Anencephaly - Organ Transplantation?

By Byrne, Paul A.; Evers, Joseph C. et al. | Issues in Law & Medicine, Summer 1993 | Go to article overview

Anencephaly - Organ Transplantation?

Byrne, Paul A., Evers, Joseph C., Nilges, Richard G., Issues in Law & Medicine

A Fort Lauderdale infant with anencephaly, Theresa Ann Campo Pearson, was recently the subject of many newspaper articles, television shows, and medical and legal discussions. Her parents had filed a petition in a Florida circuit court for the "right" to authorize the excision of Theresa Ann's unpaired vital organs.(1) The petition sought a judicial determination that anencephalic infants be considered legally dead for the purposes of organ transplantation.(2) The trial court's order denying the petition was summarily upheld on appeal.(3) The Florida Supreme Court affirmed, thus rejecting an expansion of Florida's common law to include anencephaly within the legal definition of death.(4)

In this article, we will consider the case of Theresa Ann in the context of the brain death controversy. We will show how the attempt to declare death in a living baby with anencephaly is but another step in the growing acceptance of something less than actual death as legal death for the purpose of acquiring transplantable organs.

Theresa Ann was diagnosed antenatally as having anencephaly. Soon thereafter, plans were made to remove her organs for transplantation following her birth. After she was born, Theresa Ann was intubated and received ventilatory support. The ventilator was removed after about one week. Theresa Ann then breathed on her own for a period of time, clearly indicating that the brain stem function governing spontaneous breathing was intact. Other brain stem functions that control heart rate, blood pressure, salt and water balance, pituitary-endocrine organ functions, as well as many other organs and systems, were presumably also intact and functioning in Theresa Ann's body.

At least some of the physicians treating Theresa Ann knew, and made others aware, that her brain was functioning. Based on this, the Florida Supreme Court ruled that Theresa Ann could not be "brain dead" under Florida law.(5)


Anencephaly results from a failure of the neural tissue to completely close at the cephalic end. Even though anencephaly literally means the absence of the brain, functioning neural tissue is always present. The telencephalon is usually absent, but the brain stem is present. Absence of the cranium (acrania) is a constant finding. Closure of the cephalic end of the neural tube normally occurs between the second and third week of development. Thus, anencephaly is a manifestation of an abnormality of development that occurs sometime between conception and two to three weeks of gestation.(6)

Prenatal Diagnosis

Alpha-fetoprotein (AFP) is a glycoprotein normally synthesized by the fetal liver but not by the adult liver. Some AFP is normally present in the amniotic fluid. When the neural tube remains open (in anencephaly or spina bifida with myelomeningocele), there can be abnormally large quantities of AFP in the amniotic fluid, and as a result there is elevation of AFP in maternal serum. Screening of maternal serum for elevated amounts of AFP, analysis of AFP in amniotic fluid, and ultrasound examination of the fetus can lead to a diagnosis of anencephaly. (One must be aware of the potential for error in all of these tests.)

Postnatal Diagnosis

The appearance of an infant with anencephaly is characterized by the absence of bone and scalp over the part of the head posterior to the forehead. The exposed brain is covered by a thickened angiofibrous stroma. Recognizable cerebral hemispheres are absent.

Brain Death Law

The Uniform Determination of Death Act (UDDA) was recommended for adoption in all jurisdictions of the United States by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research.(7) The UDDA reads as follows:

An individual who has sustained either (1) irreversible cessation of

circulatory and respiratory functions, or (2) irreversible cessation of all

functions of the entire brain, including the brain stem, is dead. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Cite this article

Cited article

Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Anencephaly - Organ Transplantation?


Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25,

    New feature

    It is estimated that 1 in 10 people have dyslexia, and in an effort to make Questia easier to use for those people, we have added a new choice of font to the Reader. That font is called OpenDyslexic, and has been designed to help with some of the symptoms of dyslexia. For more information on this font, please visit

    To use OpenDyslexic, choose it from the Typeface list in Font settings.

    OK, got it!

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search


    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.