title: The neurological determination of death: what does it really mean?
abstract: The recent Canadian forum's recommendations regarding "neurological determination of death" claim to have determined a "Canadian definition, criteria, and minimum testing requirements for neurological determination of death." In this review the problems with this statement are discussed. The criterion of neurological determination of death does not fulfill the definition of death, because there is continued integration of the organism as a whole. The tests for neurological determination of death do not fulfill the criterion of neurological determination of death because they do not show the irreversible loss of all critical brain functions. The forum has provided no coherent argument for why neurological determination of death should be considered death. I suggest that one cannot invoke expert opinion to clarify a criterion of death, and tests for this criterion of death, without a clear concept of what death is. The forum has clarified tests for what they call "neurological determination of death," but this is not death itself; rather, it is a neurologically devastating state. Whether this state of "neurological determination of death" is enough to justify the morality of harvesting organs prior to death is the real question. A potential solution to this question is discussed.
authors.affiliation: Department of Pediatrics, Division of Pediatric Critical Care, University of Alberta, Edmonton, Canada. ajoffe@cha.ab.ca
authors.forename: Ari Robin
authors.initials: AR
authors.lastname: Joffe
mesh_terms: D001926:Brain Death / Q000175:diagnosis* / Q000473:pathology; D001933:Brain Stem / Q000473:pathology; D002170:Canada; D003625:Data Collection; D003643:Death; D006801:Humans; D009460:Neurologic Examination; D020858:Tissue and Organ Harvesting / Q000331:legislation & jurisprudence