Question

Why is the ability to determine when death has occurred so critical in today's healthcare environment?

Answer 1

Defining death has always been a debatable topic for society, as well as, medicine, since moral, ethical, and legal aspects are related with it. As the medicine evolved, and technology advanced, the definition of death also changed. Earlier, the death was cardio- respiratory centric, whereas today the death is neurocentric. In cardiac death, the failure of heart to beat is considered as death because the heart is regarded as the creator of “vital spirits”, and hence, the absence of a heartbeat is considered as the sign of death. On the other hand, in brain- oriented death, whole brain and brainstem death is considered as person’s death (Laureys, November 2005). Today, a person is not considered to be dead in absence of heart beats only; until the whole brain, as well as the brainstem of the person is not “dead”, he/she is not considered dead. For example, if a person receives almost “total organ failure”, but his/her brain is not still dead, he/she won’t be considered in contemporary world. In such cases the patients are kept on ventilators or “life support systems.”
Now, considering the huge cost of healthcare in our country, and the absence of universal access to care, as well, has sparked serious debate over the determination of death. To determine how long a person should be kept on “life support systems” for awaiting his/her brain to become functional or “total dead” is a critical issue. This is due to both cost and emotional point of views