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.
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