[Death criteria - now and in the future]

Area of Science:

• Neurology
• Medical Ethics
• Physiology

Background:

• Current definitions of death involve circulatory and brain criteria.
• Irreversible loss of brain function is a common element in all death pronouncements.
• Brainstem function, including respiration, is critical and must be irreversibly lost.

Purpose of the Study:

• To emphasize the central role of irreversible brain function loss in defining death.
• To support the World Health Organization's proposed death criterion.
• To highlight the importance of consciousness and brainstem function in future death criteria.

Main Methods:

• Review of existing medical and ethical literature on death pronouncement.
• Analysis of the physiological basis for circulatory and brain death.
• Evaluation of the proposed WHO death criterion.

Main Results:

• Irreversible loss of brain function is fundamental to both circulatory and brain death.
• Lack of blood supply or increased intracranial pressure leads to irreversible brain function cessation.
• Irreversible loss of breathing, a brainstem function, is mandatory for death pronouncement.

Conclusions:

• Brain function is central to the concept of death.
• Future death criteria should be based on irreversible loss of consciousness and brainstem function.
• The WHO's proposed criterion aligns with the essential role of brain function in defining death.