The Neurologist as a Gatekeeper: Ethics, Prognostication, and Supportive Care

This article explores the neurologist’s expanding role in end-of-life care through the lens of a real-world case of catastrophic brain injury (CBI). It examines the clinical, ethical, and legal complexities faced in Texas, particularly in the context of patients who do not meet criteria for brain death but are unlikely to regain meaningful consciousness. With a focus on prognostication, cultural sensitivity, and the Texas Advance Directives Act (TADA), it calls for proactive, interdisciplinary leadership by neurologists.