Version 1968
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September 1958
GA
DECIARATION OF SYDNEY
A STATE!v1ENT ON DEATH
17.B/68
original: English
Adopted by the 22nd world Medical Assembly
August 1968
The determination of the time of death is in most countries the
legal responsibility of the physician and should remain so. Usual-
ly he will be able without special assistance to decide that a
person is dead, employing the classical criteria known to all
physicians.
Two modern practices in medicine, however, have made it necessary
to study the question of the time of death further: (1) the
abilityiD maintain by artificial means the circulation of oxygenatec
blood through tissues of the body which may have been irreversibly
injured and (2) the use of cadaver organs such as heart or kidneys
for transplantation.
A complication is that death is a gradual process at the cellular
level with tissues varying in their ability to withstand depriva-
tion of oxygen. But clinical interest lies not in the state of
preservation of isolated cells but in the fate of a person. Here
the point of death of the different cells and organs is not so
important as the certainty that the process has become irreversible
by whatever techniques of resuscitation that may be employed.
This determination will be based on clinical judgement supplemented
if necessary by a number of diagnostic aids of which the electro-
encephalograph is currently the most helpful. However, no single
technological criterion is entirely satisfactory in the present
state of medicine nor can any one technological procedure be sub-
stituted for the overall judgement of the physician. If trans-
plantation of an organ is involved, the decision that death exists
should be made by two or more physicians and the physicians deter-
mining’ the moment of death should in no way be immediately concerned·
with performance of transplantation.
Determination of the point of death of the person makes it ethical-
ly permissible to cease attempts at resuscitation and in countries
where the law permits, to remove organs from the cadaver provided
that prevailing legal requirements of consent have been fulfilled.
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