[ExI] When Is Dead Really Dead?

[citta437 at aol.com]

"Pro/con ethics debate: when is dead really dead?

Whetstine L, Streat S, Darwin M, Crippen D.

Health Care Ethics Center, Duquesne University, Pittsburgh, PA 15282, 
USA. lwhets6623 at aol.com

Contemporary intensive care unit (ICU) medicine has complicated the 
issue of what constitutes death in a life support environment. Not only 
is the distinction between sapient life and prolongation of vital signs 
blurred but the concept of death itself has been made more complex. The 
demand for organs to facilitate transplantation promotes a strong 
incentive to define clinical death in a manner that most effectively 
supplies that demand. We consider the problem of defining death in the 
ICU as a function of viable organ availability for transplantation.

PMID: 16356234 [PubMed - indexed for MEDLINE]
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I was a registered nurse working in ICU in a private {Catholic} 
hospital where death is determined by irreversibility of consciousness 
after all the organ system stopped functioning not on the availability 
of organ transplant at the time.

A patient on life support may no longer have brain function as shown by 
the brain monitor. When the relatives/guardian and the attending doctor 
agree on discontinuing the life support machines after the heart or the 
brain both failed to function then our culture ethically consider the 
patient is clinically dead.

The standard procedure in most hospital consider the physical 
manifestation of death are rigor mortis, no heart beat and loss of 
breathing function along with the objective assessment of the medical 
team.

On another note, some patients who are waiting for organ transplant 
i.e. kidney transplant are still conscious and have their vital signs 
stable are considered good candidates for kidney transplant. In some 
cases the younger and wealthier the patient, their chances are better 
than the aged whose brain function have deteriorated and cannot have 
any brain transplant. The cost of an ICU stay is astronomical but that 
is not a factor.

BTW, has anyone heard about Israel prime minister, Ariel Sharon, who 
has been on coma for how long? Why is he kept on life support for so 
long because he is a head of state?

Terry