Læknablaðið : fylgirit - 01.09.1977, Blaðsíða 20

Læknablaðið : fylgirit - 01.09.1977, Blaðsíða 20
 ¦í^^^k,^,..*..•: v~>;.--*- v-;.--^:--.- >S'*"* 'l^*****?':- .-*¦** • « ¦ 14 STATEMENT ON DEATH DECL.ARATION OF SIDNEY Adopted by the 22nd World Medical Assembly, Sidney, Australia, August 1968. The determination of the time of death is in most countries the legal responsibility of the physician and should remain so. Usually he will be able without special assistance to decide that a person is dead, employing the classical criteria known to all physicians. Two modern practices in medicine, however, have made it neces- sary to study the question of the time of death further:(l) the ability to maintain by artificial means the circulation of oxyge- nated blood through tissues of the body wich may have been irre- versibly injured and (2) the use of cadaver organs such as heart or kidneys for transplantation. A complication is that death is a gradual process at the cel- lular level with tissues varying in their ability to withstand deprivation of oxygen. But clinical interest lies not in the state of preservation of isolated cells but in the fate of a per- son. Here the point of death of the different cells and organs is not so important as the certainty that the process has become irreversible by whatever techniques of resuscitation that may be employed. This determination will be based on clinical judgement supple- mented if necessary by a number of diagnostic aids of which the electrœncephalograph is currently the most helpful. However, no single technological criterion is entirely satisfactory in the present state of medicine nor can any one technological procedure be substituted for.the overall judgement of the physician. If transplantation of an organ is involved, the decision that death exists should be made by two or more physicians and the physi- cians determining the moment of death should in no way be imme- diately concerned with performance of transplantation. Determination of the point of death of the person makes it ethically permissible to cease attempts at resuscitation and in countries where the law permits, to remove organs from the cada- ver provided that prevailing legal requirements of consent have been fulfilled.


Læknablaðið : fylgirit

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