DEATH ISSUES AND CONCERNS

Report by: Lucila O. Lugo

Of all living beings, only man knows that he will die sometime, somehow, and somewhere. Depending upon how one looks at it, this verity may be taken either as an advantage or disadvantage, a blessing or curse.

Our impending death keeps us in anxiety and anguish, for we can never know how, when, and where it will happen, even if we are certain it will definitely occur. At the moment an individual is born, his journey towards death begins. No matter how strong, powerful, affluent, and well-situated an individual may be, his strength, power, affluence, are no avail when death summons him.

Why all these hassles about death? Isn t it as natural to die as it is to be born? Why do we seem to give so much importance to it?

Well, death appears to be simple and natural as we may think of it, but the scientific advance we have initiated and the technological culture in which we live have raised a hose of questions and problems with respect to death. While science and technology have given us solutions to many of our problems, they have also created different predicaments affecting our ordinary concept of death.

the need to redefine death

Redefine to know or be able to determine the exact point in time when a person is dead Why is there a need to redefine death? 1. There is a widespread and increasing use of new devices for prolonging life such as life-support machines.

With the use of life-sustaining devices, we are able to prolong life for a considerable period, or even to save a person s life from impending death. However, there are occasions or situations when, instead of prolonging or saving life, we are only prolonging the dying process and the suffering or the dying individual.

If we can only determine the exact point in time when a person is dead, with or without the use of lifemaintaining machines, then there is no need to attach the dying person to these devices for 3 obvious reasons: To avoid paying the numerous expenses to be incurred To eliminate the suffering of the dying individual (beneficence) To be able to use these life-support machines for patients who have better chances of survival, most especially if the demand to use them is greater than the supply.

There is a great demand for cadaver organs for transplantations. The chances of successful organic transplant are higher if the required organ is removed from the cadaver immediately after death, usually in terminal cases.
2.

several definitions of death

PHYSIOLOGICAL DEFINITION
A person is dead when the heart has stopped beating. Since blood and breath are essential to the continuation of life, when people stop breathing and pulsation stops, they are pronounced dead. Dying process is prolonged with the use of mechanical respirator.

RELIGIOUS/PHILOSOPHICAL DEFINITION
Death means the separation of the soul and the body. Soul principle of life; animates and gives form to the body, making it distinctively human with rationality and freedom When the soul departs from the body, the person ceases to be human, and death occurs because the substantial union of body and soul has been dissolved. Has weakness because there is an uncertainty regarding the precise time of soul s departure.

BRAIN DEATH DEFINITION

A condition in which the brain is completely destroyed, and in which the cessation of function of all other organs are imminent and inevitable By and through the use of electroencephalography (EEG) and electro-cardiogram (ECG), health professionals can determine the total or irreversible loss of circulatory and respiratory functions. Absence of : receptivity and responsiveness, movement or breathing and reflexes

CELLULAR DEFINITION Disintegration and breakdown of the metabolic processes of the body s substance. Considers the irreversible loss of neocortical activity as the only significant criterion, because it eliminates all capacity for consciousness and all social integration possible. Needs an EEG.

The foregoing definitions have one thing in common: Death is the cessation of life The total arrest of both intellectual and physiological functions in an individual Total ceasing of the circulation of blood and of all vital functions, such as respiration and pulsation Jewish, Roman Catholic and Protestant scholars agree that the complete and permanent absence of any brain-related vital bodily function means that an individual is dead at least for purposes of definition.

The irreversible cessation of all vital bodily functions are accepted as reasonably accurate indicators which are adequate justifications for allowing such processes as embalming and autopsy. Leading spokesmen of widely ranging traditions consider brain-related criteria for pronouncing death. Brain death is consonant with biblical pronouncements of what constitutes an acceptable definition of death.

To treat a human being who has irreversible loss all brain functions as if he were still alive seems to be an affront to that person. Maintenance of a dead person on life-support systems for no reason at all is an irresponsible squandering of economical and social resources Such a practice places unnecessary financial burden and emotional burden on the person s family which is morally wrong.

Attitudes towards death

COGNITIVE
Attitudes which indicates how dying individuals think about death include acceptance and denial

AFFECTIVE
Attitudes which bear out the feelings of the dying individual may include depression, sense of loss, and fear.

BEHAVIORAL
Attitudes includes anger or irritability, bargaining, resentment, and fear Ex. of expressions: Ang daming taong masasama, bakit hindi pa sila ang nagdaranas ng ganito? (bitter and resentful) Diyos ko, huwag naman muna sana ngayon, maliliit pa ang aking mga anak! (bargaining) Ayaw ko pang mamatay. (fear)

Several views of death

NIKOLAI BERDYAEV
Russian theologian Without death, life would be meaningless. Our last hope lies in death Death is only a path, or an intermission number between the present and hereafter Immortality- can be attained only through death; death s great paradox

EPICURUS
Athenean thinker Either there is immortality or there is none. If there is, then we should be glad there is death, for once we are dead, we shall become immortal; if there is none, then death is our final liberation from pain and suffering. We should not fear death but be happy about it. If we are still alive, death has not yet come; but once we are dead, then death cannot touch us anymore. Therefore, whether we are alive or dead, death cannot touch us. We should not fear death.

MARTIN HEIDEGGER
Death is a completion of life.

FILIPINOS
Sa kabaong at libingan ang lahat ay pantaypantay; dukha t kardinal magkaparis kung mamatay. Death is a great equalizer, for as far as the coffin and the grave are concerned, all are equal; whether you are a poor individual or a cardinal, you are alike when you die.

ST. JOHN THE EVANGELIST Quotes Jesus Christ as saying: I am the resurrection and the life; he that believes in me, though he were dead, shall live again; and whoever lives and believes in me shall never die (11:25-26)

Application of ethical theories

NATURAL LAW ETHICS
Death is a part of nature Person is dead once the soul leaves the body Do not disagree with brain death definition Extraordinary medical measures when vital functions of the brain completely stops is useless Let nature take its own course

UTILITARIAN PRINCIPLE
Brain death definition seems to be good in keeping with the utility percept Even the donations of transplantable vital organs, at least with informed consent, is warranted by the greatest happiness for the greatest number principle

PRAGMATIST
Its notion of practicality, usefulness, and beneficiality may justify the application of the brain death definition issue in the medical context.

SITUATION ETHICS
Joseph Fletcher accepts brain-related criteria for pronouncing death with conjunction with both euthanasia and organic transplantations

RAWL S CONCEPT OF JUSTICE

May justify the unplugging of life-sustaining machines if and when they are no longer useful to the dying person so that they will not prolong his suffering The same with Ross twofold principle by which to resolve conflicting duties

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