I. Traditional Criteria of Death
(I) Overview of Traditional Criteria of Death
The so-called traditional criteria of death are the cardiopulmonary criteria of death. The traditional death criteria actually used in medicine is the cessation or disappearance of pulse, respiration and blood pressure.
(2) Limitations of traditional death criteria and ethical issues
1. Limitations of traditional death criteria
Death judgment is not accurate enough. Traditional cardiopulmonary death criteria are often challenged in reality.
Modern heart transplantation technology has completely broken the stereotype that loss of cardiopulmonary function means the arrival of death. This is because it is possible to transplant a healthy heart into another patient with failing or lost heart function.
On the other hand, maintaining a heartbeat and breathing with the help of advanced medical equipment does not mean that the person is still alive, because once the equipment is removed, the heartbeat and breathing will stop immediately.
2. The ethical problems associated with traditional death criteria
(1) The inaccuracy of the determination of death puts the issue of when to stop resuscitating a dying patient into an ethical dilemma. Stopping resuscitation too soon obviously means that the patient loses the chance of survival, but for patients who have lost the value of resuscitation is a waste of health care resources and will increase the economic and psychological burden of the patient's family. It can be seen that the traditional standard of cardiopulmonary death is facing serious ethical and legal challenges.
(2) The impact on the adoption of new medical technologies The development of science has led to the application of many new and advanced medical technologies in clinical practice, giving many patients on the verge of death a chance to survive. Exam large site collection However, the traditional death criteria for the application of certain technologies constitute an obstacle. For example, in organ transplantation mainly relies on clonal organs, cadaveric organ sources, under the traditional death criteria, actually means the death of the organ, and thus with cadaveric organs as donors, the survival rate is too low. Modern medical research has shown that a brain-dead person who has suffered severe and irreversible brain damage, is in a deep coma, has no independent respiration, and relies entirely on mechanical means to maintain cardiopulmonary function is the most desirable as a donor for organ transplantation. And such transplants are unethical by conventional standards of death.
Second, the modern brain death standard
(a) the meaning of the brain death standard
In 1968, the United States, Harvard Medical School to Beecher (HoKoBee-cher) Professor as chairman, by physicians, theologians, lawyers and philosophers *** with the composition of the definition of the death of the Special Committee published a report, put forward the definition of brain death and the brain death standard The report proposed a definition of brain death and criteria for brain death. They defined death as "irreversible coma" or "brain death", including four criteria: (1) deep coma, with no perception of or response to external stimuli or internal needs; (2) absence of voluntary muscle movement and respiration; (3) disappearance of various reflexes; and (4) flatness of electroencephalographic waves. It is required that the above four items be tested repeatedly within 24 hours with no change in the results, and exclude both cases of body temperature below 32℃ or having just taken a large amount of central nervous system depressants such as barbiturates. Death can be determined by meeting this criterion.
For brain death, the following points need to be emphasized:
1, the difference between brain death and cardiopulmonary death
2, brain death is different from the vegetative state
(2) The ethical significance of the modern brain death criteria
1, scientifically determine the death of death Brain death determines the death of the most accurate. To date, the adoption of brain death criteria, the diagnosis of death has not been a case of error. Because, brain death is irreversible. Britain has sixteen scholars of one thousand and thirty-six clinically diagnosed brain death patients, although the full force of the rescue, but none of these patients survived.
2, is conducive to the rational use of limited health resources, the basic characteristics of the human consciousness state, and the state of consciousness is linked to the central nervous system. Exam website collects as a carrier of consciousness of the human brain if the death, the state of consciousness will then disappear, which means that he has lost as a person's essential characteristics. From the point of view of the quality of life, there is no longer the value of existence, should give up on their rescue and maintenance.
3, conducive to organ transplantation because the brain tissue is the most sensitive to hypoxia, so when the brain tissue due to hypoxia leading to brain death, other tissues and organs still remain vital, according to the brain death criteria for the donor to make a diagnosis of death, can be transplanted in a timely manner to provide high-quality "live" organs. Generally speaking, high-quality organs come from people who die in accidents. According to statistics, about 40,000 to 50,000 people die in car accidents each year in the United States, and about half of them are brain dead.
4, conducive to the determination of moral and legal responsibility of human death is a complex and irreversible process of the collapse of the material system of life from organs to tissues to cells. Determine the key to a person's death is to find the critical point of life and death, which is crucial, because it is related to when to stop resuscitation can be exempted from legal and ethical responsibility and exempted from the suspicion of murder.
Third, the correct standard of death