Abstract
This paper undertakes an analysis of the scientific criteria used in the diagnosis of death and underscores the importance of intellectual rigor in the definition of medical concepts, particularly regarding such a critical issue as the diagnosis of death. Under the cardiorespiratory criterion, death is defined as "the irreversible cessation of the functioning of an organism as a whole", and the tests used to confirm this criterion (negative life-signs) are sensitive and specific. In this case, cadaverous phenomena appear immediately following the diagnosis of death. On the other hand, doubts have arisen concerning the theoretical and the inner consistency of the criterion of brain death, since it does not satisfy the definition of "the irreversible cessation of the functioning of an organism as a whole", nor the requirement of "total and irreversible cessation of all functions of the entire brain, including the brain stem". There is evidence to the effect that the tests used to confirm this criterion are not specific enough. It is clear that brain death marks the beginning of a process that eventually ends in death, though death does not occur at that moment. From an ethical point of view, the conflict arises between the need to provide an unequivocal diagnosis of death and the possibility of saving a life through organ transplantation. The sensitive issue of brain death calls for a more thorough and in-depth discussion among physicians and the community at large.
Highlights
This paper undertakes an analysis of the scientific criteria used in the diagnosis of death and underscores the importance of intellectual rigor in the definition of medical concepts, regarding such a critical issue as the diagnosis of death
En la inmensa mayoría de los casos, le toca comprobar los signos negativos de vida y, menos frecuentemente, los fenómenos cadavéricos consecutivos a la muerte
El diagnóstico de muerte se hace al comprobar signos negativos de vida y no signos positivos de muerte, toda vez que éstos son más tardíos y, si se esperara su aparición para diagnosticar la muerte, se crearía una serie de problemas de orden higiénico y epidemiológico
Summary
This paper undertakes an analysis of the scientific criteria used in the diagnosis of death and underscores the importance of intellectual rigor in the definition of medical concepts, regarding such a critical issue as the diagnosis of death. Death is defined as «the irreversible cessation of the functioning of an organism as a whole» and the tests used to confirm this criterion (negative life-signs) are sensitive and specific. In this case, cadaverous phenomena appear immediately following the diagnosis of death. Este último criterio se aplica en la práctica en aquellos casos, generalmente personas jóvenes, en que está prevista la utilización de algunos de sus órganos para ser trasplantados a otras personas que los necesitan por razones médicas. Se trata de una reflexión intelectual que apunta a la necesaria rigurosidad intelectual que, a nuestro parecer, se debe aplicar en las definiciones médicas, particularmente aquellas que tienen gran trascendencia en la práctica profesional, las que requieren una discusión de alto nivel
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