Brain stem death defines death in law.
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Brain Death↗
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Results for “Defining Death”
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Uniform Brain Death Act solely intended to legally define death.
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Brain Death↗
Failure to define death: the unsettled question.
Many states have passed the Uniform Anatomical Gift Act, which places the burden of determination of actual death of the patient upon the physician. The House of Delegates of the Connecticut State Medical Society has endorsed a definition of death. The Kansas Legislature was the first to adopt a statute defining death, but many authorities believe that this is an area in which the medical profession should assume total responsibility. Failure of the medical profession to meet this responsibility will lead to the development of areas of liability with new and unexpected ramifications for physicians and hospitals.
Adolescent↗
Physicians' opinions toward legislation defining death and withholding life support.
We explored attitudes and practices of Alabama physicians regarding two bills considered in the 1978 State Legislature. One bill defined death to permit the withdrawal of life supports; the other permitted the cessation of active treatment when demanded by terminal patients. Members of the Medical Association of the State of Alabama (MASA) in practices permitting independent action in such cases composed the sample. Twenty percent of 1,300 questionnaires were returned. Most participants idealistically resented legislative interference but realistically were resigned to or welcomed legal clarification of physicians' rights and responsibilities. Respondents encountering demands for life-support withdrawal generally acceded, usually after consultation with family and/or colleagues. Most used analgesics to control pain, if necessary, even to a point compromising respiration. Most considered withdrawal of life support, and most approved of "living wills." Alabama physicians are in the mainstream of American medicine in this area of bioethical concern.
Alabama↗
Defining death. Developments in recent law.
The authors trace the progress among courts, legislatures, and professional and advisory bodies toward the acceptance of legal standards that define death by reference to neurologic criteria. Competing legal formulations and medical proposals are examined, and those standards ultimately adopted in various jurisdictions are set forth.
Brain Death↗
Defining death for persons and human organisms.
This paper discusses how alternative concepts of personhood affect the definition of death. I argue that parties in the debate over the definition of death have employed different concepts of personhood, and thus have been talking past each other by proposing definitions of death for different kinds of things. In particular, I show how critics of the consciousness-related, neurological formation of death have relied on concepts of personhood that would be rejected by proponents of that formulation. These critics rest on treating persons as qualitative specifications of human organisms (Bernat, Culver, and Gert) or as identical to human organisms (Capron, Seifert, and Shewmon). Since advocates of the consciousness-related, neurological formulation of death are not committed to either of these views of personhood, these critics commit the fallacy of attacking a straw man. I then clarify the "substantive" concept of personhood (Boethius, Strawson, and Wiggins) that may be invoked in the consciousness-related, neurological formulation of death, and argue that, on this view and contra Bernat, Culver, and Gert, persons have always been the kind of thing that can literally die. I conclude by suggesting that the discussion of defining death needs to focus on which approach to personhood makes the most sense metaphysically and morally.
Attitude to Death↗
Causes of perinatal death defined by autopsy at Ramathibodi Hospital.
Most causes of death during the fetal period are still unknown in all birth weight groups. Intrauterine anoxia evidence by clinical data and autopsy finding is the leading known cause in infants 1,001-2,500 g and over 2,500 g. In the early neonatal period in infants 1,001-2,500 g and over 2,500 g, the most common cause of death is congenital malformation which was also found as the main cause in the late neonatal over 2,500 g group. More than half of the deaths in the late neonatal period 1,001-2,500 g group, were caused by infection. Congenital syphilis and tetanus neonatorum which existed in the first study were not found in this study which reflects improved medical care.
Autopsy↗
Is life living? Defining death in a technological age.
Historically, humanity has assigned death to evil spirits, malevolent gods, and other supernatural agents; but by the eighteenth century, the scientific spirit began to manifest itself through more precise biologic definitions of death. Thanks to modern medical technology, these early scientific views, with their considerable margin for error, gave way in the twentieth century to criteria based on such diverse factors as total lack of response to external stimuli, absence of spontaneous muscular movements, absence of all reflexes, total collapse of the arterial blood pressure, flat electrocardiogram, and flat electroencephalograph tracings. Undoubtedly such difficult matters as organ transplants, wills, homicide, euthanasia, and abortion demand precise definitions of death; but modern medical advances have engendered visions of physical immortality with doctors as the arbiters who often define and determine death. Even so, such one-dimensional, scientific views fail to capture those nebulous social, religious, or spiritual definitions that pervade humanity's definition of death. Humanistic views of death resist the movement of death from the moral realm to a technological order that places people in a system, theory, or chart, where they are thus absolved from fear of freedom. Rather, humanistic definitions demand that humanity step beyond mechanistic definitions of death into a transcendent world of moral choices that guarantee human dignity and worth by ascribing meaning to life and death. These meanings counter the desiccating fear that something like biologic human might, through something called medical technology, defeat something called fate.
Attitude to Death↗
What is operative mortality? Defining death in a surgical registry database: a report of the STS Congenital Database Taskforce and the Joint EACTS-STS Congenital Database Committee.
The most concrete and universal outcome measure used in databases, whether governmental, professional society, research, or third-party payer, is operative mortality. To assure congruous data entry by multiple users of The Society of Thoracic Surgeons and the European Association for Cardiothoracic Surgery congenital heart surgery databases, operative mortality must be clearly defined. Traditionally, operative mortality has been defined as any death, regardless of cause, occurring (1) within 30 days after surgery in or out of the hospital, and (2) after 30 days during the same hospitalization subsequent to the operation. Differing hospital practices result in problems in use of the latter part of the definition (eg, the pediatric hospital that provides longer-term care will have higher mortality rates than one which transfers patients to another institution for such care). In addition, because of the significant number of pediatric multiple operation hospitalizations, issues of assignment of mortality to a specific operation within the hospitalization, calculation of operative mortality rates (operation based vs patient admission based), and discharge other than to home must be addressed and defined. We propose refinements to the definition of operative mortality which specifically meet the needs of our professional societies' multi-institutional registry databases, and at the same time are relevant and appropriate with respect to the goals and purposes of administrative databases, government agencies, and the general public.
Cardiac Surgical Procedures↗
Death: defining and determining: personal observations.
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Brain Death↗
Apoptosis: cell death defined by caspase activation.
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Animals↗
Defining death in non-heart beating organ donors.
Protocols for retrieving vital organs in consenting patients in cardiovascular arrest (non-heart beating donors, NHBD) rest on the assumptions that irreversible asystole a) identifies the instant of biological death, and b) is clinically assessable at the time when retrieval of vital organs is possible. Unfortunately both assumptions are flawed. We argue that traditional life/death definitions could be actually inadequate to represent the reality of dying under intensive support, and we suggest redefining NHBD protocols on moral, social, and anthropological criteria, admitting that irreversible (however defined) asystole can only equate a clinically determinable point of no return in the process of dying, where organ retrieval can be morally and socially accepted in previously consenting patients.
Attitude to Death↗
Adipocyte death defines macrophage localization and function in adipose tissue of obese mice and humans.
Macrophage infiltration of white adipose tissue (WAT) is implicated in the metabolic complications of obesity. The precipitating event(s) and function(s) of macrophage infiltration into WAT are unknown. We demonstrate that >90% of all macrophages in WAT of obese mice and humans are localized to dead adipocytes, where they fuse to form syncytia that sequester and scavenge the residual "free" adipocyte lipid droplet and ultimately form multinucleate giant cells, a hallmark of chronic inflammation. Adipocyte death increases in obese (db/db) mice (30-fold) and humans and exhibits ultrastructural features of necrosis (but not apoptosis). These observations identify necrotic-like adipocyte death as a pathologic hallmark of obesity and suggest that scavenging of adipocyte debris is an important function of WAT macrophages in obese individuals. The frequency of adipocyte death is positively correlated with increased adipocyte size in obese mice and humans and in hormone-sensitive lipase-deficient (HSL-/-) mice, a model of adipocyte hypertrophy without increased adipose mass. WAT of HSL-/- mice exhibited a 15-fold increase in necrotic-like adipocyte death and formation of macrophage syncytia, coincident with increased tumor necrosis factor-alpha gene expression. These results provide a novel framework for understanding macrophage recruitment, function, and persistence in WAT of obese individuals.
Adipocytes↗
Defining death. A superficial and fragile consensus.
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Brain Death↗
Defining death: organ transplants, tradition and technology in Japan.
This article explores Japanese attitudes about brain death and organ transplantation. First, ancient burial customs and death-related rituals associated with Shinto and Buddhism are examined. Next, contemporary attitudes towards the dead are discussed in the context of current controversies surrounding brain death and organ transplantation. Finally, an attempt is made to link the traditional Japanese views of death with modern medical dilemmas.
Attitude to Death↗
Race differences in estimates of sudden coronary heart disease mortality, 1980-1988: the impact of ill-defined death.
Coronary heart disease (CHD) deaths occurring outside of hospitals or in emergency rooms (OH/ER) have been used to estimate sudden CHD mortality. This study quantifies the potential impact of natural deaths coded to an unspecified cause on race differences in sudden CHD estimates, during 1980-1988. Death certificate data for OH/ER deaths in 40 U.S. states were used to create annual age-adjusted rates for sudden CHD and sudden CHD rates revised to include deaths with an unspecified cause (ICD9, 780-799). Revising the mortality rates to include unspecified deaths results in greater racial disparities for estimates of sudden CHD. In 1980, black-white race differences went from 89 to 128 and 103 to 121 (per 100,000) for men and women, respectively, with revision. Among blacks, revised sudden CHD mortality declined approximately 22%, during 1980-1988, compared to 10% for unrevised sudden CHD; with no observed effect of revision on percent declines among whites. Previous studies may have underestimated declines in racial disparities of sudden CHD, due to improved quality of OH/ER death certification among blacks. Improved access to routine and emergency medical care, through increased affordability and greater availability, may be important to address higher OH/ER CHD among blacks.
Adult↗