Guidelines for Determining Death Based on Neurological Criteria
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Piercing the Veil: the Limits of Brain Death As a Legal Fiction
University of Michigan Journal of Law Reform Volume 48 2015 Piercing the Veil: The Limits of Brain Death as a Legal Fiction Seema K. Shah Department of Bioethics, National Institutes of Health Follow this and additional works at: https://repository.law.umich.edu/mjlr Part of the Health Law and Policy Commons, and the Medical Jurisprudence Commons Recommended Citation Seema K. Shah, Piercing the Veil: The Limits of Brain Death as a Legal Fiction, 48 U. MICH. J. L. REFORM 301 (2015). Available at: https://repository.law.umich.edu/mjlr/vol48/iss2/1 This Article is brought to you for free and open access by the University of Michigan Journal of Law Reform at University of Michigan Law School Scholarship Repository. It has been accepted for inclusion in University of Michigan Journal of Law Reform by an authorized editor of University of Michigan Law School Scholarship Repository. For more information, please contact [email protected]. PIERCING THE VEIL: THE LIMITS OF BRAIN DEATH AS A LEGAL FICTION Seema K. Shah* Brain death is different from the traditional, biological conception of death. Al- though there is no possibility of a meaningful recovery, considerable scientific evidence shows that neurological and other functions persist in patients accurately diagnosed as brain dead. Elsewhere with others, I have argued that brain death should be understood as an unacknowledged status legal fiction. A legal fiction arises when the law treats something as true, though it is known to be false or not known to be true, for a particular legal purpose (like the fiction that corporations are persons). -
Classification of Cell Death
Cell Death and Differentiation (2005) 12, 1463–1467 & 2005 Nature Publishing Group All rights reserved 1350-9047/05 $30.00 www.nature.com/cdd News and Commentary Classification of cell death: recommendations of the Nomenclature Committee on Cell Death G Kroemer*,1, WS El-Deiry2, P Golstein3, ME Peter4, D Vaux5, with or without, caspase activation and that ‘autophagic cell P Vandenabeele6, B Zhivotovsky7, MV Blagosklonny8, death’ represents a type of cell death with (but not necessarily W Malorni9, RA Knight10, M Piacentini11, S Nagata12 and through) autophagic vacuolization. This article details the G Melino10,13 2005 recommendations of NCCD. Over time, molecular definitions are expected to emerge for those forms of cell 1 CNRS-UMR8125, Institut Gustave Roussy, 39 rue Camille-Desmoulins, death that remain descriptive. F-94805 Villejuif, France 2 University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA Preface 3 Centre d’Immunologie INSERM/CNRS/Universite de la Mediterranee de Marseille-Luminy, Case 906, Avenue de Luminy, 13288 Marseille Cedex 9, It is obvious that clear definitions of objects that are only France shadows in Plato’s cage are difficult to be achieved. Cell death 4 The Ben May Institute for Cancer Research, University of Chicago, 924 E 57th and the different subroutines leading to cell death do not Street, Chicago, IL 60637, USA 5 escape this rule. Even worse, the notion of death is strongly Sir William Dunn School of Pathology, University of Oxford, Oxford OX1 3RE, influenced by religious and cultural beliefs, which may UK 6 Molecular Signalling and Cell Death Unit, Department for Molecular Biomedical subliminally influence the scientific view of cell death. -
Brain Death and the Philosophical Significance of the Process Of
The Linacre Quarterly Volume 68 | Number 1 Article 3 February 2001 Brain Death and the Philosophical Significance of the Process of Development of, and Cessation of, Consciousness in Arousal and Awareness in the Human Person Theodore Gillian Follow this and additional works at: http://epublications.marquette.edu/lnq Recommended Citation Gillian, Theodore (2001) "Brain Death and the Philosophical Significance of the Process of Development of, and Cessation of, Consciousness in Arousal and Awareness in the Human Person," The Linacre Quarterly: Vol. 68: No. 1, Article 3. Available at: http://epublications.marquette.edu/lnq/vol68/iss1/3 Brain Death and the Philosophical Significance of the Process of Development of, and Cessation of, Consciousness in Arousal and Awareness in the Human Person. by Theodore Gillian, OFM The author is a priest ofthe Order ofFriars Minor in the Province of the Holy Spirit, residing in Sydney, Australia. Before entering the priesthood, he was a pharmacist I am arguing that the human person, as the human identity from conception to death, links death with the beginnings of life and vice versa. This challenges us to identify the human person as one in a unitary development, physical and spiritual, that is sundered only at death. In approaching the matter from this angle I bring into focus the problem of identifying what happens at death and the problem of identifying what happens at the " beginning of personal life. This requires seeing through our psychological states to discover the necessary substratum that actually is the human person. At the outset, death is taken as the demarcation between the "process of dying and disintegration" (1 Garcia, 37). -
Brain Death Panel Slides
SUPPORTING THE BRAIN DEATH DECLARATION THE ROLE OF PALLIATIVE CARE May Ronci, RN, CHPN Lori Carlton-Mowry, MSW, ACSW Frequently What is brain death? Asked Questions Brain death occurs when a person has an irreversible, catastrophic brain injury, which causes total cessation of all What Tests can be used to brain function (the upper brain structure and brain stem). evaluate brain death? Brain death is not a coma or persistent vegetative state. Brain death is determined in the hospital by two physicians. • Apnea Test: The apnea test looks for a patient’s effort to breathe on their own. If • Some causes of brain death include, but are not limited to: someone cannot breath on • Trauma to the brain (i.e. severe head injury caused by a motor vehicle crash, gunshot wound, fall or blow to the head) their own, this is considered a very strong • Cerebrovascular injury (i.e. stroke or aneurysm) confirmatory test for brain • Anoxia (i.e. drowning or heart attack when the patient is revived, but not before a lack of blood flow/oxygen to the brain death. has caused brain death) • Brain tumor • Electroencephalogram (EEG): An EEG measures If my loved one is brain dead, what does that mean? electrical activity in the When someone is brain dead, it means that the brain is no brain. An EEG can help longer working in any capacity and never will again. When caregivers evaluate the brain death is declared, it means your loved one has died. presence of electrical activity of the brain and the Your loved may not appear dead because the chest will type of electrical activity continue to rise and fall with the ventilator providing breaths, that is occurring. -
Locked-In' Syndrome, the Persistent Vegetative State and Brain Death
Spinal Cord (1998) 36, 741 ± 743 ã 1998 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/98 $12.00 http://www.stockton-press.co.uk/sc Moral Dilemmas Moral dilemmas of tetraplegia; the `locked-in' syndrome, the persistent vegetative state and brain death R Firsching Director and Professor, Klinik fuÈr Neurochirurgie, UniversitaÈtsklinikum, Leipziger Str. 44; 39120 Magdeburg, Germany Keywords: tetraplegia; `locked-in' syndrome; persistent vegetative state; brain death Lesions of the upper part of the spinal cord, the persistent vegetative state (PVS) stand on less safe medulla oblongata or the brain stem have dierent grounds and greater national dierences may be neurological sequelae depending on their exact location discerned: The causes may be variable, ranging from and extent. trauma to hemorrhage, hypoxia and infection. The High tetraplegia with a lesion at the level of the C3 pathomorphology is a matter of debate.5 Findings segment will leave the patient helpless but fully from the most famous PVS patient, KA Quinlan, conscious of his situation, and communication is revealed severe destruction of the thalamus,6 also usually possible. destruction of white matter and extensive destruction The patient who is `locked in' suers from a lesion of the cerebral cortex has been reported. The level of of the pyramidal tract, mostly at the upper pontine ± consciousness in these patients cannot be clari®ed, as cerebral peduncle ± level.1 Communication is reduced they are unresponsive. They are certainly not to vertical eye movements and blinking. comatose, as they open their eyes, and the kind of The persistent vegetative state is a quite hetero- pain perception that these patients have is similarly genous entity, and the underlying lesions are variable. -
Death & Decomposition Part II
Death & Decomposition Part II Review: Why is TSD/PMI so important? Review: What happens in the Fresh (1st) Stage of Decomposition? STAGE 2: Bloat ⦿ 0-10 days ⦿ Putrefaction: bacterially-induced destruction of soft tissue and gas formation › Skin blisters and marbling › Build-up of fluids from ruptured cells and intestines Putrefaction – the gross stuff ➢ Decomposition that occurs as a result of bacteria and other microorganisms ➢ Results in gradual dissolution of solid tissue into gases and liquids, and salts Putrefaction ➢ Characteristics: ○ Greenish discoloration ○ Darkening of the face ○ Bloating and formation of liquid or gas-filled blisters ○ Skin slippage Putrefaction ➢ Begins about 36 hours after death ➢ Further destruction is caused by maggots and insects ➢ Above 40 F, insects will feed until the body is skeletonized Influences of Putrefaction ➢ Heavy clothing and other coverings speed up the process by holding in body heat ➢ Injuries to the body surface promote putrefaction ○ provide portals of entry for bacteria Marbling Stage 3: Active Decay ➢ 10-20 days after death ➢ Body begins to collapse and black surfaces are exposed ➢ Bloated body collapses and leaves a flattened body ➢ Body fluids drain from body Active Decay Active Decay: Destruction of Tissue • Severe decomp can result in complete destruction of soft tissue Active Decay: Advanced Decomposition Stage 4: Dry Decay ➢ 20-365 days after death ➢ Remaining flesh on body is removed and body dries out ➢ Body is dry and continues to decay very slowly due to lack of moisture ➢ -
How to Deal with Brain Death: Legal and Ethical Considerations] [Jessica Robinson] James Madison University Lexia Volume V 2
Lexia: Undergraduate Journal in Writing, Rhetoric & Technical Communication Volume V 2016–2017 [How to Deal with Brain Death: Legal and Ethical Considerations] [Jessica Robinson] James Madison University Lexia Volume V 2 Approximately 3,000 people are diagnosed as brain dead every year. This leads to about 3,000 families fighting to continue treatment, and 3,000 doctors trying to inform those families that their loved ones are gone and cannot come back to life. Brain death can be difficult to deal with because of the varying legal and ethical considerations that must be considered when diagnosing someone as brain dead. There is no distinction between what patients can and can’t do, which makes it difficult for doctors to accurately do their job. Through researching the definition of death, the rights of a patient, and the ethical responsibilities of the doctor and the patient, I noticed a gap between the ethical responsibilities of the doctor and the impact the law has on how the doctor does their job. Following a tonsillectomy in 2013, an eighth-grade girl, Jahi McMath, suffered rare complications which led to severe neurological damage. McMath was pronounced brain dead and doctors recommended the removal of ventilation. McMath’s parents, however, did not believe their daughter was dead; she was breathing, her heart was beating, and her skin was warm and moist. They refused to let the doctors remove McMath from ventilation because they believed their daughter still had a chance at regaining consciousness. The doctors could not refuse her parents’ wishes despite the fact that they knew that McMath would not regain consciousness, and unnecessarily keeping her alive would be wasting scarce hospital resources and the family’s money on a dead body. -
Life After Death and the Devastation of the Grave
In Michael Martin and Keith Augustine, eds., The Myth of an Afterlife: The Case Against Life After Death, Rowman & Littlefield 2015. Life After Death and the Devastation of the Grave Eric T. Olson 1. Life After Death One of the fundamental questions of human existence is whether there is life after death. If we had an oracle willing to answer just one philosophical question by saying “Yes” or “No,” this is the one that many of us would ask. Not being an oracle, I am unable to tell you whether there is an afterlife. But I can say something about whether there could be. Is it even possible? Or is the hope that we have life after death as vain as the hope that we might find the largest prime number? One way to think about whether there could be life after death is to ask what would have to be the case for us to have it. If it were possible, how might it be accomplished? Suppose you wanted to know whether it was possible for a hu- man being to visit another galaxy and return to earth. To answer this question, you would need to know what such a journey would involve. What sort of spaceship or other means of transport would it require? How fast would it have to go, and how long would the journey take? Only once you knew such things would you be able to work out whether it could possibly be done. In the same way, we need to know what our having life after death would require in order to see whether it is possible. -
Guideline Completion of Death Certificates
Department of Health Center for Health Statistics Guideline Revised – 2/23/17 Title: Completion of Death Certificates Number: CHS D-10 References: RCW 70.58.170 Contact: Daniel O’Neill, Senior Policy Analyst Phone: 360-236-4311 Email: [email protected] Effective Date: February 23, 2017 Approved By: Christie Spice The Department of Health provides this guideline for medical certifiers of death certificates. Medical certifiers include allopathic and osteopathic physicians, physician assistants, advanced registered nurse practitioners, chiropractors, coroners and medical examiners to follow when completing death certificates. The Department receives complaints that health care providers fail to complete death certificates in a timely manner or fail to accurately list the cause of death on the death certificate. The death certificate provides important information about the decedent and the cause of death. Death certification errors are common and range from minor to severe. Under RCW 70.58.170, a funeral director or person having the right to control the disposition of human remains must present the death certificate to the medical certifier last in attendance upon the deceased. The medical certifier then has two business days to certify the cause of death according to his or her best knowledge and sign or electronically approve the certificate, unless there is good cause for not doing so. The medical certifier should register cause and manner of death information through the Washington State Electronic Death Reporting System (EDRS). The EDRS facilitates timely registration of the death and rapid collection of cause and manner of death information. The EDRS can be found at https://fortress.wa.gov/doh/edrs/EDRS/. -
2018 Infant Mortality and Selected Birth Characteristics
OCTOBER 2020 Infant Mortality and Selected Birth Characteristics 2019 South Carolina Residence Data and Environmental Control Vital Statistics CR-012142 11/19 Executive Summary Infant mortality, defined as the death of a live-born baby before his or her first birthday, reflects the overall state of a population’s health. The infant mortality rate is the number of babies who died during the first year of life for every 1,000 live births. The South Carolina (SC) Department of Health and Environmental Control (DHEC) collects and monitors infant mortality data to improve the health of mothers and babies in our state. In 2019, there were 391 infants who died during the first year of life. While the most recent national data shows that the US infant mortality rate in 2018 (5.7 infant deaths per 1,000 live births)1 surpassed the Healthy People (HP) 2020 Goal of no more than 6.0 infant deaths per 1,000 live births2, the SC infant mortality rate is still higher than the HP target despite a decrease of 4.2% from 7.2 infant deaths per 1,000 live births in 2018 to 6.9 infant deaths per 1,000 live births in 2019. The racial disparity for infant mortality remains a concern in SC, and the gap is now at its widest point in 5 years (see Figure 1 below). The infant mortality rate among births to minority women remained moderately constant from 2018 to 2019 (11.1 and 11.2, respectively) while the infant mortality rate among births to white mothers decreased 9.8% from 5.1 in 2018 to 4.6 infant deaths per 1,000 live births in 2019. -
Infant Mortality
Report on the Environment https://www.epa.gov/roe/ Infant Mortality Infant mortality is an important measure of maternal and infant health as well as the overall health status of the population (CDC, 2013). Infant mortality in the U.S. is defined as the death of an infant before his or her first birthday. It does not include still births. Infant mortality is composed of neonatal (less than 28 days after birth) and postneonatal (28 to 364 days after birth) deaths. This indicator presents infant mortality for the U.S. based on death certificate data and linked birth and death certificate data recorded in the National Vital Statistics System (NVSS). The NVSS registers virtually all deaths and births nationwide, with linked birth and death data coverage in this indicator from 1940 to 2017 and from all 50 states and the District of Columbia. What the Data Show In 2017, a total of 22,341 deaths occurred in children under 1 year of age, 816 fewer deaths than were recorded in 2016 (CDC, 2020). Exhibit 1 presents the national trends in infant mortality between 1940 and 2017 for all infant deaths as well as infant deaths by sex, race, and ethnicity. A striking decline has occurred during this time period, with total infant mortality rates dropping from nearly 50 deaths per 1,000 live births in 1940 to under six deaths per 1,000 live births in 2017. Beginning around 1960, the infant mortality rate has decreased or remained generally level each successive year through 2017. Exhibit 1 presents infant mortality rates in the U.S. -
Form DOH-4376
NEW YORK STATE DEPARTMENT OF HEALTH Mail-in Application for Copy of Death Certificate Bureau of Vital Records Information Page — Mail-in Application for Copy of Death Certificate General Instructions • Use this application if you are the spouse, parent, child or sibling of the deceased. • If you are not the spouse, parent, child or sibling of the deceased, then you must submit with this application a copy of documentation establishing a lawful right or claim (see below). • Use this application only if the death occurred in New York State outside of New York City. Do not use this application if the death occurred in any of the five (5) boroughs of New Y ork City. • Do not use this application for genealogy requests. • Print a copy of this application, complete and sign. • Mail application with check or money order and a copy of any required documentation (see below). To order by mail, send by first class mail, registered mail, For Expedited order placement and processing: certified mail or U.S. Priority Mail to: Please visit www.VitalChek.com New York State Department of Health Vital Records Certification Unit or call VitalChek Network, Inc. at 877-854-4481 P.O. Box 2602 Albany, NY 12220-2602 What is a lawful right or claim? • If the applicant is not the spouse, parent, child or sibling of the decedent, a lawful right or claim must be documented. An example of a lawful right or claim would be a death record needed by the applicant to claim a benefit. • Documentation would consist of a copy of a court order or an official letter verifying that a copy of the requested death record is required from the applicant in order to process a claim.