Cuba has Passed a Law for the Determination and Certification of Death

Variability of Brain Death Determination Guidelines in Leading Us Neurologic Institutions

“…Among those tests to detect absent CBF, we defended the use of TCD, and a neurophysiologic test battery (multimodality evoked potentials and electroretinography) to show loss of bioelectric activity. 5 Considering the variability of BD guidelines in the United States 1 and the rest of the world, 2 I agree with the authors that the AAN Guidelines should be reviewed, including this diagnosis in children. Furthermore, the World Federation of Neurology should also organize a Committee for reviewing and standardizing guidelines for worldwide consensus in BD diagnostic criteria.…”

“…In some countries, TCD is allowed to confirm BD by law. 5 We performed a 4-year survey of 101 cases of clinically diagnosed BD by TCD monitoring. 7 The sensitivity and specificity was high (77% vs 100%) in middle cerebral artery and basilar artery.…”

Determination of death

“…‘Physicians are the only professionals authorized to diagnose and certify death according to a norm established by the Ministry of Public Health’ (5). According to the Cuban Parliament, a resolution is a law that legalizes a working standard within any Ministry and that can be signed and changed by the Minister in function (4, 5). Hence, our lawyers left to physicians the responsibility of presenting norms related to human death.…”

“…As the Civil Code did not require a definition, the Commission followed this norm and presented not a concept, but ways to diagnose death. Hence, the Commission enumerated three possible situations for diagnosing death (3, 4):…”

“…Cuba has recently passed a law for the determination and certification of death. The National Commission for the Determination and Certification of Death has accepted a neurological view of death and emphasized that any legislation of death should be completely separated from any norm governing organ transplants (2–4).…”