South African Guidelines on the Determination of Death

D Thomson, I Joubert, K De Vasconsellos, F Paruk, S Mokogong, R Mathivha, M McCulloch, B Morrow, D Baker, B Roussouw, N Mdladla, G A Richards, B Levy, I Coetzee, M Spruyt, N Ahmed, D Gopalan


Death is a medical occurrence that has social, legal, religious and cultural consequences requiring common clinical standards for its diagnosis and legal regulation.


The following document compiled by the Critical Care Society of Southern Africa outlines the core standards for determination of death in the hospital context. It aligns with the latest evidence-based research and international guidelines and is applicable to the South African context and legal system.


The aim is to provide clear medical standards for health care providers to follow in the determination of death, thereby promoting safe practices and high-quality care through the use of uniform standards. Adherence to such guidelines will provide assurance to medical staff, patients, their families and the South African public that the determination of death is always undertaken with diligence, integrity, respect and compassion, and is in accordance with accepted medical standards and latest scientific evidence.


The consensus guidelines were compiled using the AGREE II checklist with an 18-member expert panel participating in a three round modified Delphi process. Checklists and advice sheets were created to assist with application of these guidelines in the clinical environment.

Authors' affiliations

D Thomson, University of Cape Town

I Joubert, University of Cape Town

K De Vasconsellos, University of KwaZulu-Natal School of Health Sciences

F Paruk, University of Pretoria

S Mokogong, University of Pretoria

R Mathivha, University of the Witwatersrand

M McCulloch, University of Cape Town

B Morrow, University of Cape Town

D Baker, Walter Sisulu University

B Roussouw, University of Cape Town

N Mdladla, Sefako Makgatho Health Sciences University

G A Richards, University of the Witwatersrand Faculty of Health Sciences

B Levy, Netcare Rosebank Hospital

I Coetzee, University of Pretoria

M Spruyt, Busamed Bram Fischer International Airport Hospital

N Ahmed, Stellenbosch University Faculty of Medicine and Health Sciences

D Gopalan, University of KwaZulu-Natal College of Health Sciences

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Cite this article

Southern African Journal of Critical Care 2021;37(1b):41-54. DOI:10.7196/SAJCC.2021.v37i1b.466

Article History

Date submitted: 2021-04-06
Date published: 2021-04-06

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