To the Editor.—
As the "Guidelines for the Determination of Death" (1981;246:2184) point out, the co-authors do not agree on every detail but do agree on the principles outlined. For instance, valid protocols for apnea testing may vary, but it is generally accepted that a patient who is not apneic is not fully brain-dead. Conversely, some may justifiably argue that the guidelines protocol for apnea testing should contain precautions for patients who have ventilation-perfusion defects or who have had chronic hypercapnea. Others may justifiably argue that apnea testing is unnecessary for the determination of brain death. Nevertheless, the guidelines will still serve a useful purpose for clinicians.We regret that the guidelines are an appendix to the President's Commission's report. The commission was chartered by Congress to study "the ethical and legal implications of... the matter of defining death, including the advisability of developing a uniform definition of death."1
Burroughs JT, Furlow TG. Guidelines for the Determination of Death. JAMA. 1982;247(5):582–583. doi:10.1001/jama.1982.03320300012008
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