Death

Abstract

The obvious place to begin our inquiry is with an examination of the concept of death. As it happens, in recent years there has been considerable discussion in medical and legal circles about the definition of death.¹ Of course, physicians have always been concerned with the matter of a reliable sign of death. However, until recently their chief concern was the prevention of premature burial. Today the question has acquired urgency because of a number of advances in medical science, particularly in the technology of artificial life-support systems and in the techniques of organ transplantation. These life-support systems can artificially sustain functions like heart beat, the absence of which was formerly taken to be evidence of death. A patient’s heart can still be beating with the aid of a respirator though a flat EEG reading indicates “brain-death”. Should the respirator be turned off, given that the “brain-dead” patient is making economic demands on scarce hospital resources and huge psychological demands on relatives? Moreover, if the patient possesses functioning organs that can be donated for transplantation purposes then the question of the significance and definition of death is further complicated. The sooner the organs are removed from the body after somatic death (i.e. the extinction of personality), the better the chance of the graft taking. Hence deciding when the patient is dead becomes extremely important since the organs must be “alive” to be valuable while, of course, the donor must be “dead” in order that they can be removed. These ethical problems in turn also pose legal difficulties.