The suicide of Luiz Phillipi Machado de Moraes Mourão, arrested in Operation Compliance Zero, sparked confusion over brain death. Experts clarify that suspicion does not equal diagnosis, which requires a rigorous protocol endorsed by the Federal Council of Medicine. The process confirms the irreversibility of total brain function loss.
Luiz Phillipi Machado de Moraes Mourão, arrested in the Federal Police's Operation Compliance Zero, committed suicide in a cell in Minas Gerais. The case drew attention to the distinction between suspicion and diagnosis of brain death, also known as cerebral death, which is irreversible and equivalent to cardiorespiratory death.
According to intensivist Fábio Gomes from Hospital Alemão Oswaldo Cruz, brain death involves complete inactivity of the encephalon, including the cortex responsible for thought and the brain base controlling vital functions like breathing. The heart continues beating due to an autonomic system, which can distress families, but without artificial support, the patient stops breathing.
The protocol, updated by the Federal Council of Medicine's Resolution in 2017 and more rigorous than in many countries, begins with suspicion in severe coma patients in the ICU. Requirements include non-responsive coma to stimuli, known cause (such as trauma), hemodynamic stability, absence of sedatives, and lab confirmation of no drug influence.
The process is divided into stages: two clinical neurological evaluations by different doctors, with at least one hour interval, testing pupillary, corneal, auditory reflexes and others, followed by an apnea test to check spontaneous breathing. Then, a complementary exam, such as transcranial Doppler, confirms absence of cerebral blood flow. The entire process takes 24 to 48 hours.
"There is a difference between suspicion and actually decreeing it. The brain death protocol is well systematized," explains neurosurgeon Marcelo Valadares. The family is informed but does not authorize the start, as it is a clinical process. After confirmation, organ donation possibility opens if authorized by relatives; otherwise, support measures are suspended.
Experts stress that without the complete protocol, the condition is not officially declared, and the body tends to fail within days without brain activity.
