Brain death is understood to occur when the brain is completely and irreversibly destroyed, ceasing all its activity. Therefore, vital functions such as breathing, blood circulation or heartbeat disappear. Now, artificially, even if the brain does not function, the organs can continue to function if that person is connected to a respirator and other support systems. But it is not possible to breathe without this assistance, there is no response of the pupil to light, there is no response to painful stimuli and the blood flow to the brain is interrupted so there is no possibility of recovery of brain function. The patient is dead even though he is still breathing connected to a respirator.
In reality, this concept of brain or brain death appeared when advances in intensive care medicine and progress made in organ transplant surgery made it necessary to clearly define when a person is dead and, therefore, although the concept of death It is something obvious, however the difficulty in defining it has increased. Until 1981, criteria were not established to define brain death, when the so-called Harvard report replaced the concept of irreversible coma with that of brain or brain death in order to try to clearly establish the death criteria for using organs for transplant. The reality is that, until then, the diagnosis of death was based on the absence of a heartbeat (asystole), absence of breathing (apnea) and, consequently, interruption of blood circulation and oxygenation of all the tissues of the body. What was established in 1981 was that it is the brain when it stops working, and not the heart, that defines the end of life.
From the above it can be deduced that in reality brain death is real death and that although a brain dead person can continue breathing and their blood circulating for some time, a short time in reality, this is only possible when they are connected to a respirator. The moment that respirator is disconnected, oxygen stops reaching the organs and actual death would occur, although in reality that person was already dead. Thus, brain death was recognized as the death of the individual in our country in 1993 by the Spanish Society of Neurology and this equivalence of brain death as real death is what is currently considered.
María Elisa Calle PurónShe is a doctor specializing in epidemiology, preventive medicine and public health.
Question sent via email byPaula García Pásaro
Coordination and writing:Victoria Toro.
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