Controversies in defining and determining death in critical care

  title={Controversies in defining and determining death in critical care},
  author={James L. Bernat},
  journal={Nature Reviews Neurology},
  • J. Bernat
  • Published 1 March 2013
  • Medicine, Biology, Psychology
  • Nature Reviews Neurology
Circulatory–respiratory or brain tests are widely accepted for definition and determination of death, but have several controversial issues. Both determinations have been stimulated by organ donation, but must be valid independently of this process. Current controversies in brain death include whether the definition is conceptually coherent, whether the whole-brain or brainstem criterion is correct, whether one neurological examination or two should be required, and when to conduct the… 
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Contemporary controversies in the definition of death.
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The circulatory–respiratory determination of death in organ donation*
The use of unmodified extracorporeal membrane oxygenation in the circulatory determination of death donor after death is declared should be abandoned because, by restoring brain circulation, it retroactively negates the previous death determination.
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Every step in the determination of brainDeath bears potential pitfalls which can lead to errors in the diagnosis of brain death, and possible solutions are identified.
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This year marks the 40th anniversary of the publication of the landmark Harvard Medical School Ad Hoc Committee report that established brain death as an accepted medical phenomenon.1 Therefore, it
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