X-Message-Number: 11403 Date: Wed, 10 Mar 1999 22:03:02 -0800 From: Olaf Henny <> Subject: Controversy about the definition of "death" I have spotted the following article in The Province, a mainstream daily in Vancouver, B.C. I found the fact interesting , that the idea, that the definition of death is modified as medical technology evolves (or as it is convenient to the medical establishment), is recognized "out there". Title: Plucking organs from one sick patient to patch another is wrong by Susan Martinuk Just hoe dead is dead? Contemplating such a question inevitable conjures up images of a Monty Python movie of the mostly dead hero in The Princess Bride. But last week the uncomfortable question of when life ends and death begins was also put to a House of Commons committee on organ and tissue donation. According to the testimony by a group of medical doctors the definition of "death" is far from clear and it could be that organ transplant is the equivalent of taking a life to save a life. Dr. Michael Brear, a retired Vancouver physician, says, that taking organs from one sick patient to patch up the life of another sick patient is wrong. Even "evil". He further suggests, that the definition of brain death, currently used as the criteria for harvesting organs is a myth and has been artificially constructed by medical doctors to justify taking organs from living patients. One year after the world's first heart transplant took place in South Africa, the definition of "brain death" was proposed by a team of doctors at Harvard Medical School. Prior to that, death was determined when heart and lung ceased to function. But under this definition there would be no hearts available for transplants, since the doctors would have to wait for the heart to die. So a new definition of death had to be created to provide living organs for transplant material. Dr. Brear gave evidence of at least seven cases where brain-dead women had given birth to healthy babies, including one woman who gave birth 201 days after being declared brain dead. So even though the brain may not be functioning, it is clear that certain processes associated with the brain are still occurring. The womb is still receiving hormones from the pituitary gland, the spinal chord is still carrying messages and some body functions are still occurring. He also told the committee that some brain-dead people have recovered and that brain dead patients still require a general anesthetic to prevent a reaction to pain. Suddenly brain-dead doesn't seem so dead any more. A Vancouver psychiatrist, Dr. Ruth Oliver, testified that she had been declared clinically dead over 20 years ago, after she suffered complications from giving birth. Yet she stood before the committee as living proof that brain-dead does not necessarily mean dead. She recovered and went on to finish her medical training. In today's organ-hungry world, she might not have been so lucky. Dr. John Yun, a Richmond oncologist concurred with Dr. Brear and Dr. Oliver, suggesting that medical hypothesis of brain death is a dubious definition at best. This testimony gives rise to a number of questions about death. How can we separate the brain's function from the rest of the body? When a person's heart stops, we put them into a machine to keep that organ going until the heart can be treated. If the patient is technically dead when the brain stops functioning, why does the heart continue to pump? Do cadavers have beating hearts? Do the brain and the body die in two different stages? Are there different "levels" of death? Ironically the House of Commons subcommittee was holding public hearings to examine ways to increase Canada's low donor rate of 12.1 per million people, compared to 26.2 in Austria an 17.7 per million in the United States. Considering the publicity given to the above testimony and the questions raised about the nebulous definition of death, it is unlikely that Canada's rate of organ donation is going to increase any time soon. Rather, it may spark a renewed debate about tissues involved in organ donation and encourage all to proceed with caution. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=11403