Brain death and the Soul

[Benjinho]

When does a human’s soul depart his or her body?

I’ve worked in intensive care units and have seen many patients with anoxic brain injury, where their brains are deprived of oxygen and are essentially destroyed. Typically these people are unable to breathe on their own because the brainstem is also dead. Most certainly, their basic personalities are gone because the frontal lobe/cortex are even more sensitive to oxygen deprivation.

So if a person is brain dead, requiring a ventilator to even breathe, has their soul already left the body? Or is this considered to occur once all bodily functions, whether supported artificially or not, have ceased completely?

 

[Neithan]

I don’t know of any certain Catholic answer to this. Personally I find the idea of hylomorphism most compelling: that the soul is the form of the body. It’s not a ghostly substance that departs some part of the body; it’s present as long as the body is physically alive. So I would go with your second option (all bodily functions cease).

 

[Ghosty1981]

This is something I’ve thought about a lot as well, working in the medical field for over 15 years (and a week away from finishing nursing school, yay!).

My view is that the soul survives as long as cellular function continues, because the soul is the life of the body and humans are not composed of more than one soul (rational stacked over animal, for example). This does mean that a person who is brain dead still has a rational soul in their body, but I don’t believe that it is murder to remove their life support because there is no hope for any kind of recovery in a truly brain-dead patient. This isn’t a matter of “life not worth living”, but rather the rational soul being utterly trapped in a body that can’t operate beyond the most basic life functions that even starfish possess.

I personally draw the line at “vegetative” function and clinical brain death as being the point of no return where it is more merciful to let the rational soul free by carefully and compassionately removing artificial life support. This line may someday change if our medical techniques develop to where we can help such patients recover, but currently I think it is best to provide them with Last Rites and allow their family to say their goodbyes.

This question also raises interesting moral dilemmas regarding organ donation. I’ll see if I can find a thread from last year where we debated that matter here on the forum.

Just my thoughts!

Peace and God bless!

 

[CRV]

So if a person is brain dead, requiring a ventilator to even breathe, has their soul already left the body?

IMO I’d say no. Not quite dead? The Case for caution in the definition of brain death "surgeons have observed that brain-dead patients frequently react strongly to surgical incision at the time of organ procurement, with a rapidly increasing heart rate and a dramatic rise in blood pressure. Because of these signs of distress, donors are sometimes anesthetized during organ retrieval. Again, one must ask, what purpose would anesthesia serve for a corpse? "

 

[Delphinus]

I would argue no, the soul is still there. The brain is just an organ, albeit a very important one! But it’s still just a part of the body. If the kidney dies, the person still has a soul. If the heart dies, they still have a soul. If a leg is chopped off, they still have a soul.

We know from Catholic theology that body and soul go together. I think maybe we are talking about total death on a cellular level and decomposition as the point that is broken.

 

[F_Marturana]

If the person is brain dead, why the respirator?

Or do you mean a brain injury?

 

[Wozza]

Again, one must ask, what purpose would anesthesia serve for a corpse? "

It’s not to help the corpse. It’s for the surgeon. You need to keep the body ‘alive’ so that the organs are maintained. The body will still react to invasive surgery unless anaethetised.

 

[F_Marturana]

If the heart dies, circulation and respiration end. That’s death.

 

[Benjinho]

Brain death means the brain stem also dies, which is needed to breathe. The ventilator is artificial respiration and so replaces the function of the dead brain stem.

 

[F_Marturana]

So the person is dead. The respirator is not necessary.

 

[Benjinho]

Only the brain is dead. The other parts of the body are kept alive artificially through the ventilator.

 

[F_Marturana]

Why? (12345)

 

[Benjinho]

The family might not be ready to accept the reality of their family member’s brain death, or the person may have been an organ donor, in which case the other body parts must be kept alive.

 

[F_Marturana]

Oh. I understand now what you meant.

 

[Ghosty1981]

The body will still react to invasive surgery unless anaethetised.

Do you have links to any studies on this? I don’t doubt that it could happen in a case of misdiagnosis of brain death, but unless we’re talking spinal reflexes (which occur below the brain stem), there isn’t any way for the person to react to being cut open for organ harvesting in a properly diagnosed brain-dead person. One of the tests for brain-death is for brain-stem level reflexes, after all.

What I’m guessing you’re talking about are things like the Lazarus Sign, where bodies lift and move their arms. We know the neurological pathways for these kinds of movements and they don’t involve the brain. These types of movements are like the kick you make when your knee is struck by the rubber hammer, and the signal comes from the spinal cord in a reflex arc.

Peace and God bless!

 

[Wozza]

Wozza:

The body will still react to invasive surgery unless anaethetised.

Do you have links to any studies on this? I don’t doubt that it could happen in a case of misdiagnosis of brain death, but unless we’re talking spinal reflexes (which occur below the brain stem), there isn’t any way for the person to react to being cut open for organ harvesting in a properly diagnosed brain-dead person. One of the tests for brain-death is for brain-stem level reflexes, after all.

What I’m guessing you’re talking about are things like the Lazarus Sign, where bodies lift and move their arms. We know the neurological pathways for these kinds of movements and they don’t involve the brain. These types of movements are like the kick you make when your knee is struck by the rubber hammer, and the signal comes from the spinal cord in a reflex arc.

Peace and God bless!

There’s this:

…peri‐operative neuromuscular blocking agents should be given to prevent reflex muscle contraction and that hypertension may be treated with sodium nitroprusside or a volatile anaesthetic agent such as isoflurane

Some anaesthetists responsible for the clinical management during the donation operation may be uncomfortable with this guidance. Firstly, under few circumstances do we allow operative surgery with muscle relaxation and without analgesia or anaesthesia, leading to a psychological compulsion to provide anaesthesia. Second, the hypertension and tachycardia that accompanies the donation operation can be distressing for operating theatre personnel to witness and for this reason alone one should always administer anaesthesia or agents to control these reflexes. https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2044.2000.055002105.x

 

[Ghosty1981]

This haemodynamic response could be considered to represent an organism in distress and probably occurs at a spinal level, although we are unaware of EEG studies during organ collection to confirm this.

So it is referring to spinal reflexes, as I suspected. It would be interesting to see EEG studies during organ harvesting, however.

The muscle relaxants are required to prevent spinal reflexes of the limbs that could interrupt the procedure. These are the same types of reflexes as the hammer-to-knee movements I mentioned previously; these could happen even in a fresh headless corpse.

Peace and God bless!

 

[Wozza]

This haemodynamic response could be considered to represent an organism in distress and probably occurs at a spinal level, although we are unaware of EEG studies during organ collection to confirm this.

There was a sad case reported of a mother saying goodbye to her son after organ donation. The heart had been kept beating artificially. And when it was switched off, her boy’s heart continued beating unaided for a while.

Your heart has to go out to people in that sort of situation.

 

[Ghosty1981]

There was a sad case reported of a mother saying goodbye to her son after organ donation. The heart had been kept beating artificially. And when it was switched off, her boy’s heart continued beating unaided for a while.

Your heart has to go out to people in that sort of situation.

It’s hard even for the medically trained, so I can only imagine what it would be like to see that and not understand what’s going on. I just hope I can go painlessly in more of a hospice type situation with loved ones around me; that is the happiest death I’ve personally witnessed. The ICU or operating room isn’t the most soothing place for death.

 

[CRV]

It’s not to help the corpse. It’s for the surgeon. You need to keep the body ‘alive’ so that the organs are maintained. The body will still react to invasive surgery unless anaethetised.

Point understood. I understood that remark in the article to be satire and mean - well if the person was truly dead an anaesthetic wouldn’t be needed. A corpse/truly dead person does not react to painful stimuli.

I can vouch for that as I was with my mum when she died, and the nurses and doctor need to ascertain the person is truly dead etc.

Edited to add:- post reading I agree with Ghosty1981. Also wish to add that owners of animals being euthanized are informed that their pet may yelp/cry/ and exhale or inhale - just the nervous impulses /reflexes. Didn’t happen often, but it did happen. (Yes, animals are not the same as people, I added this just as a further example).