From McGill U: International guideline development for the determination of death

Intensive Care Med. 2014 Mar 25. [Epub ahead of print]

International guideline development for the determination of death.

Shemie SD1, Hornby L, Baker A, Teitelbaum J, Torrance S, Young K, Capron AM, Bernat JL, Noel L; and The International Guidelines for Determination of Death phase 1 participants, in collaboration with the World Health Organization.

Author information

• 1Canadian Blood Services and Division of Critical Care, Montreal Children's Hospital, McGill University Health Centre, 2300 Tupper Street room C-806, Montreal, QC, H3H 1P3, Canada, sam.shemie@mcgill.ca.

Abstract

INTRODUCTION AND METHODS:

This report summarizes the results of the first phase in the development of international guidelines for death determination, focusing on the biology of death and the dying process, developed by an invitational forum of international content experts and representatives of a number of professional societies.

RESULTS AND CONCLUSIONS:

Precise terminology was developed in order to improve clarity in death discussion and debate. Critical events in the physiological sequences leading to cessation of neurological and/or circulatory function were constructed. It was agreed that death determination is primarily clinical and recommendations for preconditions, confounding factors, minimum clinical standards and additional testing were made. A single operational definition of human death was developed: 'the permanent loss of capacity for consciousness and all brainstem functions, as a consequence of permanent cessation of circulation or catastrophic brain injury'. In order to complete the project, in the next phase, a broader group of international stakeholders will develop clinical practice guidelines, based on comprehensive reviews and grading of the existing evidence.