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HagiaSophia
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On the surface, death - when it occurs, who is dead and who isn’t - seems black and white. Obvious.
Generations ago, it probably was.
But science has blurred those black-and-white lines, and philosophers, ethicists and theologians are struggling to keep up.
As one medical ethicist put it this week, if society can’t agree about when life begins, why would anyone expect absolute consensus as to when it ends?
“Science has made it more complicated and science can’t answer the question of what is death by itself,” said Dr. Stuart Youngner.
“We’d all agree that somebody who has been cremated and is in ashes in a bowl is dead. But in an ICU, when somebody’s heart has stopped but could beat again, there is no answer to that question,” said Youngner, a psychiatrist and chair of the bioethics department at Cleveland’s Case Western Reserve University.
But recently, the ongoing shortage of organs has caused the medical establishment to wade gingerly into what is known as “donation after cardiac death.”
DCD can be used in cases where a patient is breathing on a ventilator, but does not meet the accepted standard for being declared brain-dead.
“They are not expected to reach brain death, but they are not expected to ever recover,” Prall said.
In those cases, with a family’s permission, a patient can be taken to the operating room and removed from the ventilator. Presumably breathing stops, followed closely by heart function.
Because the heart stops, organs must be removed immediately befo
re they atrophy.
Donation after cardiac death troubles some, including Youngner.
“What if the heart starts again? At two minutes, if you shocked it, you could start it again,” he said. “Are they dead at two minutes? At 15?”
But Prall points out that there are 80,000 people in the U.S. waiting for transplants, “many of whom die every day.”
DCD has recently been condoned, with caveats, by the American Medical Association and a committee of the Institute of Medicine. The institute recommends that physicians treating the dying patient be separate from those recovering the organs and that at least five minutes pass between when the heart stops and organs are taken.
denverpost.com/cda/article/print/0,1674,36%257E53%257E2453691,00.html
Generations ago, it probably was.
But science has blurred those black-and-white lines, and philosophers, ethicists and theologians are struggling to keep up.
As one medical ethicist put it this week, if society can’t agree about when life begins, why would anyone expect absolute consensus as to when it ends?
“Science has made it more complicated and science can’t answer the question of what is death by itself,” said Dr. Stuart Youngner.
“We’d all agree that somebody who has been cremated and is in ashes in a bowl is dead. But in an ICU, when somebody’s heart has stopped but could beat again, there is no answer to that question,” said Youngner, a psychiatrist and chair of the bioethics department at Cleveland’s Case Western Reserve University.
But recently, the ongoing shortage of organs has caused the medical establishment to wade gingerly into what is known as “donation after cardiac death.”
DCD can be used in cases where a patient is breathing on a ventilator, but does not meet the accepted standard for being declared brain-dead.
“They are not expected to reach brain death, but they are not expected to ever recover,” Prall said.
In those cases, with a family’s permission, a patient can be taken to the operating room and removed from the ventilator. Presumably breathing stops, followed closely by heart function.
Because the heart stops, organs must be removed immediately befo
re they atrophy.
Donation after cardiac death troubles some, including Youngner.
“What if the heart starts again? At two minutes, if you shocked it, you could start it again,” he said. “Are they dead at two minutes? At 15?”
But Prall points out that there are 80,000 people in the U.S. waiting for transplants, “many of whom die every day.”
DCD has recently been condoned, with caveats, by the American Medical Association and a committee of the Institute of Medicine. The institute recommends that physicians treating the dying patient be separate from those recovering the organs and that at least five minutes pass between when the heart stops and organs are taken.
denverpost.com/cda/article/print/0,1674,36%257E53%257E2453691,00.html
