Læknablaðið : fylgirit - 01.09.1977, Blaðsíða 20

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 modem practices in medicine, hcwever, have made it neces-
sary to study the question of the time of death further:(1) 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 canplication 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 techmques 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
electroencephalograph 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 mcment of death should in no way be innme-
diately concemed 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.