On the Definition and Criterion of Death

  1. JAMES L. BERNAT, M.D.;
  2. CHARLES M. CULVER, M.D., Ph.D.; and
  3. BERNARD GERT, Ph.D.
  1. Hanover, New Hampshire

    Abstract

    The permanent cessation of functioning of the organism as a whole is the definition underlying the traditional understanding of death. We suggest the total and irreversible loss of functioning of the whole brain as the sole criterion of death; this has always been an implicit criterion of death. If artificial ventilation is present, only completely validated brain dysfunction tests should be used to show that this criterion of death is satisfied. In most cases without artificial ventilation, permanent loss of cardiopulmonary function is sufficient. We propose a statutory definition of death based on the criterion of total and irreversible cessation of whole brain functions but allowing physicians to declare death according to their customary practices in most cases.

    Article and Author Information

    • ▸From the Division of Neurology, Department of Medicine and the Departments of Psychiatry and Philosophy; Dartmouth Medical School and Dartmouth College, Hanover, New Hampshire; and the Department of Medicine, Veterans Administration Hospital, White River Junction, Vermont.

    • ▸Requests for reprints should be addressed to James L. Bernat, M.D.; Division of Neurology, Department of Medicine; Dartmouth Medical School; Hanover, NH 03755.

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