1. What is the definition (legally and medically) of death?
Legal death is a legal pronouncement by a qualified person that further medical care is not appropriate and that a patient should be considered dead under the law.
Death is the permanent cessation of all biological functions that sustain a living organism. For example, brain death, as practiced in medical science, defines death as a point in time at which brain activity ceases.
2. How has the definition of death changed through the years and how does it vary across cultures?
Death was once defined as the cessation of a heartbeat and or breathing, but with CPR and defibrillation, these are now unreliable as heartbeat and breathing can sometimes be restarted. In the past, death also meant the loss of essential organs, but with advances in science, it is possible to sustain life even if the person has to heart, lungs or other organs.
Definitions of death have been greatly affected by religion, where it is treated as an interlude to another stage of existence. The concept of resurrection (Abrahmic religions), reincarnation (Dharmic religions), consciousness ceasing to exist (atheism) or and afterlife, commonly involving a "heaven" and "hell"
3. What are some criteria the medical community uses to determine if one is “brain dead”?
Brain Death is the absence of clinical brain function when the proximate cause is known and demonstrably irreversible.
Criteria includes:
a) Must be in Coma or unresponsive--no pain reflex
b)Absence of Brain stem reflexes eg: no response to light, no blinking, no coughing, no gagging reflex, cannot focus on one spot
c) No breathing--Apnea
4. Describe some difference between “persistent vegetative state” and “brain death”
Persistent Vegetative State means that the brain has at least a single function left alive, and can at least hold one reflex based on the criteria above. Brain death means there is completely no reflexes at all.
5. What are some of the ethical implications of these definitions of death? Provide some real-life examples
In the past, as death was inevitable when internal organs were missing, it was often that people of such victims would be proclaimed dead. However, with the recent advancements for blood transfusion and organ transplants, it allows for patients to survive. With this concept of 'escaping death', certain religions object to the use of blood transfusions due to the idea of impurity. This ethical issue has to do with the idea of either saving someone or letting them die in the name of the religion.
One current law implemented is that families/guardians have control over the life and death of a person within a persistent vegetative state. To put them out of pain, or to allow them to survive? This ethical issue deals with the concept of human suffering. Unlike normal death, a persistent vegetative state allows the body to function but not as fully as before. Families can decide to medically stop their heart, but the moral dilemma is of the "cruelty" and "immorality" behind it.
A current practice now is to use the bodies of those who are proclaimed deceased (usually brain dead) for medical practices. In several medical schools, bodies are used to practice surgery especially for the juniors. Families (or the deceased when he was alive) would have signed the documents, but it leads to the ethical issue of how the body is disposed/used after death. Many people view this as a defilement to the corpse, but for the scientific and medical advancement purposes, is it right to perform surgery on the dead?
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