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DaveBj
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The Nain widow’s son? Jairus’ daughter? Lazarus?
Edit to add: Oh, and a documentary source for your claim that it is a church teaching would be nice, too.
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Edit to add: Oh, and a documentary source for your claim that it is a church teaching would be nice, too.
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Pup7
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It is totally possible to have death of the cognitive functions and still have brain stem activity (if you are breathing on your own, you have brain stem function, but might have no cerebellar or cerebral function at all).
Brain death is not an absolute definition. It’s medically possible to split hairs. This is the problem. When a lay person talks about brain death they generally think of the patient as dead headed to the undertaker dead (sorry to be blunt; I can’t think of another way to phrase it). But you can have brain stem activity and breathe on your own - but have no cognitive function at all, possibly not even have deep reflexes, and still be breathing. That I’ve actually seen - in a baby.
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Pup7
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No, that’s not what that means - life support is actually a lay term and not a correct medical term (even though we use it, it’s not actually accurate, especially in this case). The donor patient remains vented and on pressors - drugs that artificially keep blood pressure up and force the heart to beat - to keep blood flowing to the organs - in short, to stop decomposition. Without the vent the patient will not breathe. That’s why they don’t remain on artificial support for long, because even assisted, if the body and brain are truly gone, we’re not able to keep the organs viable for very long.
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o_mlly
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The medical dictionaries do not support your claim. Look it up.
AMLS Advanced Medical Life Support
ACLS advanced cardiac life support
BCLS basic cardiac life support
BLS basic life support
PALS pediatric advanced life support
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ShowersofRoses
Guest
I disagree. How would you explain the raising of Lazarus? He was dead four days and his soul had certainly departed before Jesus miraculously brought him back. What about all the other people who were raised from the dead in the Bible? Even today there have been many stories of medical professionals bringing someone back who seemed beyond hope. And the experience of many who have had near-death experiences.
Could your source for this idea that the soul never returns?
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Pup7
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Yes, they do. I hold certs in all of those - BLS, ACLS, PALS, STABLE, and NALS. I can PM you my cards if you like to prove it.Pup7:
The medical dictionaries do not support your claim. Look it up.
https://www.medicinenet.com/script/main/art.asp?articlekey=38577
Medical Abbreviations | Taber's Medical Dictionary
AMLS Advanced Medical Life Support
ACLS advanced cardiac life support
BCLS basic cardiac life support
BLS basic life support
PALS pediatric advanced life support
CPR and medications given during resuscitation attempts aren’t mechanical ventilation, my friend. We’re talking about mechanical venting for organ donation of dead bodies. Not trying to sustain someone through a shockable rhythm - which is what all of that entails.
“Life support” in the terms of sustaining organ functioning for transplant isn’t called that at that point, and it’s not what we mean. The person is clinically and irrevocably dead. Someone receiving CPR is NOT dead, not by far - until irrecoverable asystole and the pronouncement of death.
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BroIgnatius
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Sure, no problem. From the Catechism:
1013 Death is the end of man’s earthly pilgrimage, of the time of grace and mercy which God offers him so as to work out his earthly life in keeping with the divine plan, and to decide his ultimate destiny. When “the single course of our earthly life” is completed, (LG 48 § 3) we shall not return to other earthly lives: “It is appointed for men to die once.”(Heb 9:27)
The situations like that of Lazarus are exceptions to the rule exercised by the sovereignty of God. Jesus cried when he raised Lazarus because he knew he was taking him out of paradise and back into the world to die again. But, this miracle was part of God’s plan to authenticate Jesus as the Son of God.
The soul is ordered to the body and is separate from the body only until the Final Resurrection at the end of the age, when all the dead will be raised, their souls reunited with their bodies, and then either brought into heaven body and soul, or descend into hell body and soul.
The problem is that we do not know exactly when death occurs. That is why priests can still give last rites for a period of time after “apparent” death.
But, when death is really death (according to God), there is no coming back. If that were true then God is a liar as He says, “It is appointed for men to die once.”(Heb 9:27)
1013 Death is the end of man’s earthly pilgrimage, of the time of grace and mercy which God offers him so as to work out his earthly life in keeping with the divine plan, and to decide his ultimate destiny. When “the single course of our earthly life” is completed, (LG 48 § 3) we shall not return to other earthly lives: “It is appointed for men to die once.”(Heb 9:27)
The situations like that of Lazarus are exceptions to the rule exercised by the sovereignty of God. Jesus cried when he raised Lazarus because he knew he was taking him out of paradise and back into the world to die again. But, this miracle was part of God’s plan to authenticate Jesus as the Son of God.
The soul is ordered to the body and is separate from the body only until the Final Resurrection at the end of the age, when all the dead will be raised, their souls reunited with their bodies, and then either brought into heaven body and soul, or descend into hell body and soul.
The problem is that we do not know exactly when death occurs. That is why priests can still give last rites for a period of time after “apparent” death.
But, when death is really death (according to God), there is no coming back. If that were true then God is a liar as He says, “It is appointed for men to die once.”(Heb 9:27)
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o_mlly
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No, that is not what the OP asks. Paraphrasing: Is the absence of evidence of brain activity evidence of death (to a moral certainty)? I argue that it is not.
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Pup7
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I was talking about the mechanical ventilation for organ donation in the post I responded to. In that series of posts, “we” (not necessarily you and I) were indeed speaking of organ harvesting and the support needed to keep the organs viable for transplant.
At the point we’re supporting cellular function for organ preservation, it is no longer life support. The patient has been declared dead.
I wasn’t talking about brain death in that particular post; recheck the thread, please.
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Pup7
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While it may not be the organizing principle, it stands between life and death. It also stands between life as we know it and just existing.
If your brain stem is dead, you will die - because your parasympathetic nervous system will no longer function. Your heart will not beat, you will have no respiratory drive, you will have no reflexes.
If your cerebral cortex is dead, the person you present as is gone forever. The brain stem can continue to function and you may breathe on your own and your heart may beat on its own, but you the person you were to us is gone.
If your brain stem and your cerebral cortex are gone, you will die. If your heart stops and is not restarted by artificial means (CPR being one of them - the difference in BLS and ACLS and up is the use of medications and rhythm analysis), you will die, because blood will no longer circulate, and the brain will die from lack of oxygen. We can’t correct any type of brain death.
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thistle
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JimG
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This may be true from a medical standpoint but not from a philosophical and theological standpoint. From those standpoints personhood is an aspect of the soul. So that when one dies and goes before God for the individual judgment, it is the person who is judged and conscious of the judgment even in the absence of the brain and body.
Even from a bodily standpoint, I think we have no way of knowing for sure whether consciousness perseveres in a brain impaired person. Certainly the brain function is not present and not acting to integrate and control the body, but is the soul present and somehow aware of what is happening?
Philosophically speaking, the soul animates the whole body, not just the brain.
I suppose that if artificial ventilation is stopped, and breathing and heartbeat stops, we can presume that the patient is dead or dying.
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Pup7
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And I wasn’t speaking from a philosophical or theological standpoint. Medically, that function is in the the brain. When the brain is gone and no longer functioning, it’s 100% out of medical hands.Pup7:
This may be true from a medical standpoint but not from a philosophical and theological standpoint. From those standpoints personhood is an aspect of the soul. So that when one dies and goes before God for the individual judgment, it is the person who is judged and conscious of the judgment even in the absence of the brain and body.
Even from a bodily standpoint, I think we have no way of knowing for sure whether consciousness perseveres in a brain impaired person. Certainly the brain function is not present and not acting to integrate and control the body, but is the soul present and somehow aware of what is happening?
Philosophically speaking, the soul animates the whole body, not just the brain.
I suppose that if artificial ventilation is stopped, and breathing and heartbeat stops, we can presume that the patient is dead or dying.
I can promise you that once your brain is dead, medicine cannot bring you back. That’s pretty much an irrefutable fact.
The discussion is on when brain death occurs. That’s not philosophical by my education - that’s medical.
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JimG
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Yes, that is the discussion. I would say that if the patient recovers, as in the case mentioned in the article, he was not brain dead. But the other discussion is whether brain death is equivalent to actual death. Could a brain dead patient be sent to the funeral home for burial rather than taking his or her organs? It seems that a brain dead donor cannot be totally dead because dead organs are of no use to anyone. Is the “dead donor” rule a fact or a legal fiction?
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Pup7
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This is a very simplistic description of what happens, not because I think CAFers won’t get it, but because it’s a far more elaborate process of checks and balances than this. If we find you have no brain activity, we begin to attempt to wean you from the vent. If your vitals drop as we attempt to wean you from the drugs and from forcible ventilation - if you show no attempt to breathe on your own - and when we turn the vent off you do not spontaneously breathe (because if you’re able to breathe, the brain stem - the parasympathetic nervous system - will indeed tell you to breathe as oxygen levels fall and carbon dioxide levels increase), you’re considered from our standpoint to have died.
A funeral home cannot sustain a person on a ventilator. We don’t just breathe for the patient. We use drugs to maintain heart rate, to maintain blood pressure, to maintain body pH - but artificially. And it’s easy to tell when the body is failing despite all this: drug doses have to increase and change on a scale to keep the body at its optimal balance. We can’t do this for very long and do it safely. It’s also not feasible if there’s no medical chance of survival.
What really cranks me up about these threads (and this isn’t directed at you) is the painting of my medical colleagues as ghouls standing around wantonly killing people. We don’t profit from death, folks. We don’t deserve to be painted as evildoers and purveyors of death.
We coded a woman on my floor one night and after four minutes of ACLS with no return of spontaneous respiration and complete asystole (she was a long term cancer patient in her seventies) the team called the code and the patient was pronounced. The monitor reading was asystole - a complete flat line, which we cannot shock. We had intubated her which is standard during ACLS (Advanced Cardiac Life Support) but there was no heartbeat, no pulse, no nothing. The RN caring for the patient was a new RN and came down with me, the charge nurse, to learn what to do when a patient dies. The RN went back to the room to pull the patient’s chart (we still had paper charts at this point) and she asked me, very quietly, when she returned what should she do if the patient is breathing. I said that sometimes they can indeed appear to breathe as the muscles relax. She asked me to come look at the patient. The patient was breathing and had a pulse. We moved her to the ICU, where she died the next night.
It does happen. In 15 years, I’ve seen it once. I do know of one person who came back from asystole - flat line - in the middle of a code, but that’s also very very rare. There’s an explanation for that: electrical activity that is so faint we can’t detect it. But I’ve only heard of it once.
A funeral home cannot sustain a person on a ventilator. We don’t just breathe for the patient. We use drugs to maintain heart rate, to maintain blood pressure, to maintain body pH - but artificially. And it’s easy to tell when the body is failing despite all this: drug doses have to increase and change on a scale to keep the body at its optimal balance. We can’t do this for very long and do it safely. It’s also not feasible if there’s no medical chance of survival.
What really cranks me up about these threads (and this isn’t directed at you) is the painting of my medical colleagues as ghouls standing around wantonly killing people. We don’t profit from death, folks. We don’t deserve to be painted as evildoers and purveyors of death.
We coded a woman on my floor one night and after four minutes of ACLS with no return of spontaneous respiration and complete asystole (she was a long term cancer patient in her seventies) the team called the code and the patient was pronounced. The monitor reading was asystole - a complete flat line, which we cannot shock. We had intubated her which is standard during ACLS (Advanced Cardiac Life Support) but there was no heartbeat, no pulse, no nothing. The RN caring for the patient was a new RN and came down with me, the charge nurse, to learn what to do when a patient dies. The RN went back to the room to pull the patient’s chart (we still had paper charts at this point) and she asked me, very quietly, when she returned what should she do if the patient is breathing. I said that sometimes they can indeed appear to breathe as the muscles relax. She asked me to come look at the patient. The patient was breathing and had a pulse. We moved her to the ICU, where she died the next night.
It does happen. In 15 years, I’ve seen it once. I do know of one person who came back from asystole - flat line - in the middle of a code, but that’s also very very rare. There’s an explanation for that: electrical activity that is so faint we can’t detect it. But I’ve only heard of it once.
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JimG
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Thank you for sharing your expertise on this. Your account of the patient who was transferred to the ICU reminded me of another thread about DNR’s and advance directives. On that thread it was mentioned that without a directive, the default position was to do everything possible to resuscitate a patient, even when the attempt would do more harm than good. That struck me as equally questionable as it would be to try to hurry death along. Why should a doctor not simply say to a relative, “we’ve done all we can reasonable do. Your loved one is dying” I mean, surely the medical team can recognize when further treatment is futile even in the absence of a DNR or an AD, and they ought to be able to act (or not act) accordingly.
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Pup7
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You’re welcome. 
Thanks for the thanks.
They do. Sometimes, though, the patient codes without family present. We run the code and someone is assigned to contact family. We bring them as up to date as we can and the physician then gives their best assessment of the situation at hand.
There is a culture of litigation in this country (I can only speak for the US) that stops docs from making arbitrary calls on that sort of thing - and I agree, it’s not always the best course of action. The doc also has to think about the licenses of those working with him and the position the facility may be in.
And yes, I have seen many times where the doc has said - “we can’t do anymore - we’ve done all we can do. It’s time to call it”.
Thanks for the thanks.They do. Sometimes, though, the patient codes without family present. We run the code and someone is assigned to contact family. We bring them as up to date as we can and the physician then gives their best assessment of the situation at hand.
There is a culture of litigation in this country (I can only speak for the US) that stops docs from making arbitrary calls on that sort of thing - and I agree, it’s not always the best course of action. The doc also has to think about the licenses of those working with him and the position the facility may be in.
And yes, I have seen many times where the doc has said - “we can’t do anymore - we’ve done all we can do. It’s time to call it”.
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Pup7
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I’ll add this - a code looks nothing like what one sees on television.
If more folks saw what an actual code looks like, I would bet there would be an increase in DNRs in many cases. It’s traumatic and it’s brutal. Compressions are 2 inches deep in adults and you’re pushing on bone and the heart muscle. Ribs will break. Bruises happen. It’s rough.
Don’t believe what you see on TV. It’s fake. It’s very, very fake.
If more folks saw what an actual code looks like, I would bet there would be an increase in DNRs in many cases. It’s traumatic and it’s brutal. Compressions are 2 inches deep in adults and you’re pushing on bone and the heart muscle. Ribs will break. Bruises happen. It’s rough.
Don’t believe what you see on TV. It’s fake. It’s very, very fake.
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