally at 18 months of age. Although the technical aspects of prolonged life support are demanding and the economic costs are very high ($217 784), there are ample ethical arguments justifying the separation of brain death and somatic death and the maintenance of the brain-dead mother so that her unborn fetus can develop and mature.

(JAMA 1988;260:816-822)

Author Affiliations
From the Department of Obstetrics, Gynecology, and Reproductive Sciences (Drs Field, Gates, Creasy, and Laros) and the Division of Ethics in Medicine (Dr Jonsen), University of California, San Francisco. Dr Field is now with the Department of Obstetrics and Gynecology, Naval Hospital, Oakland, Calif. Dr Creasy is now with the Department of Obstetrics and Gynecology, University of Texas, Houston. Dr Jonsen is now with the Department of Medical Ethics, University of Washington, Seattle.

Footnotes
Reprint requests to Department of Obstetrics, Gynecology, and Reproductive Sciences, M-1485, University of California, San Francisco, CA 94143-0132 (Dr Laros).

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