On 4 September, we met for the first installment of the discussion group on the “Meaning of Death” at Harvard. Here are some notes I put together in preparation.
9/4 “And death shall have no dominion” – Contemporary issues in dying
What is at stake in the question of defining death?
Wood, Daniel (2014) “When does life end? Two emotional cases probe the complexities.” Christian Science Monitor (online: 19 Jan 2014)
Some terminology: the following are some distinctions and classifications that may be helpful when diving into this subject matter.
A “Concept” of Death describes how the word/idea is used in a particular setting
A “Definition” of Death provides a philosophical framework including necessary and sufficient conditions
A “Criterion” for Death provides tests by which death may be diagnosed.
[The three need not be the same.]
It is worth asking what is at stake for each person in the discussion – for you personally and whomever you are conversing with.
Different areas in which the question is asked (and some concepts of life/death within them):
[We considered the idea that “dead” referred to things that used to be alive and not simply to things that were not alive. This clarification was useful to many but worth revisiting after more thought.]
– Loss of integrative function
– Loss of homeostasis
– Loss of response to stimuli
– Loss of growth and/or reproduction
[We wanted to add some idea of potential here to cover dormant states like seeds and spores. Some things do not have the above functions but may have them in the future.]
Clinical Death (US medical consensus; German; Japanese; other countries?)
– Diagnostic criteria necessary for treatment, cessation of treatment
– Heart stops
– Breathing stops
– Brain stops
Legal Death (US law and precedent; other countries?)
– Clinical death as “a question of fact, to be determined by physicians” PLUS
– Declaration in absentia (when someone is missing and declared dead under the law.
– (ontological, ethical, and pragmatic questions regarding)
– Loss of moral agency, culpability (that is loss of responsibility)
– Loss of dignity (that is loss of the right to be treated a certain way)
Religious Death (Christian; Jewish; Muslim; Shinto; Buddhist; others?
– Loss of Spirit, Soul, Breath, Blood, Mind, Consciousness, Relationship, …
Clinical Features related to Death Criteria
(Terminal) Apnea – cessation of breathing
– “no spontaneous breathing”
(Terminal) Asystole – cessation of heartbeat
– No Movement or Response to stimuli [cp. Animal soul]
Brain Death – irreversible cessation of brain function, including the regulation of breath (and leading eventually to cessation of heartbeat)
– Higher Brain Death – cessation of function in the cerebrum and cerebellum
– Brainstem Death – cessation of function in the brainstem, including cardiovascular and respiratory control
– Total Brain Death – cessation of all function in the brain
[A coma or “Vegetative State” is not strictly defined, but suggests vegetable functions (maintenance and nutrition) but not animal functions (movement and response to stimuli) or rational functions (consciousness, reason). The terminology relates historically to Aristotle’s vegetable, animal, and rational souls, though the concepts have changed dramatically. In the US Persistent Vegetative State suggests at least 4 weeks have passed; Permanent Vegetative State at least one year. Neither necessarily implies persistence, permanence, or irreversibility, only duration.]
Four stages of Clinical Death
- Cessation of function
- Diagnosis of cessation
- Cessation becomes irreversible
- Diagnosis of irreversible cessation
Concern arose in the late 20th century because transplants required (at the time) patients with active circulation.
What’s at stake? In saying that death is a biological concept, I suspect most authors wish to emphasize that it is objective and empirical, rather than determined by biologists. Biologists have not spoken extensively on the topic.
If these definitions are biological, what areas of biology do they draw on?
If they are scientific, but not biological, then what is the difference between biology and science dealing with life?
If they are not objective and empirical, where are we getting our ideas?
Along these lines, claims have been made for Death of the Person versus Death of the Organism. Is there a difference and, if so, what is it?