To Die or Not to Die
Michael C. Braswell, Belinda R. McCarthy, Bernard J. McCarthy in Justice, Crime, and Ethics, 2019
Arbitrariness is hard to eliminate. The federal courts now use a guidelines system that is meant to reduce arbitrariness in all criminal sentencing. Problems persist. For one thing, the Federal Sentencing Guidelines allow for reductions based on offenders providing information on other criminals. Therefore, offenders who either have no information to give or refuse to give information receive no reductions. One first offender, for example, refused to implicate her own mother and was given a ten-year sentence, while an offender caught with 20,000 kilos of cocaine served only four years in prison because he “cooperated,” that is, gave information on other dealers (Schlosser, 2003, p. 61). Another effort to reduce arbitrariness is proportionality review. This means that courts review death penalty cases in the jurisdiction (usually one state) to attempt to ensure that only the most horrible murders get the death penalty and that all homicides less serious than the least serious death penalty case get a sentence less severe than the death penalty. The basic problem is that such a proportionality review is difficult to do (Mandery, 2003). Measuring severity is not as simple as measuring blood pressure, especially in light of the fact that “the fundamental equality of each survivor’s loss creates an inevitable emotional momentum to expand the categories for death penalty eligibility” (Turow, 2003, p. 47).
Cases
Ira Bedzow in Giving Voice to Values as a Professional Physician, 2018
While brain death has become the predominant criterion for determining whether a person is dead or not, the legal and clinical guidelines for determining death and the public understanding of brain death versus other criteria of death creates controversy and sometimes conflict in the clinical setting. Before understanding how to act in a situation where different views of death are being voiced, it is important to first take a step back to see how these views were formed and the practical ramifications between them. First, there is a difference between definitions of death, criteria of death, and tests that prove that death has occurred. A definition of death is an explanation of the concept that makes its meaning explicit. Definitions of death are not explicitly scientific or medical; rather, they are social and legal. For example, two prominent definitions of death are the following: Death is the permanent cessation of functioning of the organism as a whole. Despite this cessation, individual subsystems may continue to function.27Death is the irreversible loss of that which is essentially significant to a species.
Death and Dying
Gary Seay, Susana Nuccetelli in Engaging Bioethics, 2017
The standard account of death has three components: a definition, a criterion, and medical tests. Defining death is a philosophical matter. For American philosopher Thomas Nagel death is “the unequivocal and permanent end of our existence” (1979: 1). But when does one of us go out of existence? The standard account responds with the biological sciences’ definition of organismic death: That is, an organism dies when it has ceased to function as a coordinated system. Death is the permanent cessation of function in the brain if this is the central coordinator of bodily functions in humans. But if the heart and lungs are the central coordinators, then death is the permanent cessation of cardiopulmonary function.
What is Death and Why Do We Insist on the Dead Donor Rule? A Response to Our Critics
Published in The American Journal of Bioethics, 2023
Emil J. Busch, Marius T. Mjaaland
Although we are inclined to think that donors in all cDCD-protocols are dead following the 5-minutes no-touch period, that is not the issue we are trying to settle. Instead, the scope of our article is to discuss the question: “[E]ven if we assume that the plain meaning of irreversibility is required before the determination of death is valid, does this entail that cDCD cannot comply with the DDR?” Biologically, dying and even “death” is a long process that still goes on at the time when death is declared. The physician knows that there is living organic material within the dying patient that may save other lives. This makes the need for ethical principles such as the DDR all the more significant (Batra and Latham 2023; Napier 2023). The 5 minutes limit is to some extent arbitrary, but we argue that it is sufficient in order to secure the dignity of the patient, indicating that the organism biologically is “dead enough” for the ethical and medical declaration of death. We hope that this specification makes some points of our argument clearer.
A primer on sleeping, dreaming, and psychoactive agents
Published in Journal of Social Work Practice in the Addictions, 2023
Rick Csiernik, Maeghan Pirie
Ketamine, a glutamate receptor antagonist, is used clinically, primarily in developing nations, as an anesthetic though more recently has become popular as an anti-depressant for treatment-resistant individuals. Thus, it, like PCP, has potent sedative effects that can not only disorientate a user but also induce sleep. When ketamine is used in surgery, recovery tends to be slower than when other anesthetics are employed (Schwenk et al., 2018). Violent dreams and flashbacks have been associated with both clinical and non-medical use of the drug. In larger doses, the ‘K-hole’ effect occurs, a distinct feeling of mind and body separation that in severe circumstances can lead to stupor or unconsciousness, with a resulting feeling of confusion and loss of short-term memory. Some have equated this to an out-of-body or near-death experience. Ketamine use increases nREM intensity and duration, and while it does not increase or decrease REM sleep, ketamine use does tend to produce more vivid and violent dreaming (Feinberg & Campbell, 1993; Hejja & Galloon, 1975).
Clarifying the DDR and DCD
Published in The American Journal of Bioethics, 2023
James L. Bernat
Moreover, in light of reports describing how emerging technologies have changed previously irreversible states to be reversible, there is an even greater necessity to rely on the permanent cessation of vital functions as the criterion of death. Intractable cardiac arrest after failed CPR had been universally regarded as the sine qua non of the circulatory-respiratory criterion of death because the unsuccessful attempt to reverse cardiac arrest proved that circulatory cessation was irreversible. But recently, cases have been reported in middle-aged patients with acute myocardial infarction producing intractable cardiorespiratory arrest in whom physicians suspected that heartbeat might spontaneously resume days after the acute interval. Therefore, these patients were not declared dead—the universal medical practice after failed CPR—but instead were treated with extracorporeal membrane oxygenation (ECMO) which kept their blood oxygenated and circulating (Ortega-Deballon et al. 2016). After several days, when their heartbeat returned spontaneously, ECMO was discontinued, and at hospital discharge the patients were neurologically intact (Brown et al. 2013; Tweet et al. 2013). This remarkable series of events showed that even in cases of intractable cardiac arrest after failed CPR, physicians no longer can rely on the irreversibility of circulation as a criterion of death.
Related Knowledge Centers
- Ageing
- Biogerontology
- Biological Process
- Brain Death
- Cardiopulmonary Resuscitation
- Necrosis
- Virus
- Cardiovascular Disease
- Decomposition
- Clinical Death