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What Is Death?

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How should we define the death of a person? Philosophers and physicians have long pondered this question, yet we still don’t have a satisfactory answer. For much of human history, death was synonymous with the cessation of the heartbeat. However, there are patients in hospitals whose hearts are still beating but who appear to be less than fully alive. Are they dead?

Fifty years ago, a Harvard committee tried to bring a modern perspective to this question. The chairman, Henry Beecher, a renowned bioethicist, was motivated by the conundrum of “hopelessly unconscious” patients being kept alive by mechanical ventilation and other newly developed medical technologies. Such patients were “increasing in numbers over the land,” he wrote.

Dr. Beecher’s committee, in a report titled “A Definition of Irreversible Coma,” defined a new state of death — brain death — in which patients were unconscious, unresponsive to pain and unable to breathe on their own, and had no basic reflexes (pupils unreactive to light, no gag reflex and so on). These were conditions suggesting a brain stem that was irreversibly damaged. Such patients, the committee asserted, were in fact dead and could be declared so by a physician. Additional tests, such as a flat brain-wave scan or an angiogram showing no cerebral blood flow, could be used to confirm the........

© The New York Times