Defining death
in Medicine, patients and the law (sixth edition)
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Whilst death cannot be evaded, the precise moment of its onset is subject to debate. Biologically, death is a process and not an event. Historically, the key factors in the process used to determine whether death had occurred were the cessation of breathing and the cessation of heartbeat. Medical advances show this to be problematic. Consider elective cardiac arrest during open-heart surgery, for example, or cases of spontaneous cardiac arrest followed by successful resuscitation. The heart stops but the patient is not dead. Official endorsement of ‘brain stem death’ in the UK is now to be found in a comprehensive Code of Practice issued by the Academy of Medical Royal Colleges. The legal implications are examined in full.

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