Encephalic death, ethical, diagnostic, therapeutic aspects

Death has always been traditionally defined by the cessation of all organic functions, in particular breathing and cardiac automatism. Since the advent of advanced methods of resuscitation, allowing these activities to be resumed after suspension, as well as the artificial maintenance of ventilation and blood circulation through assisted ventilation and positive inotropic drugs, a more precise definition has become necessary. The outdated coma was first described in 1959 at Claude-Bernard Hospital by the infectiologist Pierre Mollaret and the neurologist Maurice Goulon. In 1967, an Ad-Hoc Committee on Brain Death was set up at Harvard. The meetings of this committee gave rise to a report, published one year later, exactly on 5 August 1968, which is considered to be at the origin of the transformation of medical practice at the end of life and organ transplants in almost all technically developed countries. The conclusion of this report was to consider brain-dead patients as dead people, after confirmation of the irreversibility of brain damage.