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What Brain Death Is and Why It Matters
Technology has helped us prolong life indefinitely. But that brings with it a lot of ethical questions, and questionable practices when it comes to brain death.
Technology brings with it new understandings about nature and possibilities never before imagined, along with complications and an ethical path much thornier, and harder to discern. Scientists and policymakers have long bemoaned the lag between runaway new technologies and the moral, legal, and procedural issues needed to wrangle them in. In many ways, medical science has changed how we define the most pivotal moments in life, particularly its bookends.
Those on either side of the abortion debate still argue over when conception begins. Meanwhile, on the other end, technology has allowed us to prolong life far past what we would consider a natural end, making what death is, and what it should be, extremely difficult for some to decipher, particularly when it means letting go of someone in their family. The Terry Shiavo case was an example of this. It also brings up the question of what is a dignified death, as typified by California’s new Right to Die law.
The very concept of death has been shaken up by life support technology. The heart may beat on for weeks in a living cadaver. The skin may feel warm to the touch. But without activity inside the brain, the person is dead without question. Still, with these signs, it’s hard for a family to let go. Once the brain stem is gone, they are no longer with us.
Here is where the controversy comes in. There are cases where medical professionals say a person is brain dead, while the family fights to keep their loved one on life support. For instance, the 2013 case of Jahi McMath. The thirteen year-old Oakland, Calif. native was undergoing routine surgery for sleep apnea. Surgeons were removing her tonsils and some other soft tissue, and elected procedure to help her sleep better. Unfortunately, something terrible happened while she was on the operating table.
McMath was declared brain dead on December 12 of that year. The family fought in court to keep her on the ventilator, and she was moved to another, unnamed medical facility across the country. Despite the lack of activity in her brain, her other life signs registered normal. Another case surrounded Marlese Munoz, a woman 14 week pregnant who on November 26, 2014 suffered a pulmonary embolism. She was soon pronounced brain dead at John Peter Smith Hospital in Fort Worth, Texas. Here, the family insisted she be taken off life support, while the hospital refused, citing a Texas law that states such support cannot be withdrawn from a pregnant patient.
We tend to think of brain death and a coma as the same thing. In medicine, they are worlds apart. Coma is a state of unconsciousness, according to the Mayo Clinic. Generally speaking, a coma doesn’t last more than a few weeks. After that, the person awakens. Best case scenario, they regain full cognitive and physical functioning. Worst case, they remain in a persistent vegetative state. Terry Schiavo was an example of this. Such a person may move their eyes or make sounds. Yet, they cannot understand speech or respond to it. Fortunately, most comatose patients recover with time.
A brain dead person however is technically dead. They will never recover, and once removed from the machines, all bodily functions will eventually cease. The Uniform Determination of Death Act states that the cessation of respiratory or heart functions, or of brain functioning inside the brain stem constitute brain death.
Lower brain functions derive from the top portion of our spinal cord. This is responsible for body function regulations such as breathing, heartbeat, the reflexes, sleep-wake cycles, and body temperature. The Upper Brain is where higher functions take place, such as the five senses. With brain death, neither the upper nor the lower part of the brain functions. But certain body functions, including the heartbeat, may go on. Though these give some families hope, unless it is a case of misdiagnosis, the patient will never recover.
Physicians say it is difficult for many grieving families to understand that a person is dead, even when their heart is still beating. Whereas the heart usually stops at some point within the first 72 hours, in can in some cases continued to beat for a week or more. Without brain function, someone on a ventilator may look like their breathing. But they could never do it on their own.
The American Academy of Neurology updated the guidelines for brain death in 2010. Here, doctors must go through a checklist including 25 separate items before brain death can be declared. All the criteria must be met. However, these definitions vary legally from one state to the next. Even so, no one has ever been declared brain dead and survived.
Brain death was a term first created for the routinization of organ and tissue harvesting. That’s according to Margaret Lock, a medical anthropologist at McGill University in Montreal. In an article called, “Inventing Death and Making it Believable,” she writes that the concept of brain death only exists to give legal parameters in cases where the organs were still viable, yet the patient is longer alive. This designation became protection for medical professionals and organizations to handle such organs without fear of legal reprisal.
Many countries today argue over just what brain death actually means. There is no conception of this in Japanese culture for instance. They do not discriminate between the heart and the mind, which in the West comes from Descartes. Whereas, in America, it has a hard and detailed definition. Without this designation, organ donation would be hobbled.
That doesn’t stop unscrupulous organ traders and medical centers from harvesting organs even before families are made aware that their loved one is deceased. Since a large number of accidents and incidents of violence happen in the inner cities of America, a disproportionate number of organs come from these places. Many times the families are not made aware, or medical centers don’t do everything they can to make sure families know before their loved ones organs are made into a commodity. Medical technologies have bred so much advancement, and have helped improve human life in tremendous ways. But the ethical lag means that there are a lot of dark corners and niches that cause waste, deceit, denial, and harm. How we move forward in these instances, and what motivations are involved must also be considered.
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What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
Scientists find that bursts of gamma rays may exceed the speed of light and cause time-reversibility.
- Astrophysicists propose that gamma-ray bursts may exceed the speed of light.
- The superluminal jets may also be responsible for time-reversibility.
- The finding doesn't go against Einstein's theory because this effect happens in the jet medium not a vacuum.
Jet bursting out of a blazar. Black-hole-powered galaxies called blazars are the most common sources detected by NASA's Fermi Gamma-ray Space Telescope.
Cosmic death beams: Understanding gamma ray bursts<div class="rm-shortcode" data-media_id="cu2knVEk" data-player_id="FvQKszTI" data-rm-shortcode-id="c6cfd20fdf31c82cb206ade8ce21ba3f"> <div id="botr_cu2knVEk_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/cu2knVEk-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/cu2knVEk-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/cu2knVEk-FvQKszTI.js"></script> </div>
Researchers dramatically improve the accuracy of a number that connects fundamental forces.
- A team of physicists carried out experiments to determine the precise value of the fine-structure constant.
- This pure number describes the strength of the electromagnetic forces between elementary particles.
- The scientists improved the accuracy of this measurement by 2.5 times.
The process for measuring the fine-structure constant involved a beam of light from a laser that caused an atom to recoil. The red and blue colors indicate the light wave's peaks and troughs, respectively.
Scientists at Washington University are patenting a new electrolyzer designed for frigid Martian water.
- Mars explorers will need more oxygen and hydrogen than they can carry to the Red Planet.
- Martian water may be able to provide these elements, but it is extremely salty water.
- The new method can pull oxygen and hydrogen for breathing and fuel from Martian brine.