[A new formulation of death: definition, criteria and diagnostic tests].
OBJECTIVE
To present a new formulation of human death based on neurological considerations.


METHODS
One of the reasons there is still controversy over a new formulation of human death which is acceptable to society, is that many authors do not suitably integrate three fundamental aspects which should be included in such a formulation: definition, criteria and diagnostic tests. We review the physiopathological mechanisms for generation of consciousness and discuss the three fundamental criteria presented by different authors in recent decades: the whole encephalum, brainstem death and neocortical criteria. We conclude that there are major contradictions in the three criteria with regard to satisfactory integration of the elements, definition, criteria and diagnostic tests. We therefore present a new formulation of human death.


BACKGROUND
irreversible loss of consciousness, since this gives the essential human attributes, and is the most integrating function of the organism.


METHODS
cortico-subcortical connections for the generation of both components of consciousness (capacity and content).


METHODS
no waking response to stimuli (capacity), no cognitive nor affective functions (content).


CONCLUSIONS
We present a new formulation of human death on a neurological basis which permits satisfactory integration of the three fundamental elements, definition, criteria and diagnostic tests, and so offers a suitable starting point from which man may start to understand death.
Machado-Curbelo
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Departamento de Neurofisiología Clínica, Instituto de Neurología y Neurocirugía, La Habana, Cuba. machado@braind.sld.cu
D001921:Brain / Q000473:pathology; D001926:Brain Death / Q000175:diagnosis; D001933:Brain Stem / Q000503:physiopathology; D002540:Cerebral Cortex / Q000503:physiopathology; D003243:Consciousness; D003643:Death; D003937:Diagnosis, Differential; D004596:Electroretinography; D005071:Evoked Potentials; D006323:Heart Arrest; D006801:Humans; D019579:Neocortex / Q000503:physiopathology; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology; D012131:Respiratory Insufficiency
Una nueva formulación de la muerte: definición, criterio y pruebas diagnósticas.