
According to a US law passed in 1981, after one's condition remains irreversible after six hours, their physician can legally declare them dead. Also included in the law, a group of experts appointed by the President determined this definition of death: "An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead." Many physicians feel uncertainty with the phrases "irreversible" and "entire brain". The fact that death holds no clear definition halts the progress of the organ transplantation system. Although many countries use this law as a model for their legal definition of death, one must ask how this group of "experts" could have successfully defined death for millions of people. In reality, death holds a different meaning for many people. The author of Delimiting Death, an editorial in Nature Magazine, believes that death needs a realistic and set definition in order to keep up with the fast-paced organ transplantation system. Attaching a definition to death for the sake of this system seems insensitive and harsh.
Many physicians often follow “the spirit” when declaring someone dead instead of following the law definition. The author feels this poses a major problem and calls it unfortunate. On the contrary, I believe that following a spirit or having emotion when practicing your job, whatever it may be, is a necessity. We are humans! We have feelings and emotions and we should use them. These actions are what allow people to be so passionate about their jobs. Yes, guidelines carry essential roles, but the serious topic of death requires and deserves much more considerations than guidelines. A family is not going to understand any law or guideline when they see their loved one with vital signs of life, however minuscule they may be.
Another point the author makes claims that physicians struggle with how long one should wait before declaring the patient’s condition “irreversible”. The law recommends six hours! This seems much too short to give someone a chance to save their life. Even the author shares that some physicians who were required to wait up to 36 hours under given circumstances, have observed brainstem-mediated reflexes, such as a cough. Respecting the law, the "entire brain" must be non-functional to declare one dead. It seems to me that the patient and family should at least be given 48 hours to accept death. Although organ transplantation system carries a time restraint, the declaration of death should not be rushed for the system's sake. Why is the life of a person in need of a transplant deemed more significant than a person nearing death? Physicians also struggle with determining when the "entire brain is irreversible." According to a statement opposing death, signed by 120 professionals of 19 different nations, "'brain death' is not death, and death ought not to be declared unless the entire brain, including the brain stem, and the respiratory and circulatory systems have been destroyed." The 1981 US law lacks this crucial and straight-forward statement.
The author does make a valid point: “The problem is that death is not a phase transition whereby a person stops being alive and becomes dead in an instant.” The 1981 US law does not support this statement, making it unclear and ineffective. In response to this statement, the author feels a clear definition of death is needed. However, it is with this statement that I believe a clear definition of death can never be determined. There does come a point in which a person is clearly dead and will never return to life again. This point varies between doctors, especially when looking at their experience levels. A doctor who has been in practice for thirty years will feel more comfortable with declaring death and sharing the news with the family, or be more successful in explaining to the family that the time has come to take the patient off life support. On the other hand, a first-year doctor most likely does not acquire enough confidence and certainty to declare their patient dead, especially with a family not ready to depart from their loved one. What needs to be determined is not the definition of death, but at what point death is a better option than life. Although organ transplants obtain importance and carry a time-restraint, they should not be a deciding factor in declaring death.
The last statement the author argues really upsets me. He claims, “Few things are as sensitive as death. But concerns about the legal details of declaring death in someone who will never again be the person he or she was should be weighed against the value of giving a full and healthy life to someone who will die without a transplant.” I am sure many other people, me included, have had experiences that change who they are forever. This does not mean that the person can no longer live. In almost all cases of illness survivors, they do become different people at the end of the process. Whether they miraculously become healthy again or spend the rest of their lives in the hospital, they are just thankful to be alive. In my opinion, a person willing to fight for their life should have the chance to do so.