van Till--d'Aulnis de Bourouill H A
Am J Law Med. 1976 Summer;2(1):1-40.
In this Article, which draws primarily on continental West European views on death and dying, the author contends that the Harvard criteria for irreversible coma (1968) are not reliable for diagnosing death in comatose patients under resuscitation treatment. The Article suggests that use of the Harvard Criteria to diagnose death leaves such patients legally unprotected against surgical assaults such as organ removal and biomedical experiments while they still may be living and capable of perception, possibly including the perception of pain and the spoken word. An alternative to the Harvard Criteria--angiography--is offered, and several additional issues related to the definition and diagnosis of death are discussed. Finally, the author suggests that even prior to death, termination of resuscitation treatment of irreversibly comatose patients, though followed by death, should be lawful.
在本文中,作者主要借鉴了西欧大陆对死亡和临终的观点,认为哈佛不可逆昏迷标准(1968年)对于诊断接受复苏治疗的昏迷患者的死亡并不可靠。文章指出,使用哈佛标准诊断死亡会使这类患者在法律上得不到保护,无法免受诸如器官摘除和生物医学实验等外科侵犯,而此时他们可能仍活着且有感知能力,可能包括对疼痛和言语的感知。文中提供了一种替代哈佛标准的方法——血管造影,并讨论了与死亡定义和诊断相关的其他几个问题。最后,作者认为,即使在患者死亡之前,不可逆昏迷患者的复苏治疗终止(尽管随后会导致死亡)也应该是合法的。