Euroanaesthesia Congress Gathering to Define Exactly When People Die

Wednesday 7th June 2017

It is possibly the most complex and biggest question possible in humanity: When do we die? While this is a question that for most professionals is just about theory, for people working in emergency services or preparing life-saving care, it is a vital issue, one that has led to countless debates, arguments and lawsuits, some of which lasted for decades. Now, a group of dental experts attending the Euroanaesthesia Congress are meeting to try and find an answer once and for all.

What is death? As basic a question as it seems, particularly if you answer in terms of being “the opposite of life”, in issues such as healthcare and legislation, a firm definition has eluded medical and legal professionals. What needs to be missing for someone to be declared no longer alive?

The definition has changed, from the heart no longer functioning (given that life support devices and modern medical developments mean that in some cases a heart can be restarted after stopping or pulmonary function can be assisted or replaced) to the concept of brain dead, which given the confusion between a lack of brain function and a persistent vegetative state, has led to fierce legal cases brought against doctors to ensure they provide care that keeps organs functioning but is ultimately futile.

It must be noted at this point that the congress is looking at the definition of death, so the care of people in persistent vegetative states is unlikely to change regardless of definition.

Generally the medical definition of death involves the death of the brain, but how to prove this has proved to be difficult and inconsistent. Many countries use the absence of brain stem activity to determine death. Some countries, Italy being the most notable example, require brain scans to detect a lack of electrical activity in the brain.

As it relates to death and the right of doctors to provide or withdraw life preserving care, this is an incredibly emotive topic. There are a number of examples of cases where definitions of death have conflicted, the most recent being the case of Mordechai Dov Brody, who had been pronounced brain dead after a brain tumour. His heart was beating however and the parents argued that since his heart was still beating he was still alive, although he died before a conclusion could be reached. A similar landmark case was the case of Jesse Koochin, who similarly was declared brain dead, a declaration that his parents rejected due to the presence of a heartbeat. Finally, there was the case of Baby K, a baby born without most of her brain and was kept alive longer that other babies with the same condition due to ethical and legal issues concerning withdrawing care.

The debate has only intensified over the years as medical care has improved to take care of people and keep people alive in situations where they would otherwise, and therefore it is completely welcome that a congress is gathering to ethically determine once and for all when someone has passed on, as simply as checking for a lack of heartbeat.