Determination of death

Machado, Calixto

doi:10.1111/j.1399-6576.2004.00584.x

Cited by 10 publications

(4 citation statements)

References 3 publications

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“…Confirmatory laboratory tests are recommended when specific components of the clinical testing cannot be evaluated reliably. 50,51,106 Sometimes the apnea test cannot be performed or it must be interrupted by the examiner. Eye injuries may impede an appropriate assessment of pupillary, corneal, or vestibulo-reflex testing.…”

Section: Confirmatory Testsmentioning

confidence: 99%

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Diagnosis of brain death

Machado

2010

Neurol Int

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Brain death (BD) should be understood as the ultimate clinical expression of a brain catastrophe characterized by a complete and irreversible neurological stoppage, recognized by irreversible coma, absent brainstem reflexes, and apnea. The most common pattern is manifested by an elevation of intracranial pressure to a point beyond the mean arterial pressure, and hence cerebral perfusion pressure falls and, as a result, no net cerebral blood flow is present, in due course leading to permanent cytotoxic injury of the intracranial neuronal tissue. A second mechanism is an intrinsic injury affecting the nervous tissue at a cellular level which, if extensive and unremitting, can also lead to BD. We review here the methodology of diagnosing death, based on finding any of the signs of death. The irreversible loss of cardio-circulatory and respiratory functions can cause death only when ischemia and anoxia are prolonged enough to produce an irreversible destruction of the brain. The sign of such loss of brain functions, that is to say BD diagnosis, is fully reviewed.

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Section: Confirmatory Testsmentioning

confidence: 99%

“…The Cuban Commission proposed that confirmatory tests should be mandatory in cases of patients with primary brainstem lesions undergoing BD diagnosis. 1,49–51 …”

Section: Confirmatory Testsmentioning

confidence: 99%

Diagnosis of brain death

Machado

2010

Neurol Int

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“…It arose through a process of syncretism between the traditional Yoruba religion of West Africa, the Roman Catholic form of Christianity, and Spiritism. Curiously, although in Cuba, Santeria, and Christian religions are common, contrary to Africa, most people accept BD/DNC and organ donation [21][22][23][24][25][26][27][28][29][30][31].…”

mentioning

confidence: 99%

Hitches to establish BD/DNC protocols to declare death in Africa

Machado¹

2021

Frontiers Drug Chemistry Clinical Res

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The World Brain Death Project addresses discrepancies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis. The World Brain Death Project published an outstanding paper formulating a consensus statement of recommendations on the determination of brain death/ death by neurologic criteria (BD/DNC). Now, Lewis et al particularized analysis of brain death/death by neurologic criteria (BD/DNC) protocols in Africa and found that the percentage of countries with BD/DNC protocols is much lower in Africa than in other developing regions. This is the largest assessment up to the present time about the prevalence of BD/DNC protocols in that continent. The authors also affirmed that, compared with Africa, the proportion of countries with BD/DNC protocols in Latin America/the Caribbean and Asia/the Pacific is similar to that of the world in general. In Africa, hundreds of religions are recognized. In Cuba, the Yoruba religion is very common [1]. Santería, was developed in Cuba and then spread throughout Latin America and the United States. Santería was brought to Cuba by people of the Yoruban nations of West Africa (mainly from the actual territory of Nigeria), who were enslaved in great numbers in the first decades of the 19th century. It arose through a process of syncretism between the traditional Yoruba religion of West Africa, the Roman Catholic form of Christianity, and Spiritism. Curiously, although in Cuba, Santeria, and Christian religions are common, contrary to Africa, most people accept BD/DNC and organ donation. It is also important to consider many African countries are lacking primary and essential medical services, which makes more difficult the establishment of BD/DNC and organ donation protocols.

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“…1 In this article I want to present the historical procedure for issuing a law in Cuba for the determination and certification of death. 20,24,[37][38][39][40][41][42][43] Of course, it is impossible to compare our country with USA. Cuba is a small and developing country, in which a law encompasses a national scenery, in contrast with USA, a multistate nation.…”

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confidence: 99%

More about the Determination of Death by Neurologic Criteria

Machado¹

2020

Preprint

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Lewis et al. published an important and timely necessary article about the determination of death by neurological criteria, revising the Uniform Determination of Death.The acceptance of brain death (BD) has been progressively accepted beginning at the late 1950s. Nonetheless, contentious brain-death cases have recently raised new controversies about the diagnosis of BD, such as the Jahi McMath case, extensively covered by the US and international press. Jahi McMath meant a terrible tragedy for her and her family. But further than this gloomy story, the case has also raised confusion and challenging qualms about a fundamental query: how we confirm whether a person is dead or alive? Since 1981, the Uniform Determination of Death Act (UDDA) has served as the legal foundation for the medical practice of determining death. But, although death by neurologic criteria is considered legal death throughout the United States, several recent lawsuits have quizzed the rightfulness the authority of the UDDA to declare death by neurological criteria. This issue explains the importance of Lewis’s et al. paper. In this article I want to present the historical procedure for issuing a law in Cuba for the determination and certification of death. Of course, it is impossible to compare our country with USA. Cuba is a small and developing country, in which a law encompasses a national scenery, in contrast with USA, a multistate nation.

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Determination of death

Cited by 10 publications

References 3 publications

Diagnosis of brain death

Diagnosis of brain death

Hitches to establish BD/DNC protocols to declare death in Africa

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