Jeremy Laurance: A case that should make doctors think again

In 30 years of medical reporting I have not come across a case like Tasleem Rafiq's. You hear of people recovering from a coma against medical expectations, or buried for hours in ice and snow where the cold preserves life.

But to come back from the dead, unharmed and with no sign of physical or brain injury, after all attempts at resuscitation in a major UK hospital have failed, is unprecedented.

What if Mrs Rafiq's family had not been present? Would she have been carted off to the morgue – and then the cemetery? David Mossop, senior emergency care consultant at the Royal Berkshire, said that would not have happened. "She would have been reassessed," he said.

But Tony Calland, chair of the British Medical Association's medical ethics committee, said it was not unheard of for a pathologist to start a post mortem "and then the patient swallows".

He added: "You are always going to get bizarre cases. You can't make policy on the basis of extreme exceptions. Death is like appendicitis – it is one of the easiest and most difficult conditions to diagnose. Medicine is an inexact science."

Maybe Mrs Rafiq had a heart beat all along but it was so faint as to be undetectable. Or maybe the protocol on determining death has to be rethought.

Whatever the explanation, the outcome was a relieved patient and a family that was overjoyed.

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