Editing Clinical death (section)

==Determination==
Death was historically believed to be an event that coincided with the onset of clinical death. It is now understood that death is a series of physical events, not a single one, and determination of permanent death is dependent on other factors beyond simple cessation of breathing and heartbeat.<ref name="Crippen"/>

Clinical death that occurs unexpectedly is treated as a medical emergency. [[cardiopulmonary resuscitation|CPR]] is initiated. In a United States hospital, a [[hospital emergency codes|Code Blue]] is declared and [[Advanced Cardiac Life Support]] procedures used to attempt to restart a normal heartbeat. This effort continues until either the heart is restarted, or a physician determines that continued efforts are useless and recovery is impossible. If this determination is made, the physician pronounces [[legal death]] and resuscitation efforts stop.

If clinical death is expected due to terminal illness or withdrawal of supportive care, often a [[do not resuscitate|Do Not Resuscitate]] (DNR) or "no code" order is in place. This means that no resuscitation efforts are made, and a physician or nurse may pronounce [[legal death]] at the onset of clinical death.{{Citation needed|date=May 2010}}

A patient with working heart and lungs who is determined to be [[brain death|brain dead]] can be pronounced [[legal death|legally dead]] without clinical death occurring.  However, some courts have been reluctant to impose such a determination over the religious objections of family members, such as in the [[Jesse Koochin]] case.<ref>Appel, JM. Defining Death:  When Physicians and Families Differ" ''Journal of Medical Ethics'' Fall 2005</ref>  Similar issues were also raised by the case of Mordechai Dov Brody, but the child died before a court could resolve the matter.<ref>
{{cite news
|url=https://www.usatoday.com/news/nation/2008-11-16-braindead-death_N.htm
|title=Brain-dead NYC boy at center of care controversy dies – USAToday.com
|publisher=usatoday.com
|access-date=November 17, 2008
| date=16 November 2008
}}
</ref>
Conversely, in the case of [[Death of Marlise Muñoz|Marlise Muñoz]], a hospital refused to remove a brain dead woman from life support machines for nearly two months, despite her husband's requests, because she was [[pregnant]].<ref name=cnn2014>{{cite news|title=Texas judge: Remove brain-dead woman from ventilator, other machines|url=http://www.cnn.com/2014/01/24/health/pregnant-brain-dead-woman-texas/|publisher=CNN|date=January 24, 2014}}</ref>