Jan 12, 2019
One of the tasks assigned to physicians, and certainly not a
task one thinks of when entering medical school, is to verify
death. The first time you declare someone dead - for me, it was as
a first year resident in the ICU - is a weird feeling because of
the finality of it. As with anything you do as a physician for the
first time there is some uncertainty that you aren't "messing up."
But you don't need to be a doctor to declare someone dead because
anyone can tell when someone or something is dead, right?
However, what happens when they are breathing on a machine,
being fed by a tube, and receiving medicines by IV? Are they dead?
Unconscious? Can the rest of the body be alive while just the brain
isn't? Is brain death declared at the bedside really a way of being
dead despite the rest of the body continuing on?
My guest, Dr. Alan Shewmon, is a professor emeritus in
pediatric neurology who spent his career evaluating brain and
neurological disorders. You can find a lot of his work online and
much of it now has to do with whether brain death (as we
traditionally think of it as declaring someone dead because of a
loss of brain function) can be a separate definition of death. He
presents a number of extraordinary clinical cases which challenge
the reasons most physicians feel comfortable declaring death
without the cellular death of the patient's other organs.
Aside from being an interesting philosophical or bioethical
discussion, there are practical considerations for not being able
to declare patients brain dead. Primarily, the solid organ
transplantation specialty would be dramatically scaled back and the
number of patients needing transplants would increase. Also, the
ability of hospitals to stop life saving interventions, i.e. life
support, for "hopeless cases" would be made more difficult
Dr. Alan Shewmon is Professor
Emeritus in Pediatrics & Neurology at UCLA. He has publicly
questioned whether we can die twice - whether there is truly a
brain death that should count as the death of the patient while the
rest of their body may be viable.
The Curious Case of Jahi McMath- Dr. Shewmon's discussion and
evidence from his review of the case of the young girl. His
discussion begins at the 41:35 mark.
What Does it Mean to Die? An article from the New
Yorker regarding the case of Jahi.
Episode 017: The
practice of forced organ harvesting in China where they don't
bother to determine whether someone has an irreversible loss of
brain function - they execute the donors.
Andy Larson: This is the donation link to honor Andy's death
with the Grand Rapids Choir of Men and Boys where he blossomed and
served as a head chorister.
YouTube for Paradocs:
Here you can watch the video of my late son singing his solo on the
Paradocs YouTube page.
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