[A new formulation of death: definition, criteria and diagnostic tests].

OBJECTIVE

To present a new formulation of human death based on neurological considerations.

DEVELOPMENT

One of the reasons there is still controversy over a new formulation of human death which is acceptable to society, is that many authors do not suitably integrate three fundamental aspects which should be included in such a formulation: definition, criteria and diagnostic tests. We review the physiopathological mechanisms for generation of consciousness and discuss the three fundamental criteria presented by different authors in recent decades: the whole encephalum, brainstem death and neocortical criteria. We conclude that there are major contradictions in the three criteria with regard to satisfactory integration of the elements, definition, criteria and diagnostic tests. We therefore present a new formulation of human death.

DEFINITION

irreversible loss of consciousness, since this gives the essential human attributes, and is the most integrating function of the organism.

CRITERIA

cortico-subcortical connections for the generation of both components of consciousness (capacity and content).

DIAGNOSTIC TESTS

no waking response to stimuli (capacity), no cognitive nor affective functions (content).

CONCLUSIONS

We present a new formulation of human death on a neurological basis which permits satisfactory integration of the three fundamental elements, definition, criteria and diagnostic tests, and so offers a suitable starting point from which man may start to understand death.