Clinical Death - Clinical Death and The Determination of Death

Clinical Death and The Determination of Death

Death was historically believed to be an event that coincided with the onset of clinical death. It is now understood that death is a series of physical events, not a single one, and determination of permanent death is dependent on other factors beyond simple cessation of breathing and heartbeat.

If clinical death occurs unexpectedly, it will be treated as a medical emergency. CPR will be initiated. In a United States hospital, a Code Blue will be declared and Advanced Cardiac Life Support procedures used to attempt to restart a normal heartbeat. This effort will continue until either the heart is restarted, or a physician determines that continued efforts are useless and recovery is impossible. If this determination is made, the physician will pronounce legal death and resuscitation efforts will stop.

If clinical death is expected due to terminal illness or withdrawal of supportive care, often a Do Not Resuscitate (DNR) or "no code" order will be in place. This means that no resuscitation efforts will be made, and a physician or nurse may pronounce legal death at the onset of clinical death.

A patient with working heart and lungs who is determined to be brain dead can be pronounced legally dead without clinical death occurring. However, some courts have been reluctant to impose such a determination over the religious objections of family members, such as in the Jesse Koochin case. Similar issues were also raised by the case of Mordechai Dov Brody, but the child died before a court could resolve the matter.