Spudis E W, Oleck H L
J Leg Med (N Y). 1977 Aug;5(8):5-11.
We have presented the choices available in the management of seven representative kinds of brain death and partial death as well as their legal ramifications. Refinements of tests of brain functions and new methods of evaluating cerebral blood flow allow more and more accurate estimates of brain viability. Human qualities of life are directly related to how much and which parts of the brain are viable and are indistinguishable from life itself. The decision to end life support should at present remain with the attending physician. New statutes concerning brain death imply that irrefutable technical evidence is readily available to diagnose brain death, that brain death is as valid a sign of death as any former criteria, and that in certain situtations brain death must be used to pronounce death. From the medical practitioner's viewpoint, we believe that a brain death law would rarely be useful and that community and national customs concerning heroic efforts would be sufficient. We do support a simple acknowledgement by statute that brain death may be a cause for determining death. The legal need for determining a precise time of death is understandable, but premature and restrictive definitions based on a rapidly evolving technology will create many problems.
我们已经介绍了七种具有代表性的脑死亡和部分死亡管理方式及其法律后果。脑功能测试的改进和评估脑血流量的新方法使得对脑存活能力的估计越来越准确。人的生活质量直接取决于大脑的存活部分及存活程度，与生命本身并无二致。目前，停止维持生命支持的决定权仍应掌握在主治医生手中。有关脑死亡的新法规意味着，诊断脑死亡的无可辩驳的技术证据已唾手可得，脑死亡与以往任何死亡标准一样是有效的死亡标志，并且在某些情况下必须依据脑死亡来宣告死亡。从医学从业者的角度来看，我们认为脑死亡法很少会有用，而且关于全力抢救的社会和国家习俗就足够了。我们确实支持通过法规简单认可脑死亡可能是判定死亡的一个原因。确定精确死亡时间的法律需求是可以理解的，但基于快速发展的技术而制定的过早且具有限制性的定义会引发诸多问题。
