What is the disconnection from life support equipment in Poland?

The case of a Pole in a coma, who is in a British hospital and is to be disconnected from life-support equipment, aroused a lot of emotions at home and abroad. What does this procedure look like in Poland?

1. A Pole living in Great Britain is in a coma. According to doctors, the damage to the brain is so serious that the patient must be disconnected from life-support equipment
2. In Polish law, disconnecting the apparatus that supports vital functions is possible only after confirmation of brain death
3. To adjudicate brain death, a team of doctors and multi-stage tests are needed
4. You can find more such stories on the TvoiLokony home page

A Pole from Great Britain in a coma is to be disconnected from life-support equipment

According to medics at the Plymouth facility, the man suffered permanent and serious brain damage as a result of cardiac arrest for at least 45 minutes. The hospital asked the court for permission to disconnect the patient from the equipment that supports vital functions. The man’s wife and children, living in the UK, agreed to this. However, his mother and sister, who live in Poland, and the patient’s other sister, who lives in England, are against it.

The British court agreed to the separation of the Pole. The Polish authorities joined the controversial case and want the patient to be transported to Poland. The Alarm Clock Clinic, which deals with patients in a coma, has declared that it can take care of the man.

1. Find out more: A court in Warsaw agreed to transport a Pole in a coma to the country

Disconnection from life support equipment in Poland

According to Polish law, the possibility of disconnection from life support equipment occurs only in one case – brain death. It is decided by a team of doctors, consisting of specialists in various fields: one in anaesthesiology and intensive care or neonatology, and the other in the field of emergency medicine or internal medicine, or cardiology or pediatric cardiology or paediatrics. The commission checks whether the brain has lost its functions definitively and irreversibly.

If experts find brain death, it is tantamount to human death. The patient disconnects from the equipment that was supporting vital functions. The date and time of confirming cerebral death are entered in the death certificate.

Brain death is confirmed

Several studies are needed to confirm brain death. In the beginning, doctors must find that brain death is suspected.

The stage of suspicion of cerebral death includes:

1. stating that the patient is in a coma,         
2. stating that the patient is artificially ventilated,         
3. determining the cause of coma,         
4. finding that there is primary or secondary brain damage         
5. stating that the damage to the brain is irreversible by using all available treatment options         

and at the same time excludes:

1. poisoned patients and those who are under the influence of certain pharmacological agents (drugs, neuroleptics, sleeping pills, hypnotics, muscle relaxants),         
2. hypothermic patients,     
3. patients with metabolic and endocrine disorders,         
4. newborns under seven days of age.         

The next step is to perform a series of tests. They are carried out twice at three-hour intervals, during which the following is stated:

1. absence of trunk reflexes,         
2. persistent apnea.         

The absence of trunk reflexes is evidenced by:

1. no pupil reaction to light,         
2. no corneal reflex,         
3. no spontaneous eye movements,         
4. no eye movements during the caloric test,         
5. lack of any motor reactions to the pain stimulus applied in the innervation of the cranial nerves, as well as the lack of a motor reaction in the face in response to pain stimuli applied in the area of ​​spinal innervation,         
6. lack of vomiting and coughing reflexes,         
7. lack of oculocerebral reflex.         

Doctors also measure the electrical activity of the brain with an electroencephalograph (EEG) for 12-24 hours.

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