Danish ethics council rejects brain death as the criterion of death -- commentary 2: return to Elsinore.

No discussion of when an individual is dead is meaningful in the absence of a definition of death. If human death is defined as the irreversible loss of the capacity for consciousness combined with the irreversible loss of the capacity to breathe spontaneously (and hence to maintain a spontaneous heart beat) the death of the brainstem will be seen to be the necessary and sufficient condition for the death of the individual. Such a definition of death is not something radically new.

The elderly and their ankle jerks.

The ankle jerks of 200 consecutive patients admitted to a geriatric department were assessed on the second or third hospital days by two independent observers. The test consisted of a "plantar" rather than Achilles tendon strike with a standard patellar hammer. 188 patients had ankle jerks.

Malignant histiocytosis and encephalomyeloradiculopathy complicating coeliac disease.

A 62 year old Irish woman with an eight year history of probable coeliac disease developed brain stem signs, unilateral facial numbness and weakness, wasting and anaesthesia in both lower limbs. Over the next two years, a progressive deterioration in neurological function and in intestinal absorption, and the development of anaemia led to a suspicion of malignancy. Bone marrow biopsy revealed malignant histiocytosis.

Whole-brain death reconsidered--physiological facts and philosophy.

Four main areas generating confusion in discussion on brain death are identified as a) the relation of criteria of death to concepts of death, b) the argument about whether death is an event or a process, c) the inadequate differentiation of different neurological entities having different cardiac prognoses, and d) insufficient awareness of the separate issues of 'determining death' and 'allowing to die'. It is argued that if by death we mean the dissolution of the human 'organism as a whole', then whole-brain death is death. Behavioural patterns, legitimate in the presence of a cadaver, should be legitimate from the time whole-brain death is diagnosed.