Medical experts in central China's Hubei Province have officially announced the first case of brain death, an indication that cardiac function is no longer the sole criterion in determining death.
China has accepted brain death as a new criterion for determining death, said Zhang Suming, director of the Cerebral Surgery Department at Tongji Hospital in Hubei Province.
The hospital received a male patient suffering from a cerebral hemorrhage on March 23. Despite the doctors' efforts, the 61-year-old patient, Mao Jinsheng, fell into a profound coma. Several days later, he lost his respiratory capacity and ceased responding to stimuli. He lost all life functions with the exception of his heartbeat.
Based on brain death tests, neurosurgeons confirmed that the patient had a flat electroencephalogram (EEG) indicating a lack of cerebral and brainstem activity. The diagnosis resulted in the patient being pronounced "brain dead".
The hospital's actions have created a new chapter in Chinese medical practice, creating the necessity for a special law in this regard.
At present, the heartbeat is the current sole authorized criterion to determine death. The medical term for this is "cardiac death".
Artificial respirators and related techniques can maintain the functioning of the heart, lungs and vital organs for a period of time after the brainstem has stopped functioning.
The concept of brain death was first raised by scientists at Harvard University in 1968. Since then, more than 80 countries and regions have adopted the standard, along with the corresponding legislation.
A number of medical experts on the Chinese mainland have proposed that the cessation of brain function should become another criterion for determining death. They consider it a waste of time and money to save a patient with no brain and brainstem function.
If breathing and heartbeat are maintained by machines, a brain dead person may appear to be alive. A heartbeat is seen on a monitor. However, if there is no cerebral activity, the person is dead, said a Chinese neurosurgeon.
China currently has no legislation to justify this practice, said Zhang Yuhai, a senior doctor with the Beijing-based Friendship Hospital.
Following several rounds of wide-ranging debates, two national meetings have been held on brain death. The ministry of Health has revised the standard on the diagnosis of brain death on six occasions.
The adoption of the new concept will save valuable medical resources and free the patients' families from unnecessary expenses, said Chen Zhonghua, a leading professor with the Tongji Hospital.
(Xinhua News Agency April 16, 2003)
