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China's Ministry of Health has completed draft criteria for determining brain death, a sign that the long-debated attempt to legally recognize brain death is moving forward in the world's most populous country.
Declining to give details, Huang Jiefu, the vice-minister of health, said the criteria were a result of "careful consideration of expertise and China's actual conditions'' and would be subject to further change before being finalized.
Leading experts from the Chinese Medical Association and the China Association of Physicians are also working on related technical standards and administrative procedures, which will form a foundation for the legislation.
Huang said that the introduction of the concept of brain death and the implementation of a law on brain death were of great significance in China.
"With these criteria, doctors will be able to halt ineffective treatment to reduce the unnecessary consumption of medical resources. Medical treatment through organ transplants will greatly benefit,'' said Huang.
"It also provides a way for some people to die with dignity,'' he added.
The official said the ministry was very serious and cautious in carrying out the work because "it involves human life and should be of supreme importance.''
Arguments for and against brain death legislation have raged for more than two decades in China, where death is traditionally and legally defined as "the cessation of respiration and blood circulation.''
The moment of most deaths is regarded as being when breathing stops and the heart stops beating.
However, some people who suffer from brain injuries, cerebral tumors or cerebral vascular illnesses may continue breathing and their hearts continue beating for some time. Life-support machines can maintain a body's heartbeat and breathing even when no electrical activity in the brain or reflexes can be detected.
Huang said the criteria for determining brain death are internationally accepted as comprising: The irreversible cessation of all functions of the entire brain, including the brainstem; loss of respiration; and a flat electro-encephalogram.
But most Chinese still find it hard to accept a person being pronounced dead while his or her heart is still beating and while breathing continues.
Those opposed to the legislation worry that the criteria for brain death could be abused in complicated conditions and where the standards of doctors vary in different places.
Even among China's medical circles, a leading supporter of the brain death legislation agreed that there was much work to do before the law could eventually be passed.
Huang said: "It is a complicated issue involving many medical, legal and ethical problems.''
Using other countries' practice as reference, Chinese experts have proposed the adoption of two standards to define death, namely brain death and cardiac death.
"People must have the right to choose, under circumstances of informed consent,'' Huang said.
He stressed that the ministry would pay great attention to the successful experience of other countries and the latest research results while finalizing the criteria. Strict diagnostic standards and procedures will be set, he added.
(China Daily August 29, 2002)
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