Clinical death: a diagnosis and a testimony

Abstract

The clinical death of a person is the death of the brain. There is a fairly general consensus in western medicine on the necessary criteria and the mode of proceeding for a correct diagnosis of "brain death". In a specific case, with a reasonable previous record of catastrophic brain damage and certain neurological exploratory signs, an expert practitioner is able to diagnose clinical death. Accepting that the diagnosis of death is an exercise of diagnostic judgement, in practical application, which cannot as such provide absolute certainty; we have to accept that, in spite of this uncertainty, we have to take sensible and prudent decisions. However, there are dissenting opinions that believe in the need for a higher degree of certainty before taking decisions. It is necessary to try to understand the concept of "brain death" in order to be able to take responsible decisions. This concept is a real "cultural construction", in which it is necessary to have knowledge about the scientific definition of death, how death can be diagnosed in practice, when it is possible to say that someone is clinically dead, and what is the degree of evidence carried by the diagnosis.