Death

Death is the cessation of physical life in a living organism or the state of the organism after that event. In almost all societies, death has one or several symbols associated with it. Common symbols of death in Western cultures include the grim reaper and the color black; conversely, in certain Eastern cultures, the color white is considered symbolic of death. The grave is a metonym for death.

Human death: definitions and significance

By far the most important sort of death to human beings is human death. Thinking about human death raises a number of questions, but not many satisfactory answers.

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First, how can we identify the exact moment at which death has occurred? This seems important, because identifying that moment would allow us to put the correct time on death certificates, make sure that the deceased's will is enacted only after the deceased is truly deceased, and, in general, guide us in emotional behavior regarding death. In particular, identifying the moment of death is important in cases of transplantation, as organs must be harvested as quickly as possible after death.

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Historically, attempts to define the exact moment of death have been problematic. Death was once defined as the cessation of heartbeat (cardiac arrest) and of breathing, for example, but the development of CPR and early defibrillation posed a challenge: either the definition of death was incorrect, or techniques had been discovered that really allowed one to reverse death (because, in some cases, breathing and heartbeat can be restarted). Generally, the first option was chosen. (Today this definition of death is known as "clinical death".)

Related Topics:
Heart - Cardiac arrest - Breathing - CPR - Defibrillation

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Today, where a definition of the moment of death is required, we usually turn to "brain death" or "biological death": people are considered dead when the electrical activity in their brain ceases (cf. persistent vegetative state). It is presumed that a stoppage of electrical activity indicates the end of consciousness.

Related Topics:
Brain death - Persistent vegetative state - Consciousness

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Brain activity is a necessary condition to legal personhood, and, perhaps with the exception of the fetus, it is a sufficient condition for legal personhood. "It appears that once brain death has been determined … no criminal or civil liability will result from disconnecting the life-support devices." Dority v. Superior Court of San Bernardino County, 193 Cal.Rptr. 288, 291 (1983)

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However, those maintaining that only the neo-cortex of the brain is necessary for consciousness sometimes argue that only electrical activity there should be considered when defining death. In most places the more conservative definition of death (cessation of electrical activity in the whole brain, as opposed to just in the neo-cortex) has been adopted (for example the Uniform Determination Of Death Act in the United States). The recent case of Terri Schiavo brought the question of brain-death and artificial sustainment to the front of American politics. However, in all cases the common cause of death is anoxia.

Related Topics:
Neo-cortex - Uniform Determination Of Death Act - United States - Terri Schiavo - Anoxia

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Even in these cases, the determination of death can be difficult. EEGs can detect spurious electrical impulses when none exists, while there have been cases in which electrical activity in a living brain has been too low for EEGs to detect. Because of this, hospitals often have elaborate protocols for determining death involving EEGs at widely separated intervals.

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Medical history contains many anecdotal references to people being declared dead by physicians and coming back to life, sometimes days later in their own coffin or when embalming procedures are about to get underway. Stories of people actually being buried alive (which must assume embalming has not occurred) led at least one inventor in the early 20th century to design an alarm system that could be activated from within the coffin.

Related Topics:
Embalming - 20th century

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Because of the difficulties in determining death, under most emergency protocols, a first responder is not authorized to pronounce a patient dead; some EMT training manuals, for example, specifically state that a person is not to be assumed dead unless there are clear and obvious indications that death has occurred, such as mortal decapitation, rigor mortis (the stiffening of the body), dependent lividity (blood pooling in the lowest part of the body), decomposition, or incineration. If there is any possibility of life and in the absence of a do not resuscitate order, emergency workers must begin rescue and not end it until a patient has been brought to a hospital to be examined by a physician. This frequently leads to situation of a patient being pronounced dead on arrival.

Related Topics:
First responder - Decapitation - Do not resuscitate - Dead on arrival

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It is also possible that death does not occur at a particular moment, but unfolds as a process over a period of time. Under this definition, the term "exact moment of death" loses meaning.

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