When is death considered death

I have been following this story for some time now.. A young girl is brain dead after a routine tonsillectomy but the hospital wants her off life support. They even took the family of the girl to court to see it happen. Now the doctors say she is brain dead, though she is responding to her mothers voice and touch........ As Jedi we know that all life is precious... but what state should a person be in to be declared dead or "Void of life"

Also thank that in some cases like this a machine is keeping the person alive

http://www.newser.com/story/180826/enough-this-girl-is-dead.html

Brain's seem to take a long time to heal; "“The natural history of a brain injury is very similar to the natural history of a bruise. Day two, day three, the bruise comes up. Day four, day five, the bruise goes down".

So I'd be waiting a long time to see if brain electrically activity restores, perhaps many months. It's an interesting topic which I havent explored because I'd already made my mind up on it :whistle:


So I had a look, and I 'do not like' the local definition for brain death;

Two appropriately qualified senior doctors perform separate tests at the bedside to determine whether the brain is working or not. These doctors check to see if the cranial nerves that pass through the brain stem and control all vital involuntary reflexes are working.
They will be looking to see if the person has any:
1. response to pain;
2. response to light by the pupil of each eye;
3. blinking response when each eye is touched;
4. eye movement or response to ice cold water when it is put into the ear canal,;
5. cough or gag (swallowing) reaction when the back of the throat is touched;
6. breathing when the person is disconnected from the ventilator .
For a person to be declared brain dead they must not show any response to each and every one of these tests.

.... and would argue against termination of life support given those tests alone. Since we know the conscious mind can switch off to heal (passing out, coma), why would not also the subconscious too. Seems barbaric to use such tests to determine something as important as life.

They further say if "a spinal injury, eye or facial injury will mean those nerves cannot be adequately tested. In this case, special x-rays are done to check if there is any blood flow to the brain.".

That is a big if, and here I think we get to see one way to test actual brain survivability, is blood flow is possible - swelling management and life support can address this in many (most?) cases.

Then we end up in the situation where their is no outward signs but good blood flow. I guess then they test for electrical activity within the brain, and consider an absence of such to be a sign of brain death, but they are discovering new things all the time;

A Melbourne hospital is trialling a new procedure that it says can save the lives of heart attack victims who have been clinically dead for up to an hour.

The Alfred Hospital is using portable CPR and heart-lung machines to continue chest compressions, while rapidly cooling the patient's body to prevent brain damage.

So yea, I'll stick with the opinion to support life if the brain is outwardly intact as long as its financially viable in the hope of recovery, but I'm not a medical professional and its just my personal opinion.

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Adder wrote: So I'd be waiting a long time to see if brain electrically activity restores, perhaps many months.

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...i couldn't help myself.

Since we know the conscious mind can switch off to heal (passing out, coma), why would not also the subconscious too.

Here, I might argue with you, solely on the basis of the fact that I don't think our subconscious (and the related bodily functions) have evolved quite to the same speed as our medical technology. If your body shuts down (i.e., coma) to heal, then there is the possibility you can survive the healing process in just about any time period, given a handful of considerations (i.e., not drowning or starving or being mauled by a bear).

However, if your body shuts down something as vital to your existence as breathing, I begin to question this as a rational move on the brain's part, simply because it may not know that we have the requisite technology to "fix" that long enough for you to heal. The ventilator is new, in terms of human existence, and I'm not sure that our brains have caught on quite yet. That's not to say that people on ventilators are beyond the aid of medical science at all--the opposite is often the case--just that, I'm not sure I'm willing to put stock in "cessation of breathing" as a "healing practice" natural to the body just yet.

...they are discovering new things all the time;

A Melbourne hospital is trialling a new procedure that it says can save the lives of heart attack victims who have been clinically dead for up to an hour.

The Alfred Hospital is using portable CPR and heart-lung machines to continue chest compressions, while rapidly cooling the patient's body to prevent brain damage.

WOAH. That is so cool! Absolutely brilliant, really.

So yea, I'll stick with the opinion to support life if the brain is outwardly intact as long as its financially viable in the hope of recovery, but I'm not a medical professional and its just my personal opinion.

I can accept and appreciate that, especially in line with these new findings, but I think I'll maintain my "quality of life" stance, because there just hasn't been enough extensive testing on the brain's ability to survive these things. I mean, it's kind of hard, ethically, to find a way to put it to the test, and even if we could, I'm not sure how much of what we can measure will be what's actually going on, y'know?

I can say but if I was the child I wouldn't want anyone to give up on me if there a chance. It is up to the family though. I was the one my mom asked to pull the plug if it came to that, It never did but I dreaded the thought of making that call.

This is to personal for a catch all rule. Let the caretaker decide if it comes to it.

rugadd wrote: This is to personal for a catch all rule. Let the caretaker decide if it comes to it.

and not the insurance companies.

The part of the brain that holds consciousness is mostly the frontal lobes. These are also very sensitive to oxygen deprivation. Once killed they will never come back to life ever ;however, other brain cells may regrow in their place ,but will never regain the functionality that they did before. Other parts of the brain such as the brain stem which control reflex motion are less sensitive to oxygen deprivation giving the illusion of brain still being alive ,but this is a knee jerk response stimulus.

Other thing to note, there are two kinds of dead, brain dead and cardiovascular death. You can come back from cardiovascular death you can not come back from brain death. Both are considered legally dead.

IMO keeping a brain dead person alive is irresponsible and ignorant. Keeping someone alive on machines costs an enoumous amount of time and resources that could be spent saving other people's lives. While it may be emotional hard to let go, you have to understand that there is no chance they are coming back and you are selfishly absorbing resources that could go to helping others.

Vesha wrote: You can come back from cardiovascular death you can not come back from brain death. Both are considered legally dead.

The problem is knowing if the brain is actually unable to recover, remembering they really are only now discovering how the brain really works;

'Miracle recovery' of teen declared brain dead by four doctors
A teenager who was declared brain dead by four doctors has made a "miracle" recovery after his parents asked for another medical opinion, just moments before his life support machine could have been switched off.
http://www.telegraph.co.uk/health/healthnews/9223408/Miracle-recovery-of-teen-declared-brain-dead-by-four-doctors.html

So (personally) I'd err on the side of allowing time for recovery.

I mean... imagine if your wrong and the brain can recover if supported through healing in specific methods... perhaps for example one day they discover that histone modification and DNA methylation in the neuron's could capture brain state while electrochemical activity was halted/reduced, allowing it to restart at a later date after healing and pick up where it left off before the damage was done..... since there does seem to be examples of brain's recovering function after a period of time. Of course many do not recover, but I find it strange to bridge the knowledge deficit by jumping onto the side of economics/statistics instead of patient care. Also, the knowledge deficit is not bridged by giving up, I'd rather people tried all things to save them within the capacity of persons estate and generosity of family.

http://journal.ics.ac.uk/pdf/1404324.pdf

The Daily mail is know for publishing accurate infomration. This scientific article address that article referencing it being the 6th reference. It also explains a lot about the subject incase anyone wants to read it.

Occasionally people can misunderstand a diagnosis ,but a properly done brain death diagnosis is almost %100 accurate.

Vesha wrote: http://journal.ics.ac.uk/pdf/1404324.pdf

The Daily mail is know for publishing accurate infomration. This scientific article address that article referencing it being the 6th reference. It also explains a lot about the subject incase anyone wants to read it.

I think that is a professional journal and not a scientific journal, and written by a Nurse who has to enact such decisions. Also my link was to the Telegraph, not the Daily Mail.

I can completely understand the need for the medical institution to defend its practises, its vital that the patients, family and community have trust in it, and I'm sure 99% have the best interests of the patient at heart but they are bound to operate within the body of scientifically accepted knowledge. They do not have all the answers, and often the best course of action is beyond that body of knowledge, and therefore even occasionally counter productive to the health of the patient - its just a consequence of using a legislated system, which is of course required for it to be accountable and effective within its capabilities.

Vesha wrote: Occasionally people can misunderstand a diagnosis ,but a properly done brain death diagnosis is almost %100 accurate.

How would anyone know 100% have been irrecoverable? It seems simply impossible to know because the deceased where not given that chance to recover.

I think the patients family should be able to take them away and take over care-giving responsibilities if able to afford it, and hospitals should not try and push them to process as 'deceased' to make way for other patients or to farm the organs.