Before the middle of the twentieth century there was no major dispute about the criteria for death. In the nineteenth century several isolated cases of premature burial from around the world raised some alarm, and safeguards (e.g., coffins equipped with alarms) were established to minimize the possibility of that practice. However, concern about the accuracy of diagnosing death largely abated by the turn of the twentieth century.
Beginning with the advent of more effective artificial respirators in the 1940s, major technological breakthroughs in modern medicine raised serious questions about the traditional ways of diagnosing death. Before the widespread use of respirators, defibrillators, intensive-care units, and cardiopulmonary resuscitation failures of cardiac, respiratory, and neurological functions were closely linked. When one system failed, the other two inevitably failed as well. However, respirators and other advanced life-support systems can sustain cardiac, respiratory, and other autonomic functions for prolonged periods even after neurological functions have ceased.
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