[Legal problems of brain death]. 1985

A Laufs

It is necessary to adhere to a uniform time of death. To determine this, the normatively relevant concept of death and the criteria for establishing death in terms of medical proof must be distinguished. The notion of death, which must be determined as a matter of first priority, is not something which is medically predetermined but is a normative convention. According to the legal view prevailling today, this does not depend on complete cessation of biological activities, or on the cessation of heart and breathing activity, but solely on brain death, i.e. (to quote from pertinent commentary of the scientific advisory board of the Federal Chamber of Physicians), on the "complete and irreversible collapse of the overall function of the brain with a circulatory function which can still be maintained in the rest of the body." Brain death is characterized by the irreversible loss of cerebral and brainstem function. Death of the patient is the extreme boundary of therapeutic activity which the physician may not transgress. Irreversible and total loss of function of the brain thus justifies the doctor in discontinuing his measures and indeed compels him to do so. The physician should preserve life and help the dying patient, but should not prolong death. Even before the extreme limit of brain death, intensive therapy may no longer be indicated, so that the physician is not obliged to make further efforts to prolong life.

UI MeSH Term Description Entries
D007258 Informed Consent Voluntary authorization, by a patient or research subject, with full comprehension of the risks involved, for diagnostic or investigative procedures, and for medical and surgical treatment. Consent, Informed
D008020 Life Support Care Care provided patients requiring extraordinary therapeutic measures in order to sustain and prolong life. Extraordinary Treatment,Prolongation of Life,Care, Life Support,Extraordinary Treatments,Life Prolongation,Treatment, Extraordinary,Treatments, Extraordinary
D010344 Patient Advocacy Promotion and protection of the rights of patients, frequently through a legal process. Patient Ombudsmen,Patient Representatives,Clinical Ombudsman,Patient Ombudsman,Advocacy, Patient,Ombudsman, Clinical,Ombudsman, Patient,Ombudsmen, Patient,Patient Representative,Representative, Patient,Representatives, Patient
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
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
D005065 Euthanasia The act or practice of killing or allowing death from natural causes, for reasons of mercy, i.e., in order to release a person from incurable disease, intolerable suffering, or undignified death. (from Beauchamp and Walters, Contemporary Issues in Bioethics, 5th ed) Mercy Killing,Killing, Mercy,Killings, Mercy,Mercy Killings
D005554 Forensic Medicine The application of medical knowledge to questions of law. Legal Medicine,Medicine, Forensic,Medicine, Legal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
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

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