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Defining Death


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Poll: Defining Death (21 member(s) have cast votes)

Defining Death

  1. Irreversible cardiopulmonary cessation (0 votes [0.00%])

    Percentage of vote: 0.00%

  2. Irreversible cessation of functions of the brainstem (0 votes [0.00%])

    Percentage of vote: 0.00%

  3. Irreversible cessation of functions of the entire brain (6 votes [33.33%])

    Percentage of vote: 33.33%

  4. Irreversible loss of the capacity for consiousness (10 votes [55.56%])

    Percentage of vote: 55.56%

  5. Define your own (1 votes [5.56%])

    Percentage of vote: 5.56%

  6. Never (1 votes [5.56%])

    Percentage of vote: 5.56%

  7. After 40 ;) (0 votes [0.00%])

    Percentage of vote: 0.00%

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#1

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Posted 25 January 2006 - 08:59 AM


Of course one may become rather creative with the above list. The permutations of the degree of physiological damage, which may range from early to advanced decay, from partial to complete obliteration of critical organs are endless. The definition and the measurement of consciousness is in itself worthy of extensive discussion. A topic that one may hope to tackle with less resort to the metaphysical and philosophical (as is usually the case with matters that tend to elude rigid adherence to scientific explanation) is the concept of irreversibility .

Hershenov (1) states:

Irreversibility should be limited to an organism's ability to 'restart' itself after vital organs have ceased to function. However, this would mean that every hour people who cannot be revived without the intervention of medical personnel and their technology are coming back from the dead. However, the alternative of irreversibility being dependent upon technology will lead to even more counterintuitive results such as: some people are dead at a particular time and place, but others in more technologically advanced eras and locations are alive despite their being in identical physical states; in the future, millions of cryogeneically frozen human beings could spend centuries in a non-dead state because of the future technological breakthroughs; or large numbers of 'frozen' people are dead for aeons but coroners are not able to declare them so because they are unaware of what biological conditions science will never be able to reverse.

It is reasonable to state that the definition of death is largely a function of the current state in our understanding and practice of medicine. Cardiac arrest or 'flatline', as is so often depicted on film and TV, is no longer sufficient for pronouncement of death unless the attending physician determines that the patient's heart cannot be restarted (or in some cases be supported by mechanical means or replaced by transplantation). Sadly, such determinations as Hershenov has stated above, can be variant on the resources available to the physician (and the patient).

In light of the inevitability of medical and technological progress along trajectories that we may not even be able to foresee, it is very likely that it will be in our power to reverse what we deem as irreversible today. Is it inappropriate to consider that each person who is allowed to be physically obliterated through the rituals of burial or cremation rather than, for example be cryopreserved, being declared dead prematurely? Or this notion in itself premature?

(1) Hershenov D.
The problematic role of 'irreversibility' in the definition of death.
Bioethics. 2003 Feb;17(1):89-100.

#2 Infernity

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Posted 25 January 2006 - 10:47 AM

Hmmm I don't know if to vote Irreversible cessation of functions of the entire brain or Irreversible loss of the capacity for consciousness.

That's because I define death as cessation of functions of the entire brain, but when losing the capability for consiousness... that's like the same thing... the brain works only for keeping the body "alive" doing the things it needs to keep the brain functioning, heart beating to provide minimum energy for this single thing of do, brain functions just to give orders to keep him doing so, which means that is a cycle of vanity... for yourself- you are dead, that same oblivion. The YOU is dead. I don't know what to vote.

-Infernity

#3 JonesGuy

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Posted 25 January 2006 - 05:22 PM

You know that section of the brain that answers the question "Am I me?" I figure that's the least necessary to still be alive. You can take my hands, my eyes, and my memories, and that will still be 'me'.

However, I have no idea what would happen if you kept all my memories alive, and that part of my brain was destroyed. I have a feeling that *I* would be off. If you reconstituted that area (like with stem cells), whoever came back would probably think he was me

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#4 bgwowk

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Posted 25 January 2006 - 06:44 PM

I think we have to face the reality that the definition of death is essentially pragmatic, not biological. This recognition is already built into medicine in the form of "no code" or DNR (do not resuscitate) status, which says that a terminally ill person is considered dead when their heart stops, while anyone else would be vigorously resuscitated and only pronounced dead if resuscitation was unsuccessful.

Max More has written

http://www.alcor.org...sOfTheSelf.html

of two kinds of death. One is "Permanent" death, which means a state that by circumstances (such as heart stopping in the wilderness) or choice (DNR status) is not going to be reversed, so might as well be considered "dead". The other kind of death is "irreversible" death, which means death that nobody anywhere, anytime could ever reverse. Ralph Merkle has called this "information theoretic death".

A person is dead according to the information theoretic criterion if their memories, personality, hopes, dreams, etc. have been destroyed in the information theoretic sense. That is, if the structures in the brain that encode memory and personality have been so disrupted that it is no longer possible in principle to restore them to an appropriate functional state then the person is dead. If the structures that encode memory and personality are sufficiently intact that inference of the memory and personality are feasible in principle, and therefore restoration to an appropriate functional state is likewise feasible in principle, then the person is not dead.

Where cryonics is concerned, information theoretic death is what we want to avoid. Anyone who has not suffered information theoretic death is still a candidate for cryonics.

Here's the tricky part. Cryonicists would generally like cryonics patients to have legal status as people, and would therefore probably like the information theoretic criteria for death to be legally applied to cryonics patients. France has de-facto done that, and will apparently not let any type of cryonics procedures be done there until there has been a day or more of warm ischemia, ostensibly to make sure cryonics is not done to anybody who is not information theoretically dead (really dead). Watch out what you wish for, as they say.

This question of pragmatic death really comes to the fore in the practice of organ donation after cardiac death. Usually vital organs are removed for transplant only after brain death (wherein the brain rots while the body is on life support), which is pretty close to information theoretically dead. But there is a new procedure afoot in which vital organs are being removed in some patients promptly after cardiac arrest, just like cryonics. This leads to ethical conundrums like should anesthesia be used when circulation is restarted to washout out blood? If anesthesia is necessary, are they really dead? They were never going to wake up anyway, so surely they are dead, right? These issues are debated at length in a recent mainstream medical journal article pointed to by

http://www.alcor.org...ry/html/dcd.htm

The article is especially interesting because cryonics expert Mike Darwin was an invited participant.

Prometheus ends by asking

Is it inappropriate to consider that each person who is  allowed to be physically obliterated through the rituals of burial or cremation rather than, for example be cryopreserved, being declared dead prematurely?

If cryonics is available as an option, then the answer is probably "yes". Some have speculated that part of the reason cryonics is so despised is that if it is taken seriously, the implications for contemporary medical care (specifically, failure to deliver care) are unthinkable.

For further writing on the subject of how "death" in medicine is typically nothing more than a class of disease (cerebral ischemic injury) that medicine is still learning to fix, see

http://www.alcor.org...reForDeath.html

---BrianW

P.S. Of the choices offered, I chose "irreversible loss of the capacity for consciousness". That's the moral/ethical issue on which death depends. The biological conditions that transplate to that loss of capacity are a separate question, and get into the issue of whether we want absolute irreversibility, or irreversibility as determined by available technology, etc.

#5 quadclops

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Posted 25 January 2006 - 08:34 PM

I chose "Irreversible loss of the capacity for consiousness", because that for me defines death as a sentient human being. Any of the other criteria could apply equaly well to any animal with a brain stem.

Thus death of the Mind, for me, is really the only death that really matters.

#6 Mind

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Posted 25 January 2006 - 11:36 PM

I have to go with "Irreversible loss of the capacity for consiousness", not because it is a perfect definition, but because it is good enough.

I lean toward the "pattern" definition of self, as in, we are just specific unique patterns of information. Thus we would be dead if our pattern was lost or suddenly severely disrupted.

#7 Brainbox

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Posted 31 January 2006 - 07:00 PM

Hmm, I chose "Irreversible cessation of functions of the entire brain". It's a bit of a physical interpretation. There are a lot of dependencies between the criteria of death. But bottom-line, I presume that the basis of our existence is our physical appearance. As a layered “system”. Our physical body carries or implements our logical consciousness, or “pattern”. I would say that the moment the body cannot protect itself anymore from internal and external integrity attacks, death starts, or better, life stops. A disintegrated body cannot hold any life, i.e. when the chemical factory shuts down, its over. The implementation of our consciousness stopped to exist. The blueprint of our physical and logical life, the meta-pattern or genome, is passed on through our offspring.

However, I’m also sure this theoretical approach must be to simple being complete standing on its own. What about someone in a severe coma? If this is due to part of the brain that became dysfunctional, it could even support this theory. And how about ghosts, do they exist and if yes, could they be considered as “alive”? And what about various religious concepts?

Probably our level of consciousness or intelligence does not span sufficient dimensions to be able to know who or what we are….. however complex we are, we will always lack one dimension of consciousness to judge ourselves in many ways. :)

#8 Brainbox

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Posted 31 January 2006 - 08:34 PM

Some have speculated that part of the reason cryonics is so despised is that if it is taken seriously, the implications for contemporary medical care (specifically, failure to deliver care) are unthinkable.


The issue is even much broader. Our entire civilisation is based on the fact that we die after 80 years and eventually are forgotten about entirely. Already a gradual development in extension of the duration of life is becoming a problem now, combined with other issues concerning the baby-boomers generation. Parts of our civilisation will simply collapse if some form of immortality would al of a sudden be possible. Or the insight that such a thing might be possible in the near future.

(Just some developing thoughts of a newbe in this, that will already be obvious to longer term members of a board like this….)

#9 John Schloendorn

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Posted 31 January 2006 - 10:50 PM

"Irreversible loss of the capacity for consiousness" seems to me like the safest and the most apt, but it also begs the underlying question, because it is the only non-technical definition in the list. We can't measure consciousness after all, or even define it in non-conscious terms. As long as this remains so, this definition of death has little practical relevance. The practical question is which of the other items, which we can measure, should we deem indicative of the capacity for consciousness?

#10 Infernity

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Posted 31 January 2006 - 10:53 PM

Aye losing consciousness is enough to be determined dead, Convinced for that.

-Infernity

#11 bgwowk

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Posted 01 February 2006 - 12:01 AM

This discussion is underscoring the two distinct and separate questions of death. First, what do we mean conceptually by death? A reasonable concept of death would seem to be "permanent loss of consciousness." The second question of death is, what physical states correspond to our concept of death? Is it when the heart stops (cardiac criterion) or when the brain disintegrates (information theoretic criterion for death)?

Both questions are controversial. Consider the first question of conceptual definition. There is a big ethics debate in medicine right now over whether death should be defined as "irreversible loss of consciousness" versus "permanent loss of consciousness". Ground zero of that debate is the new practice of harvesting organs based on cardiac death. Cardiac death is a "permament loss of consciousness" if there is no attempt to restart circulation. But it is not an "irreversible loss of consciousness" because consciousness can be restored after cardiac death if resuscitation is begun fast enough. Thus you have bioethicists beside themselves over the issue whether anesthesia should be used during organ harvesting. The way these questions are finally resolved will be pivotal to the practice of cryonics.

---BrianW

#12 Lothar

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Posted 01 February 2006 - 06:50 AM

@ Prometheus:

In the February issue of a popular german science magazine (that's called 'Spektrum der Wissenschaft', that means 'Spectrum of Science') there is a big article by neurologist Steven Laureys about brain death, coma patients and the concept of death in general. It's a translation from 'Nature Reviews Neuroscience', Number 6, November 2005. Before his text he quotes two insights from others. One goes like this: 'I think, only a very bold man would risk to define death.'

Here you find a short summary of the original publication:
http://www.ncbi.nlm....t_uids=16261182

#13 boundlesslife

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Posted 01 February 2006 - 06:56 AM

Quoting bgwowk:

This discussion is underscoring the two distinct and separate questions of death.  First, what do we mean conceptually by death?  A reasonable concept of death would seem to be "permanent loss of consciousness."  The second question of death is, what physical states correspond to our concept of death?  Is it when the heart stops (cardiac criterion) or when the brain disintegrates (information theoretic criterion for death)?

More on this (concept of death, re: "Does the Public Really Want Immortality?") just posted elsewhere:

Link to Posting

These are important issues, as BrianW says, above:

The way these questions are finally resolved will be pivotal to the practice of cryonics.

boundlesslife

#14 Lothar

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Posted 01 February 2006 - 06:58 AM

PS: The german version is free available:

http://www.wissensch..._06_02_S062.pdf




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