Is it enough with a heart that doesn’t beat anymore even if there still is brain function? How are we medically sure that even if there is no brain function someone is dead?
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Medical death is when there is no heartbeat. It does not mean that someone is dead permanently – if CPR restarts their heart, they will no longer be medically dead.
There are two conditions for medically declaring death, and they both have the same important qualifier – irreversible. This means in the opinion of the medical expert “declaring” the person death, the problem is now permanent and no amount of medical intervention can fix the issue.
The conditions are – the irreversible stopping of the heart and/or the irreversible stopping of brain function.
In either case, if the heart has 100% stopped, never to start again, the brain will eventually die, if the brain has 100% stopped functioning the heart will stop beating soon after.
In terms of “being sure”, it’s a medical opinion. If in the doctor’s opinion the heart absolutely cannot be restarted or the brain will absolutely never function again, the person is declared dead.
Heartbeat isn’t the best indicator of death, because it isn’t terribly uncommon for the heart to start beating again if medical care gives the patient a fighting chance. Brain death is a better indicator that someone is definitely gone.
There are diagnostic tests that can be performed to determine brain death. Many of these measure reflexes that are very rarely absent or lost, except in cases of irreversible damage to parts of the brain that are absolutely necessary for survival.
No test is perfect, but these are very good.
It mostly refers to brain death, i. e. irreversible loss of brain function. You can keep such a person “alive” on ventilation, but the person will not survive once taken off ventilation. Their organs are working and the tissues are alive, some reflexes may even work, but the person will never “wake up.” Nerves cannot regenerate once dead, so once you lose a vital function of your brainstem, like respiration, it’s gone forever.
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