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In Reply: Drs Miller and Truog argue that the determination of brain death is not equivalent to death of a person. Their position is both a philosophical and religious one to which they are entitled. Determination of brain death as defined in my Commentary implies that the patient's comatose state is irreversible. The patient will never regain consciousness, never again be able to express human qualities, having lost all neurological ability to express his or her identity, memories, and cognitive functions. These facts indicate that from any practical perspective the patient has died. I leave it to others to debate the nonscientific issues.

Dr Finucane asks how it is possible to measure awareness in a patient in PVS who does not show any response to stimuli on neurological examination. In my Commentary, I pointed out that by measuring the functional magnetic resonance imaging response of a patient in PVS to . . . [Full Text of this Article]

Roger N. Rosenberg, MD
roger.rosenberg@utsouthwestern.edu
Department of Neurology
University of Texas Southwestern Medical Center
Dallas

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