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Commentary: What Is Death?

Should parents have to option to determine the definition of death for their children? JahiMcMath’s case has motivated that question, along with a host of associated ethical concerns. In this edition of Valley Public Radio’s The Moral Is, Christopher Meyers, Professor of Philosophy at CSU Bakersfield and a clinical ethicist, concludes that there are medical, scientific and moral reasons why determinations of death must be left to health care experts.

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What does it mean to say someone has died?

Jahi McMath’s tragic story has brought to surface the many confusing ways we talk about death, often with profound moral implications. 

Thirteen-year-old Jahi, like more than a half million other U.S. children last year, went in for a fairly routine surgical procedure to help with her sleep apnea: Doctors removed her tonsils and adenoids, along with some excess tissue in the back of her throat. Things went terribly wrong, however, right after Jahi’s surgery: A ruptured blood vessel resulted in oxygen deprivation to her brain, causing her death.  

She died, and yet … her heart was beating, her chest rose and fell and her skin was warm. And, as we learned as the story progressed, it became clear that other organs – kidneys, liver, digestive track – also continued to function.

How can that be? How can one be dead and yet have a body that appears very much alive?

The last 50 years have brought some amazing medical technologies and skills that effectively keep body parts functioning – typically to allow other organs to heal, but sometimes to preserve those parts after the brain has suffered complete and irreversible damage. Such preservation after death is necessary for organ donation and it is also sometimes used – briefly used – to help ease a family’s transition to the reality of the death.

As amazing as those medical advances are, however, they cannot bring back a dead brain. Nor can brains be resuscitated, or replaced. Further, when the brain is sufficiently damaged, the rest of the body is completely dependent on medical intervention. Remove the intervention and the normal decay process rapidly occurs. Indeed that process occurs even with those interventions, it just happens more slowly.

Furthermore, when the brain is gone, we are gone. Our consciousness, our memories, our ability to experience pleasure and pain – indeed to experience anything at all – is gone. Some sense of self may survive in the afterlife, but survival in bodily form is lost. This is why every state in the country has adopted whole brain death as the legal definition of death of the person.

Hence the horrible tragedy of Jahi’s case. Her family experienced the terrible shock of a medical occurrence that seemingly should not happen to a healthy 13-year-old. But it did; she died, and no amount of wishing, no court order, no continuing medical intervention will change that.

But isn’t it the family’s right to retain such false hope? I would say ‘no’.

First, they do not have the right to determine their own definition of death – that’s a medical decision, based on the best available science.

Second, they cannot demand that a hospital continue to provide scarce resources when there is no associated benefit – not just an ICU bed, but countless hours of time for hospital personnel and lawyers.

Further, I worry about how all this is affecting Jahi’s family, especially the other children. The associated emotional and financial harms will undoubtedly have a lasting impact.

In short, and like it or not, Benjamin Franklin was right: Death and taxes continue to be certain, and no amount of wishing or hoping will make it otherwise. 

Christopher Meyers is a Professor of Philosophy and Executive Director of the Kegley Institute of Ethics at California State University, Bakersfield. The views expressed are his own and do not necessarily reflect those of the University or the Institute or Valley Public Radio.

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