BIOETYKA / WPROWADZENIE

In this report (…) we suggest that responsible medical opinion is ready to adopt new criteria for pronouncing death to have occurred in an individual sustaining irreversible coma as a result of permanent brain damage. If this position is adopted by the medical community, it can form the basis for change in the current legal concept of death.

(…)

It is recommended as a part of these procedures that judgment of the existence of these criteria is solely a medical issue. It is suggested that the physician in charge of the patient consult with one or more other physicians directly involved in the case before the patient is declared dead on the basis of these criteria. In this way, the responsibility is shared over a wider range of medical opinion, thus providing an important degree of protection against later questions which might be raised about the particular case. It is further suggested that the decision to declare the person dead, and then to turn of the respirator, be made by physicians not involved in any later effort to transplant organs or tissue from the deceased individual. This is advisable in order to avoid any appearance of self-interest by the physicians involved.

It should be emphasized that we recommend the patient be declared dead before any effort is made to take him off a respirator, if he is then on a respirator. This declaration should not be delayed until he has been taken off a respirator and all artificially stimulated signs have ceased. The reason for this recommendation is that in our judgment it will provide a greater degree of legal protection to those involved. Otherwise, the physicians would be turning off the respirator on a person who is, under the present strict, technical application of law, still alive.

A Definition of Irreversible Coma, s. 87