Tuesday, April 05, 2005

Terri Schiavo's corpse continued to function for 15 years

I'm now coming to think that the biggest mistake in the Terri Schiavo case was that the doctors failed to declare her dead long ago. As long as she was officially alive, one could argue that she should be treated as other living human beings. But for all intents and purposes, she wasn't alive.

Now, of course, it's me saying that. But as I understand it, her cortex had disintegrated and had been replaced with spinal fluid. There was no way she could have recovered consciousness. Don't we have brain dead as a criterion for death? Why wasn't it applied in her case?

Declaring a patient brain dead is certainly a very serious responsibility, and the physician who does it must be very cautious. But presumably it is done. I'm sure we have faced similar cases in the past. We must have a fairly large body of precedent. I'm surprised it wasn't applied. I don't understand why the situation was allowed to go on the way it was.

One thing this case illustrates is that one can be brain dead even though one's body can continue to function more or less on its own. Should that make a difference? If one is brain dead but with a functioning body, isn't one still dead? Probably. After all, we retrieve functioning organs from corpses and implant them in living people. Is that really so different from having an entire corpse (except for the part that exhibits consciousness) that is still functioning? I think that's the way the analogy would have to go.

1 comment:

Ereshkigal said...

The term "brain dead" is not defined the same way from jurisdiction to jurisdiction, nor even within the medical community. The most generally descriptive definition was promulgated by the Quality Standards Subcommittee of the American Academy of Neurology, which declared that brain death was “the irreversible loss of function of the brain, including the brainstem.”

The problem with using the term to describe Ms. Sciavo's condition is that she retained brainstem activity, even though her cerebral cortex was destroyed.

No state (and internationally, no nation) defines brain death in a way that would permit a person who had lost cortical functioning (but still had brainstem activity) to be declared brain dead, and therefore dead.

The tragedy for those who desire not to be bodily maintained after cortical brain death (as in Ms. Schiavo's case) is that the only legally permissible means of ceasing brainstem activity is withholding medical treatment, i.e. artificially administered nutrition and hydration. "Complete" brain death subsequently occurs after major organs break down and fail, and in turn disturb the electrochemical balances necessary for brainstem activity.

By that point, of course, the dead person's organs are useless for transplanting or any other beneficial use.

We have a long way to go before we arrive at a humane, rational, and respectful definition of death.