X-Message-Number: 3288 From: Brian Wowk <> Date: Tue, 18 Oct 94 17:24:09 CDT Subject: SCI.CRYONICS.Death Newsgroups: sci.cryonics > Subject: Re: Right to Die (Re: Frozen alive References: <> In <> (Ian Taylor) writes: > wrote on 12.10.94 >>The accepted medical definition of death has changed over time, but is >>still quite different from a cryonicist's definition of death. Legal >>death is pronounced when there is no evidence of pulse, respiration, or >>brain activity (I am oversimplifying, here) >Do these medical and legal definitions vary from country to country? Perhaps >you could give one full definition that you know. There are three typical scenarios encountered in medicine that are relevant to this question. 1) A victim of heart attack, trauma, or some other treatable condition suffers cardiac arrest. 2) A dying patient with a terminal prognosis. 3) A patient on life support with little or no brain activity (typically following a massive stroke or head injury). In scenario (1) the patient is said to be "coded" (code blue= cardiac arrest, the most extreme form of medical emergency). A team led by a doctor will aggressively attempt to restart the heart. The patient will be declared dead when the doctor decides to give up. In scenario (2) standard procedure is to designate the patient as "no code," meaning no attempt at resuscitation will be made. The patient will be declared dead (by either a doctor, or in some jurisdictions a nurse) the moment pulse and respiration cease. It is notable that in most cases these patients could be revived for up to several minutes after "death." This is rightfully not done, however, because it would only add to suffering of a terminal patient. This scenario (2) is the most favorable (and common) scenario for cryonics. Prompt application of CPR and various medications at the beginning of cryonics procedures preserves brain integrity of the so-called "dead" patient just as well as if they had been living when the procedure was started. Scenario (3) is the most problematic for both cryonics and society generally. DON'T GET A HEAD INJURY IF YOU WANT TO BE FROZEN! You will be hooked up to a respirator for several days until so little of your brain is left that doctors can unequivalently say you are DEAD. (And you will be dead even by the information-theoretic criterion of cryonics in many such cases.) It is in these cases of "brain death" that you will find the largest variation from jurisdiction-to-jurisdiction in the criterion used for pronouncing death. (This is a very hot and controversial area because respirator-supported brain dead patients are where all donated organs come from.) The most common criterion for brain death of patient on life- support is "cessation of brain activity in all parts of the brain, including the brain stem" after several days of repsirator support in absence of any drugs that might suppress brain actitity. Patients with activity remaining in the brain stem are said to be in a "persistent vegetative state" and are still legally alive. ---- Brian Wowk Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=3288