The Declaration of Sydney on human death

Machado, Calixto; Korein, Julius; Ferrer, Y; Portela, Liana; Garcia, M d. l. C; Chinchilla, Mauricio; Machado, Y; Manero, J M

doi:10.1136/jme.2007.020685

Cited by 29 publications

(16 citation statements)

References 70 publications

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“…A living human being is more than just the sum of his or her body parts; the death of a human being is, therefore, a distinct concept from the death of individual body parts (24). This distinction underlies the Sydney Declaration on human death issued in 1968 by the World Medical Assembly (25)(26)(27). The widely known and externally recognizable signs of death-livor mortis and rigor mortis at first, then signs of putrefaction and decomposition-are lacking in ILBF because of the continued blood perfusion of the skin and musculature for as long as the circulation is sustained by intensive care medicine.…”

Section: The Significance Of Ilbf As a Reliable Sign Of Deathmentioning

confidence: 99%

The Relevance of Irreversible Loss of Brain Function as a Reliable Sign of Death

Brandt¹,

Angstwurm²

2018

Deutsches Ärzteblatt International

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he diagnosis of irreversible loss of brain function (ILBF) means that the patient's brain has irretrievably ceased to function despite the ongoing maintenance of cardiovascular function by the methods of intensive care medicine (Box 1). In §3 of the German Transplantation Law (Transplantationsgesetz, TPG), ILBF is described as "the final, irreversible loss of all function of the cerebrum, cerebellum, and brainstem." The significance of ILBF as a reliable sign of death has been definitively established in Germany (as in other countries) in position statements of multiple involved organizations, including the German Medical Association (Bundesärztekammer) (Box 2), medicalscientific specialty societies, and religious communities (2-8). The basic elements of the determination of ILBF have not changed, and the position statements concerning them are still applicable. The present article, Summary Background: There is an ongoing need for clear explanation of the diagnostic entity called "irreversible loss of brain function" (ILBF), as the absolute reliability of this diagnosis and its significance continue to be widely misunderstood. The determination of death as an objective medical-scientific matter is often not clearly distinguished from various other aspects of death, such as its metaphysical and cultural aspects and the ways in which the living deal with the dead. Method: This review is based on articles retrieved by a selective literature search in the PubMed database and on guidelines and standardized diagnostic protocols from Germany and abroad. Results: ILBF can be caused by brain ischemia or anoxia or by any other type of brain disease or injury leading to an elevation of the intracranial pressure above the blood pressure and thereby to an arrest of the cerebral circulation. All situations in which brain function is merely reduced but not abolished, or only temporarily but not permanently abolished, can be clearly differentiated from ILBF through the use of standard diagnostic procedures as recommended in the relevant guidelines. Biological features that are common to all human beings underlie the medical criteria for the determination of death. The most important elements of the determination of death are irreversibility of the loss of brain function, loss of integration of bodily functions into a single living being, and loss of ability for any self-reflection or any independent interaction with the environment. Conclusion: ILBF is a reliable sign that a human being is dead. There has never been even one known case of incorrect determination of ILBF after proper application of the standardized diagnostic procedures that are set down in the guideline according to §16 of the German Transplantation Law.

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Section: The Significance Of Ilbf As a Reliable Sign Of Deathmentioning

confidence: 99%

The Relevance of Irreversible Loss of Brain Function as a Reliable Sign of Death

Brandt¹,

Angstwurm²

2018

Deutsches Ärzteblatt International

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“…21 Simultaneously, the World Medical Assembly announced the Declaration of Sydney, which differentiated the meaning of death at the cellular and tissue levels from the death of the person and emphasized that the determination of death remained the responsibility of the medical practitioner. 22 Clinical, legal, and national codification followed 23 -26 but vocal opponents to neurological criteria for diagnosing death persist.…”

Section: A History Of Diagnosing Deathmentioning

confidence: 99%

International perspective on the diagnosis of death

Gardiner

Shemie

Manara

et al. 2012

British Journal of Anaesthesia

121

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There is growing medical consensus in a unifying concept of human death. All human death involves the irreversible loss of the capacity for consciousness, combined with the irreversible loss of the capacity to breathe. Death then is a result of the irreversible loss of these functions in the brain. This paper outlines three sets of criteria to diagnose human death. Each set of criteria clearly establishes the irreversible loss of the capacity for consciousness, combined with the irreversible loss of the capacity to breathe. The most appropriate set of criteria to use is determined by the circumstances in which the medical practitioner is called upon to diagnose death. The three criteria sets are somatic (features visible on external inspection of the corpse), circulatory (after cardiorespiratory arrest), and neurological (in patients in coma on mechanical ventilation); and represent a diagnostic standard in which the medical profession and the public can have complete confidence. This review unites authors from Australia, Canada, and the UK and examines the medical criteria that we should use in 2012 to diagnose human death.

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“…1) In the same year, detailed criteria of brain death were presented at the 22nd World Medical Association meeting, at which time brain death was officially recognized as death from a medical perspective. 7) A rare spinal reflex related to death of the brainstem or entire brain was reported for the first time in 1973 by Ivan 4) . In 1984, Ropper 8) reported a case of a brain-dead patient who demonstrated a complex reflex movement: bilateral arm flexion to the chest, shoulder adduction, and hand crossing; he named this collective movement the Lazarus sign.…”

Section: Introductionmentioning

confidence: 99%

Chronic Brain-Dead Patients Who Exhibit Lazarus Sign

Moon

Cha

2017

Korean J Neurotrauma

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Lazarus sign, a complex reflex movement of the upper limbs after brain death, is a rare occurrence. We report two patients who showed a Lazarus sign following a diagnosis of brain death. It has been accepted that cardiac arrest usually occurs within 1 week after brain death; however, the two patients described herein survived for over 100 days after brain death was diagnosed. This report is intended to examine the relationship between the Lazarus sign and long-term survival after brain death, as well as to share our rare experience.

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The Declaration of Sydney on human death

Cited by 29 publications

References 70 publications

The Relevance of Irreversible Loss of Brain Function as a Reliable Sign of Death

The Relevance of Irreversible Loss of Brain Function as a Reliable Sign of Death

International perspective on the diagnosis of death

Chronic Brain-Dead Patients Who Exhibit Lazarus Sign

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