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Complexity of defining death: organismal death does not mean the cessation of all biological life

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  • i I use this term for convenience, while agreeing with the authors’ clarification that patients who satisfy the standard diagnostic tests for brain death can retain some hypothalamic function (p 10). I believe that the persistence of some hypothalamic regulation of sodium and osmolarity is compatible with my own rationale for the validity of the neurological standard of death.

  • ii Despite its shortcomings, I use this term for the sake of convenience to refer to what remains of a human organism (or of what used to be a human organism) after brain death.

  • iii I make no claims regarding the sufficiency or reliability of current diagnostic tests for brain death. Particularly in light of the recent story of Jahi McMath, I am inclined to think that, at least when dealing with juvenile cases, standard diagnostic protocols may be insufficiently rigorous.

  • iv Here I use the word ‘brain’ as shorthand for the entire central nervous system.

  • v For more details on the differences between brain-mediated integration and the mere coordination of cells and tissues independent of the brain, see Condic,2 p 13ss.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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