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Almostuniformlythroughouttheworld,precisestatutorycriteriafordeathdeterminationareincorporatedinlegislation. Most laws only mention the requirement that criteria are met and leave the practical aspects of determining criteria and describing methods for diagnosing death to the medical profession.
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In most institutions without donation after circulatory death (DCD) programs, process and procedures for cardiac death remain poorly defined and are largely at the discretion of individual physicians. The criteria may include the absence of heart beat (contraction), pulse (palpable circulation), blood pressure, heart electrical activity, and may include pulseless electrical activity as well as being unresponsive with absent breathing.
As organ donation follows death, the definition of death requires clarity and consistency in the definition, medical criteria and confounding conditions. While there are persisting variabilities in the process and procedures for brain death globally and within nations, the clinical criteria for the evaluation of absent brainstem function are rarely consistent.
Most international jurisdictions support a number of sound principles for the determination of death. These often include provisions that the determination should be made by one or more physicians who must have direct care responsibility for the proposed transplant recipient and who cannot participate in the transplant proceedings.
Although access to technology varies from country to country, and even hospital to hospital, medicine has advanced to the point that it is possible to support all vital organs (heart, lung, liver, kidney) using machines, or replace them through transplantation.
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