Table 1 Comparison of the Declaration of Sydney and Harvard Committee's report on human death.

Issues to compare		Declaration of Sydney		Harvard Committee report
Reasons for a new definition of death		a) “The ability to maintain by artificial means the circulation …”		a) Improvement in resuscitative and supportive measures … the result is an individual whose heart continues to beat but whose brain is irreversibly damaged
		b) “The use of cadaver organs such as heart or kidneys for transplantation”		b) Obsolete criteria for the definition of death can lead to controversy in obtaining organs for transplantation
Concept of death		Although it does not provide a definition of brain death, it goes further, stating that death lies not in the state of preservation of isolated cells but in the fate of a person		The Committee mentioned that their primary purpose was to define irreversible coma as a new criterion for death; a clear concept of death was not provided
Use of the term brain death		Not used		Although the term brain death was discussed, the Committee recommended “irreversible coma”
Clinical criteria		Defended clinical judgment, but did not provide clinical criteria		Clinical criteria provided for diagnosis of brain death
Ancillary tests		Proposed use of EEG		Proposed use of EEG. One year later stated that EEG was not essential for diagnosis of brain death
Termination of resuscitation and respirator		Determination of death of the person makes it ethically permissible to cease attempts to resuscitate		Stated that declaration of death should be made first, followed by decision to turn off the respirator
Diagnosis of death and transplantation		Diagnosis of death should be made by two or more physicians not involved in transplantation		The declaration of death should be made by physicians not involved in transplantation procedures
Legal issues		In countries where the law permits it, removal of organs from the cadaver was allowed		Emphasised that the USA legal system was very much in need of following the kind of analysis and recommendations for medical procedures in cases of irreversible brain damage as suggested by the Harvard Committee