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Neuropathological studies have showed that damage to the brainstem was critical for brain death. These findings initiated the concept of "brainstem death" and led UK physicians to define brain death as complete, irreversible loss of brainstem function: "if the brainstem is dead, the brain is dead, and if the brain is dead, the person is dead".
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The brain-centered definition of death has a whole brain, brainstem and neocortical formulation. At present, only the two former concepts have an accepted medical basis. According to the consciousness- or personhood-centered neocortical definition of death, patients in a vegetative state are considered alive.
Death is regarded as the continuous event (linguistically it can be understood only as an event) that separates the continuous process of dying from the subsequent disintegration.
Brain death signifies death not because it is invariably imminently followed by asystole, but because it is accompanied by irreversible loss of critical cerebral functions. The concept of brain death as irreversible loss of the capacity of the organism to function as a whole that results from the permanent loss of its critical system is invalidated by the time lag between the diagnosis of brain death and cardiac arrest.
The whole brain formulation requires the bedside demonstration of irreversible cessation of all clinical functions of the brain, and is the most widely accepted.
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