Ethical dilemma: Discontinuation of ventilation after brain stem death   To whom is our duty of care?   Policy should be balanced with concern for the family   Brain stem death defines death in law

Ethical dilemma Discontinuation of ventilation after brain stem deathConfusion among the public over the difference between brain stem death and a persistent vegetative state can make it difficult to obtain consent to withdraw ventilation.Clinicians who have been faced with this dilemma outline their strategies for coping with such a situation, and a neurologist and a neurosurgeon offer their opinions.