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

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