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Article
June 10, 1968

WHEN IS A PATIENT DEAD?

JAMA. 1968;204(11):1000. doi:10.1001/jama.1968.03140240056019
Abstract

The medical, moral, and philosophical dilemma presented by modern medical technology in sustaining "life" has received and will continue to receive considerable attention in the medical and lay press. A recent communication by Kimura et al in the Archives of Internal Medicine,1 reflects the interest in the use of electroencephalography for the possible evaluation of cerebral death.

An iso-electric electroencephalogram, if sustained for a matter of hours, is highly suggestive of cerebral death. The criteria recently introduced by Rosoff and Schwab2 in establishing irreversible brain function consist of the combination of a "flat" EEG, absent spontaneous respiration, and absent reflexes of any type, all coexisting for a 24-hour period. The term "flat EEG" is obscure. The record may not be iso-electric if merely low gain is used, but maximal amplification should elucidate whether or not a record is truly iso-electric.

For the human brain a revival time between

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