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Peter McKnight: Defining Death as an Issue Canada's Parliament Must Address

Opinion: Advances in medicine and current research are making us rethink what it is.

Parliament, which has remained silent for far too long on an elemental life and death issue, must finally get involved.
Congress, which has been silent on life-or-death issues for too long, must finally come to an agreement. involvement. Photo by JUSTIN TANG /POOL/AFP via Getty Images files

, except death and taxes, nothing is certain."

— Benjamin Franklin

As far as I know, taxes are still inevitable, but death. Not so much it seems.

At least for pigs. Researchers at Yale University recently announced that they had partially revived several organs, including the heart of a pig that had been dead for an hour.

This study showed that the same team restored cellular activity to dead pig brains. Following a particularly successful previous study, there was no evidence of electrical activity consistent with consciousness.

In any case, it should be borne in mind that the experiment involved reviving pigs rather than humans, but the study raises serious ethical questions. Most importantly, it calls into question the definition of "death."

That was not always the case. In the primitive days before life support machines, things seemed relatively simple. Most agreed that death occurred after irreversible loss of cardiopulmonary function (pulse and respiration).

Likewise, advances in medicine have made the water murky. The development of life support systems has given rise to a new definition of brain death, characterized by the irreversible loss of all brain functions.

Note that neither of these definitions are "correct" answers. Both cardiopulmonary death and brain death are components of the dying process, characterized by the gradual cessation of all organic functions. 

Nonetheless, brain death is now widely accepted by the medical profession, and in 1981 the Canadian Law Reform Commission adopted a similar definition in Congress.

  1. Yale University team restored blood circulation and other cellular functions in multiple porcine organs an hour after pigs (not this one) died from cardiac arrest.

    Researchers "resurrected" dead pig organs, raising questions about life and death

  2. Cornelia Li for National Post 91} Life — After Death: Does Consciousness Continue When the Brain Dies?

Law Professor Erica Chamberlain As you do, patchwork quilts of definition were left across Canada. Some states have codified definitions of death, while others define death in different ways for different purposes. What constitutes death may differ, for example, depending on whether the subject at issue is organ donation, deprivation from life support, inheritance law, or criminal liability for murder.

To make matters worse, while brain death is widely accepted, adherents of certain religions still agree on definitions of cardiopulmonary death. And, of course, it has caused much controversy as to when life support can and should be discontinued.

It has been asked to settle, but it is not suitable for court. In the absence of a statutory definition of death, or multiple definitions depending on the law of reference, courts have left the definition of death to medical professionals.

This is utterly wrong, because physicians are no more competent than judges when it comes to defining death.

Certainly, your doctor will tell you if you meet the criteria for cardiopulmonary arrest or brain death. But since the meaning of death, like the meaning of life, is a moral question, not a medical one, he does not know which of these two equally valid definitions should be counted as death. Hmm.

Thus, a person of different moral, religious, or spiritual beliefs may draw different conclusions about when he or her loved one died. can be reached.

On the other hand, taking someone off life support is murder. Maintaining it consumes precious and scarce medical resources. You can regain your health.

So which definition should take precedence? Or is there a preferred third definition, such as irreversible loss of higher brain function? Or should patients and their families be allowed to make choices according to their values?

Given the deeply moral nature of these questions, we cannot expect doctors and judges to give us the "correct" answers. Rather, medical and legal professionals, along with bioethicists, religious leaders, and most of all, the Canadian people, must unite to provide answers.

So the long-silent Congress must finally get involved. Congress finally needs to speak up as medical care restores lives. Because silence literally equals death.

mcknightvansun@shaw.ca

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