The neurological determination of death: what does it really mean?

The recent Canadian forum's recommendations regarding "neurological determination of death" claim to have determined a "Canadian definition, criteria, and minimum testing requirements for neurological determination of death." In this review the problems with this statement are discussed. The criterion of neurological determination of death does not fulfill the definition of death, because there is continued integration of the organism as a whole. The tests for neurological determination of death do not fulfill the criterion of neurological determination of death because they do not show the irreversible loss of all critical brain functions. The forum has provided no coherent argument for why neurological determination of death should be considered death. I suggest that one cannot invoke expert opinion to clarify a criterion of death, and tests for this criterion of death, without a clear concept of what death is. The forum has clarified tests for what they call "neurological determination of death," but this is not death itself; rather, it is a neurologically devastating state. Whether this state of "neurological determination of death" is enough to justify the morality of harvesting organs prior to death is the real question. A potential solution to this question is discussed.     

The Whole-Brain Concept of Death Remains Optimum Public Policy

"Brain death," the determination of human death by showing the irreversible loss of all clinical functions of the brain, has become a worldwide practice. A biophilosophical account of brain death requires four sequential tasks: (1) agreeing on the paradigm of death, a set of preconditions that frame the discussion; (2) determining the definition of death by making explicit the consensual concept of death; (3) determining the criterion of death that proves the definition has been fulfilled by being both necessary and sufficient for death; and (4) determining the tests of death for physicians to employ at the patient's bedside to demonstrate that the criterion of death has been fulfilled. The best definition of death is "the cessation of functioning of the organism as a whole." The whole-brain criterion is the only criterion that is both necessary and sufficient for death. Brain death tests are used only in the unusual case in which a patient's ventilation is being supported. Brain death critics have identified weaknesses in its formulation. But despite its shortcomings, the whole-brain death formulation comprises a concept and public policy that make intuitive and practical sense and that has been well accepted by many societies.     

Numerous cortical tubers and rhabdomyomas in a case of sudden unexpected infant death

Sudden infant death syndrome is the leading cause of death in infants between the ages of 1 month to 1 year. Sudden infant death syndrome, a diagnosis of exclusion, can only be made after other explanations for unexpected death have been ruled out. Tuberous sclerosis complex is occasionally the findings in these patients with unexpected infant death. Here, we present a case of an unexpected infant death during sleep with multiple factors that confound the cause of death. We discuss these factors and attempt to delineate their contributions to arrive at a cause and mechanism of death.     

自愿适用脑死亡标准的法律设计

自愿适用脑死亡标准是指根据完全民事行为能力人的真实意思表示，尊重其意愿，对其适用脑死亡标准作为死亡判断标准。自愿适用脑死亡标准具有自愿性、科学性和复杂性。预立自愿适用脑死亡标准意思表示制度对自愿适用脑死亡标准有一定的制度意义。     

通过程序控制死刑

如何控制死刑问题已经成为中国亟待解决的重大现实课题。从各国的实践来看,控制死刑主要包括实体控制与程序控制两种路径。尽管通过宪法或者刑法可以对死刑控制起到立竿见影的效果,但是,通过实体控制死刑,存在难以克服的局限性。相比较而言,通过程序控制死刑,则具有明显的优势。在中国目前无法全面废除死刑而实体控制又存在较大难度的情况下,通过程序控制死刑应是明智之举。     

Is organ procurement causing the death of patients?

This article offers a philosophical foundation for the Uniform Determination of Death Act as it first examines death per se, and then examines brain death and the non-heart beating donor criteria for determining death. The author suggests that many of the debates over death can be bypassed by changing the terms of the debate: what matters is not whether death is a process or an event, but death as a state. Understanding death as a state allows us to determine death in a functional manner that is compatible with the needs of law and medicine. The second part examines objections that arise from ignoring or rejecting the distinction between killing and letting die and the principle of double effect. By clarifying the lines between life and death, on the one hand, and between intentionally killing and unintentionally hastening death, on the other, the author hopes to restore a sense that the proposals to drop the dead donor rule are radical recommendations to cross lines we have never crossed before.     

我国台湾地区死刑控制及其对大陆死刑改革的启示

本文从立法和司法两个方面分析了我国台湾地区死刑立法模式、死刑适用条件、死刑适用范围、死刑规定方式的控制以及死刑案件程序、死刑赦免、死刑执行的控制,还分析了我国台湾地区死刑立法控制和司法控制的理念。通过这两个方面的分析发现,台湾地区死刑控制与我国大陆死刑的改革方向不谋而合,即对已满75周岁的老年人犯罪绝对不适用死刑。此外,台湾地区死刑控制对我国大陆死刑改革也有一定的启示,即将死刑适用的具体条件限定为危害生命或健康的严重犯罪;废除绝对死刑;提高无期徒刑的假释门槛、新增重罪累犯不得假释的规定、延长死刑追诉权期限;增设死刑案件强制上诉制度,等等。     

当代中国死刑改革争议问题论要简

死刑改革是当代中国刑法改革过程中最受关注、最具现实意义且备受争议的重大问题。中国虽难以在短期内全面废止死刑,但却有必要将废止死刑纳入其政策内涵。在功利与人道之间,人道性应当成为我国死刑改革最主要的根据。我国应以无期徒刑作为死刑的立法替代措施,适时建立死刑赦免制度,公开死刑执行的数字,并于适当时机废止贪污罪受贿罪的死刑。     

Is there progress in the autopsy diagnosis of sudden unexpected death in adults?

Sudden death is now currently described as natural unexpected death occurring within 1h of new symptoms. Most studies on the subject focused on cardiac causes of death because most of the cases are related to cardiovascular disease, especially coronary artery disease. The incidence of sudden death varies largely as a function of coronary heart disease prevalence and is underestimated. Although cardiac causes are the leading cause of sudden death, the exact incidence of the other causes is not well established because in some countries, many sudden deaths are not autopsied. Many risk factors of sudden cardiac death are identified: age, gender, heredity factors such as malignant mutations, left ventricular hypertrophy and left ventricle function impairment. The role of the police surgeon in the investigation of sudden death is very important. This investigation requires the interrogation of witnesses and of the family members of the deceased. The interrogation of physicians of the rescue team who attempted resuscitation is also useful. Recent symptoms before death and past medical history must be searched. Other sudden deaths in the family must be noted. The distinction between sudden death at rest and during effort is very important because some lethal arrhythmia are triggered by catecholamines during stressful activity. The type of drugs taken by the deceased may indicate a particular disease linked with sudden death. Sudden death in the young always requires systematic forensic autopsy performed by at least one forensic pathologist. According to recent autopsy studies, coronary artery disease is still the major cause of death in people aged more than 35 years. Cardiomyopathies are more frequently encountered in people aged less than 35 years. The most frequent cardiomyopathy revealed by sudden death is now arrhythmogenic right ventricular cardiomyopathy also known simply as right ventricular cardiomyopathy (RVC). The postmortem diagnosis of cardiomyopathies is very important because the family of the deceased will need counseling and the first-degree relatives may undergo a possible screening to prevent other sudden deaths. In each case of sudden death, one important duty of the forensic pathologist is to inform the family of all autopsy results within 1 month after the autopsy. Most of the recent progress in autopsy diagnosis of sudden unexpected death in the adults comes from molecular biology, especially in case of sudden death without significant morphological anomalies. Searching mutations linked with functional cardiac pathology such as long-QT syndrome, Brugada syndrome or idiopathic ventricular fibrillation is now the best way in order to explain such sudden death. Moreover, new syndromes have been described by cardiologists, such as short-QT syndrome and revealed in some cases by a sudden death. Molecular biology is now needed when limits of morphological diagnosis have been reached.     

Circumstances and toxicological characteristics of deadly opiates poisoning

Facts of prehospital death of 109 heroin addicts are analysed and systematized. It is shown that examination of the corpse at the point of detection may provide information on the circumstances of death and its cause. Correlation between morphine concentration in the corpse tissues and circumstances of death is studied. It is found that information about the victim and facts of his/her death suggest cause of death and help in directions of post-mortem examination and choice of diagnostic procedures.     

Alternative to Brain Death

This article criticizes a range of assumptions that proponents of brain death usually share. It argues that one of the main contentions made in defense of brain death – that the brain is necessary for integrated functioning in a human organism – is mistaken. It then sketches an alternative account of human death that distinguishes between the biological death of a human organism and the death or ceasing to exist of a person.     

死刑案件公开审判问题研究

死刑案件审判的是最严重的刑事犯罪,公开审判是司法公正最重要的保证,死刑案件的公开审判对于维护司法公正、保障人权有极为重要的意义,受到国内外的广泛重视。本文解读联合国有关机构对死刑案件公开审判的要求,提出了公开审判在权利和义务层面的性质,分析了死刑案件公开审判要求的特殊性,介绍了国外在死刑案件公开审判方面的一些做法和存在的问题,分析了我国死刑案件公开审判的现状并提出了若干改革建议和实现的路径。     

An Unexpected Finding in SUDEP Involving a Child: Focal Myocardial Infarct Adjacent to Bundle of His

Sudden unexpected death in epilepsy (SUDEP) is a nontraumatic, nondrowning death of an individual with epilepsy in which an autopsy with appropriate ancillary studies does not identify a cause of death. The mechanism of death in SUDEP is unknown, but is thought to involve cardiac and/or respiratory mechanisms. Research in SUDEP is hindered by a lack of consensus regarding required components of a death investigation before a cause of death may be certified as SUDEP. Histopathologic examination of the cardiac conduction system is not routinely performed in SUDEP death investigations. We present a case of SUDEP where histopathologic examination of the cardiac conduction system revealed a focal myocardial infarct of the summit of the ventricular septum abutting the bundle of His, which potentially provides insight into the mechanism of SUDEP for this particular case, and suggests that routine examination of the cardiac conduction system in SUDEP may be beneficial.     

略论中国刑法中的死刑替代措施

死刑替代措施,是指基于限制死刑适用的目的,对于立法上特定性质的犯罪,司法中特殊情况下的罪犯,不适用死刑立即执行,而代之以其他刑罚处罚方法。死刑替代措施是限制死刑中不可或缺并被证明行之有效的方法。从完善既有方式、探索新的途径入手,死刑替代措施包括死刑缓期执行;严格的无期徒刑;附赔偿的长期自由刑三种。当前,有必要在立法上对刑罚体系作进一步调整、修改、完善,以全面体现死刑替代措施;在司法中,注意发挥死刑替代措施在限制死刑中的作用。     

脑死亡若干法律问题研究

脑死亡是刑法学中与人的生命保护界限密切相关的问题。脑死亡的新观念虽然面临挑战 ,但其科学合理性毋庸置疑。脑死亡的时间应当以全脑机能不可逆性丧失时为准。脑死亡的概念与判定标准 ,有必要在器官移植法中予以规定。     

冠心病猝死的法医病理学免疫组织化学研究进展

冠心病猝死(sudden coronary death,SCD)是各种猝死中最常见的原因,免疫组织化学技术(immuno-histochemistry,IHC)是近年来研究冠心病猝死的有效方法。本文根据国内外文献对冠心病猝死的法医病理学免疫组织化学研究进展作如下综述。     

死刑犯的权益保障

死刑问题是近年来刑法学界的热点之一.关于废除死刑还是保留死刑,这方面的论述颇多,尚无定论.学者们能够达成共识的是,我国目前还处于社会主义初级阶段,在当前的物质发展水平和公众观念的条件下,还不能废除死刑.因此,死刑在今后相当长的一段时间内仍将在我国存在.那么,对于可能被判处死刑的"准死刑犯"和已被判处死刑的"死刑犯"而言,如何最大程度地保障他们的合法权益,既是死刑犯及其家属们所切实关心的问题,也应当是刑法学者们密切关注的课题.     

从人权保护的视角考察宣告死亡制度

统摄现代法治社会的灵魂是人权,为失踪人设置的宣告死亡制度与人权保护紧密相关,人权的绝对性使宣告死亡的设置缺乏依据,而人权的相对性又使宣告死亡成为现代法治社会的良好制度,严格宣告死亡的条件,合理规定死亡的法律后果,使宣告死亡与人权保护相协调。     

心肌炎猝死案例的法医病理学研究

从法医尸检案例中取心肌炎猝死17例进行分析及病理学观察，对心肌炎的分关、心肌炎导致猝死机制进行探讨，认为诱发急性心力衰竭是心肌炎猝死的主要原因。