[Brain death and intensive care medicine. Legal problems]. 2009

K Ulsenheimer
Ulsenheimer@uls-frie.de

"Death as the limit of the natural legal capacity is such a simple natural event that, just as for birth, it is not necessary to exactly determine its elements" declared the legal academic Friedrich Karl von Savigny 150 years ago. However, a stable legal order necessitates clear and if possible simple, catchy objective reference. The clinical concept of death at the point of irreversible cessation of circulation and breathing, in view of the possibilities of modern intensive medical care and the obvious redundant terms "brain death" and "cardiac-circulation death", belongs to the past. Nowadays death is seen in the final cessation of all functions of the complete brain. Death as a legal term must, however, be "functionally" established with respect to the various aims and objectives of the Law. In this article the normative consequences of this distinction for intensive care medicine will be clarified.

UI MeSH Term Description Entries
D009626 Terminology as Topic Works about the terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area. Etymology,Nomenclature as Topic,Etymologies
D001775 Blood Circulation The movement of the BLOOD as it is pumped through the CARDIOVASCULAR SYSTEM. Blood Flow,Circulation, Blood,Blood Flows,Flow, Blood
D001926 Brain Death A state of prolonged irreversible cessation of all brain activity, including lower brain stem function with the complete absence of voluntary movements, responses to stimuli, brain stem reflexes, and spontaneous respirations. Reversible conditions which mimic this clinical state (e.g., sedative overdose, hypothermia, etc.) are excluded prior to making the determination of brain death. (From Adams et al., Principles of Neurology, 6th ed, pp348-9) Brain Dead,Coma Depasse,Irreversible Coma,Brain Deads,Coma, Irreversible,Death, Brain
D003326 Coronary Circulation The circulation of blood through the CORONARY VESSELS of the HEART. Circulation, Coronary
D003422 Critical Care Health care provided to a critically ill patient during a medical emergency or crisis. Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D005858 Germany A country in central Europe, bordering the Baltic Sea and the North Sea, between the Netherlands and Poland, south of Denmark. The capital is Berlin.
D014180 Transplantation Transference of a tissue or organ from either an alive or deceased donor, within an individual, between individuals of the same species, or between individuals of different species. Transplantations
D015656 Respiratory Mechanics The physical or mechanical action of the LUNGS; DIAPHRAGM; RIBS; and CHEST WALL during respiration. It includes airflow, lung volume, neural and reflex controls, mechanoreceptors, breathing patterns, etc. Breathing Mechanics,Breathing Mechanic,Mechanic, Breathing,Mechanic, Respiratory,Mechanics, Breathing,Mechanics, Respiratory,Respiratory Mechanic

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