What is Death? (6): Is Brain Dead Dead Enough?
As you can tell by the now 6 different threads on "What is Death" ( 1, 2, 3, 4, 5)there is much to write about the topic from poetry to deep philosophic analysis. One of the currently more controversial topics deals with the concept of "brain death" or in other words "death by neurologic criteria" that entered the medical and social terminology back in 1968 and has been nurtured since then on the basis that the concept from an ethical and legal perspective allows the removal of organs from a person who is not "dead" based on the classic cardio-pulmonary criteria.
Contributing to the discussion has been the recent publication of the white paper of the President's Council on Bioethics as it deals with controversies in the determination of death, when and for what reasons a person can be considered dead. D. Alan Shewmon, writing an article "Brain Death: Can It be Resuscitated?" in the March-April 2009 issue of The Hastings Center Report takes on the white paper from both the points of view as to what it was attempting to accomplish and how it was presented but also the paper's confusing conclusions. For those interested in a kind of Philosophy 101 explanation of the issues regarding death and specifically brain death, you can have free access to the Hastings article (after registering) by clicking this link.
Come back and let us all know your view of death and whether creating the concept that a person is dead if the person is declared brain dead by the established neurologic criteria to facilitate the procurement of needed vital organs for transplant was the right thing to do. ..Maurice.
posted by Maurice Bernstein, M.D. @ 5:56:00 PM
2 comments
2 Comments:
I am pleased to have a blog like this that talks about death. Death being a natural event can finally be beaten. What I am going to write about is purely Biblical. There is a Law that brings an end to man's relentless enemy death. The Holy One of Israel promised a Law in Isaiah 51:4 that brings an end to death. The same Law was prophesied in Isaiah 2:3, and the bearer of this Law was talked about in Isaiah 42. There is a Law that brings an end to all evils done beneath the sun and eventual eviction of death from the surface of earth. The Law is a simple basic instruction and death is completely out of earth.
Eric Kwame Sakyiama
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Amanda wrote today the following to my now inactive "Bioethics Discussion Pages" but I find it pertinent to the topic presented on this thread, particularly from a tech who has had to unfortunate experiences to view the EEGs of probably brain dead patients. ..Maurice.
I am an EEG technician. I 100% believe that brain death is "dead enough." Once the brain is gone, your life is gone. What is a beating heart without a brain? That is why so many hospitals now across the world are "making" patients with brain injuries hypothermic. By doing so, this preserves any brain tissue to survive that has not already been damaged. They do this because they know that the body is nothing without a working brain. I certainly feel sorry for the families and patients (at any age) when I go into a room, hook the patient up, and see that their chance for life is simply gone. I know it is a hard pill to swallow. I do know, if it were my family or child and they had tests done to confirm a brain death, I would simply let them go. In all actuality, they have already left. It is also hard for families to believe that one might be brain dead because of seizures or convulsions that the patient is experiencing in this state. The family might see any eye move, blink, open, or a hand twitch, move, or jump...but that is their brain firing off signals to make their body do so. I know what you're thinking..."If their brain is dead, how is it firing off signals to tell the body what to do." And it's not really telling the body what to do, it's just a reaction from a convulsing brain. Bursts of suppression are often mixed with straight "flat lines" on an EEG recording. That means, along with the brain being "dead", it has bursts of seizure activity. If you were to give this patient anti-convulsants to stop the bursts/seizing, then the reading on an EEG machine would simply be "flat lined" because the seizing stopped, but the brain is still dead.
I'm a DNR myself and I'm 33 years old. I have seen what people go through and I know (along with every single one of my family members) that I do not want any efforts done to try to save my life. When it's your time, it is your time. That is my opinion. I'm sure many would disagree. Just know that the brain controls the whole body; THE ENTIRE BODY. If you are told a loved one is brain dead, 10/10 times I can assure you they have passed. It is then up to you to decide their wish from that point.
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