Understanding Brain Death

AS GOOD AS DEAD: Is there really such a thing as brain death?

Just after a fourteen-year-old boy named Nicholas Breach learned that a tumor on his brain stem would be fatal, he told his parents, Rick and Kim Breach, that he wanted to be an organ donor. They respected his decision, and so did the boy's medical team at the Children's Hospital of Philadelphia. Bernadette Foley, Nick's social worker there, said that the decision reflected a "maturity and sensitivity" and a wish to help others-something Nick had shown throughout his eight-year battle with recurrent tumors. "I've never been to a meeting like this one," Foley said. "The peace that came over the family and Nick was remarkable, and once it was out that this was the end, and the decision was made about organ donation, Nick said he was happy. They all seemed to be happy." The decision was redemptive, she said. "In a way, it gave some meaning to his life."

By the time I met Nick, he was confined to a hospital bed that had been set up in the living room of the Breaches' house, a brick bungalow outside Harrisburg. It was difficult for him to speak, and we chatted only briefly-about his dog, Sarah; his brother, Nathan; and his hope that his heart, lungs, liver, kidneys, and pancreas might enable other people to live-and then he dozed off.

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