[Resolution for the determination and certification of death in Cuba]

In this paper we report on Public Health Resolution 90, which regulates the determination and certification of death in Cuba.

Public Health Resolution 90 is of great social importance in our country since it allows the determination and certification of death to be lawfully regulated throughout the whole territory. It is the fruit of over ten years work by a national commission which was set up for that purpose. This resolution includes a series of features that are unprecedented on an international level. By legalising all the aspects linked with the determination and certification of death by means of a ministerial resolution (Ministry of Public Health), and not through a law passed by Parliament, no obstacles are created to prevent it from being reassessed and changed in the future in order to keep up with scientific and technical progress. Unlike most legislation throughout the world, this resolution does not regulate the determination of death, or brain death, linked with organ transplants. In fact, the word transplants does not appear anywhere in the resolution. The clinical and instrumental criteria for determining death were grouped under the heading of the well known true signs of death , but included a true sign based on the irreversible loss of brain functions . Although the irreversible absence of respiratory and circulatory functions, together with the presence of post mortem changes, were included as true signs, the national commission concluded that the death of an individual can only be defined in terms of the irreversible loss of brain functions . The clinical and instrumental criteria for determining death are included in two annexes to the resolution, which must be reviewed from time to time by the National Commission for the Determination of Death, as and when scientific and technical progress makes it necessary to do so. Among the instrumental tests used as a diagnostic aid for the irreversible loss of brain functions and, for perhaps the first time in the world, a battery of tests made up of multimodal evoked potentials and electroretinography has been included.

Public Health Resolution 90 offers the legal framework for regulating the determination and certification of death in Cuba.