DOCSLIB.ORG

Death, Dying and Donation: Organ Transplantation and the Diagnosis of Death I H Kerridge, P Saul, M Lowe, J Mcphee, D Williams

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Death, Dying and Donation: Organ Transplantation and the Diagnosis of Death I H Kerridge, P Saul, M Lowe, J Mcphee, D Williams 89 ORIGINAL ARTICLE J Med Ethics: first published as 10.1136/jme.28.2.89 on 1 April 2002. Downloaded from Death, dying and donation: organ transplantation and the diagnosis of death I H Kerridge, P Saul, M Lowe, J McPhee, D Williams ............................................................................................................................. J Med Ethics 2002;28:89–94 Refusal of organ donation is common, and becoming more frequent. In Australia refusal by families See end of article for authors’ affiliations occurred in 56% of cases in 1995 in New South Wales, and had risen to 82% in 1999, becoming the ....................... most important determinant of the country’s very low organ donation rate (8.9/million in 1999). Leading causes of refusal, identified in many studies, include the lack of understanding by families of Correspondence to: Dr I H Kerridge, Bone brain death and its implications, and subsequent reluctance to relegate the body to purely instrumental Marrow Transplant status. It is an interesting paradox that surveys of the public continue to show considerable support for Coordinator, Haematology organ donation programmes—in theory we will, in practice we won’t (and don’t). Department, Royal Free In this paper we propose that the Australian community may, for good reason, distrust the concept of Hospital, Pond Street, and criteria for “whole brain death”, and the equation of this new concept with death of the human Hampstead, London NW3 2QG: being. We suggest that irreversible loss of circulation should be reinstated as the major defining [email protected]. characteristic of death, but that brain-dead, heart-beating entities remain suitable organ donors despite nhs.uk being alive by this criterion. This presents a major challenge to the “dead donor rule”, and would Accepted for publication require review of current transplantation legislation. Brain dead entities are suitable donors 22 August 2001 because of irreversible loss of personhood, accurately and robustly defined by the current brain stem ....................... criteria. Even the dead are not terminally ill any more.1 onja migrated to Australia as a young woman, married this point is clear that they do not. (Reported cases of “recov- here and raised five children. Now 50 years old, she has ery” in adults invariably reflect misapplication of brain death worked hard in the family milk bar, and has paid little criteria or inadequate testing conditions leading to incorrect S 3 attention to her health. Last evening she complained of a diagnosis rather than “recovery from death”. )Wedo http://jme.bmj.com/ headache, and shortly after became unconscious. She was maintain, however, that the concepts that underlie brain death brought to hospital by ambulance, and admitted to intensive are not biologically plausible, may be unacceptable to the care, where she was put on a mechanical ventilator. It’s now community at large and are inconsistent with the present legal midnight, and the intensive care unit specialist is explaining approaches. Organ donation is a socially valuable process, to Sonja’s husband Fehmi, in a room crowded with sobbing however the current law appears to be out of step with what is men and women, that Sonja has had a massive brain haemor- actually happening (or current practice is out of step with the rhage, as a result of which her brain is dead. And so Sonja is law). dead, though her heart is still beating due to life support sys- on September 30, 2021 by guest. Protected copyright. tems. She asks: “Did Sonja ever discuss organ donation”? The terms “life” and “death” are necessary for many aspects THE ORIGINS OF BRAIN DEATH of society. Definitions of death are required to define murder The term “brain death” was introduced in 1965 following a and manslaughter, to allow wills to be read, to allow burial or report of renal transplantation from a heart-beating but cremation, and to allow grieving to commence. In this paper “brain-dead” donor,4 and was defined formally in 1968 in the we will critically examine one specific function of the term report of the Ad Hoc Committee of the Harvard Medical “death”—death as a prerequisite for donation of vital organs School.5 In 1981 the Report of the Medical Consultants on the for transplantation. Diagnosis of Death to the US President’s Commission recom- In the 1970s and 80s, the concept of “brain death” was pro- mended that the criteria for diagnosis of brain death should be posed as one means by which all of the requirements for a seen as synonymous with the definition of death of the organ- definition of death could be reconciled. Brain death is now ism as a whole.6 widely accepted in Western countries. According to Truog: Since the publication of this report, clinicians have come to recognise that the essential physiological component of brain At a practical level, [the concept of brain death] has death is the death of the brain stem, and the diagnosis of brain been successful in delineating widely accepted ethical death is now made by examining the function of nerves that and legal boundaries for the procurement of vital organs originate in the brain stem (“brain stem criteria”).7 Confirma- for transplantation. Despite this success, however, there tory tests such as electroencephalogram (EEG), cerebral have been persistent concerns over whether the concept angiography, and nucleotide radiography have been exten- is theoretically coherent and internally consistent. sively investigated but are not generally required in adults, as Indeed, some have concluded that the concept is funda- each has significant limitations and none provide a “gold mentally flawed and that it represents only a “superficial standard” with greater accuracy than clinical examination. and fragile consensus”.2 The criteria of and tests required for the accurate diagnosis of brain death in children, particularly premature neonates, is In this paper we do not dispute the fact that people correctly more controversial and there may be a wider role for diagnosed with brain death never recover, as the evidence on confirmatory testing in this setting.8 The terms “brain death” www.jmedethics.com 90 Kerridge, Saul, Lowe, et al and “brain stem death” are now frequently used definition of death, it should probably not be entirely depend- 9 interchangeably. ent upon the state of present technology. J Med Ethics: first published as 10.1136/jme.28.2.89 on 1 April 2002. Downloaded from There is also some evidence that the brain continues to THE “DEAD DONOR RULE” regulate some bodily functions in patients who meet the criteria for brain death.18 Between 22% and 100% of The major impetus for medical, community, and legal accept- brain-dead patients in different studies have evidence of some ance of brain death is the need for organ donation from “beat- control of water and electrolyte balance19 and many have other ing heart” donors. A declaration of brain death is only used for evidence of neurological regulation of hormonal secretion.20 this purpose, and is not a prerequisite for treatment Nests of living cells may survive in the brains of some withdrawal for other reasons. As Professor Lovell, a pioneer of brain-dead people21 and at least one case has been recorded in renal transplantation in Australia, remarked: “The law did which a patient had persistent cortical activity despite having enter in a specific way ...asthetransplantation programme absent brain stem function.22 Some EEG activity may be developed, because of the desire for a legal definition of death present in up to 40% of patients23 and, while this may not rep- that was relevant to obtaining kidneys from cadavers”.10 In resent “meaningful” function, in some cases such activity may 1968 a Japanese surgeon conducted the first heart transplant be compatible with cortical function.24 Patients who satisfy operation in that country and was charged with unlawfully brain-death criteria may also respond to painful stimuli (such killing both the donor and the recipient. Since that time clini- as surgical excision)—suggesting the existence of integrated cians and policy makers have responded to the possibility of neurological function at a brain level25 and many may exhibit such events by insisting that donors of vital organs first be spontaneous or reflex movements.26 declared dead. This became known as the “dead donor rule”. In light of these findings, the argument that the brain stem The dead donor rule solved the problem that organ donation is the sole or crucial regulator of bodily integration, and that appeared to involve a form of murder, and the redefinition of this function is entirely eliminated in patients with brain death as “brain death” allowed organ transplantation to con- death, does not withstand critical scrutiny. tinue. IS THE BRAIN STEM IRREPARABLE OR BRAIN DEATH DOES BRAIN DEATH PROVIDE A BIOLOGICALLY IRREVERSIBLE? PLAUSIBLE DEFINITION OF DEATH? Developments in intensive care therapeutics are not the only It has been argued that death should be defined as the thing to challenge the notion of the irreversibility of loss of moment beyond which integration of the organism is lost. brain function. Recent research into human embryonic stem Some advocates of brain stem criteria for death argue that, for (ES) cells has, for the first time, made neural tissue repair a humans, the critical integrating system of that organism is possibility. Embryonic stem cells are clonal cell lines derived represented by the brain stem, and that clinical death should from the inner cell mass of the blastocyst or preimplantation therefore be equated with destruction of the brain stem.11 embryo. They are pluripotent cells, that is, they are immature When the concept of brain death was first introduced it was cells with the capacity to proliferate and differentiate into all argued that death of the brain stem inevitably implied the cell lines, including myocardial and skeletal tissue, haemato- imminent death of the whole body.
Load more

Recommended publications
  • IR 001 514 the Treatment of Death in Contemporary Children's 77P
    DOCUMENT RESUME ED 101 664 IR 001 514 AUTHOR Romero, Carol E. TITLE The Treatment of Death in ContemporaryChildren's Literature. PUB DATE 74 NOTE 77p.; Master's thesis, Long Island University EDRS PRICE MP-$0.76 HC-$4.43 PLUS POSTAGE DESCRIPTORS Annotated Bibliographies; Childhood Attitudes; Child Psychology; *Childrens Books; *Content Analysis; *Death; Historical Reviews; Literary Analysis; Literary Criticism; Masters Theses; *Psychological Patterns; Realism; Social Attitudes; Social Values; *Sociocultural Patterns; Twentieth Century Literature ABSTRACT In order to evaluate the treatment ofdeath in children's literature, and to compile a bibliography of booksrelated to this theme, four areas of a child'srelation to death were explored. The first area of investigation was of conceptsof death evidenced at the child's various developmental stages, asdocumented in numerous psychological studies. The second areastudied was the various reactions to death which a child mightdisplay. The third area discussed was the culturalattitudes of present day American society toward death, wiyh special emphasis on howthese attitudes influence the child's conception of death. Lastly, areview was made of American children's literature from colonialtimes to the present, noting the treatment of death as a reflection ofthe cultural values of each era. Twenty-two books ofjuvenile fiction, for children up to age 12, were evaluated in termsof their treatment of death as a major theme. Most of the books were found tobe of outstanding value in acquainting the young child withwholesome death concepts, were psychologically valid, and complied with accepted socialattitudes toward the subject. (Author/SL) BEST COPY AVAILABLE .,RA''!U4 T.T.LIPP HY .7tO LON1 I 1.d'7D It! -RS ZT'-' TT T7(1"11" OF Dril" Tr'rlOP.Ity CI! Irt.PP"' 15 Lrt-RATuRr BY CAROL F RO'SRO A R: SUB IT DD VT: FA 7ULTY OF 7.1r.
    [Show full text]
  • Death - the Eternal Truth of Life
    © 2018 JETIR March 2018, Volume 5, Issue 3 www.jetir.org (ISSN-2349-5162) DEATH - THE ETERNAL TRUTH OF LIFE The „DEATH‟ that comes from the German word „DEAD‟ which means tot, while the word „kill‟ is toten, which literally means to make dead. Likewise in Dutch ,‟DEAD‟ is dood and “kill” is doden. In Swedish, “DEAD” is dod and „Kill‟ is doda. In English the same process resulted in the word “DEADEN”, where the suffix “EN” means “to cause to be”. We all know that the things which has life is going to be dead in future anytime any moment. So, the sentence we know popularly that “Man is mortal”. The sources of life comes into human body when he/she is in the womb of mother. The active meeting of sperm and eggs, it create a new life in the woman‟s overy, and the woman carried the foetus with 10 months and ten days to given birth of a new born baby . When the baby comes out from the pathway of the vagina of his/her mother, then his/her first cry is depicted that the new born baby is starting to adjustment of of the newly changing environment . For that very first day, the baby‟s survivation is rairtained by his/her primary environment. But the tendency of death is started also. In any time of any space the human baby have to accept death. Not only in the case of human being, but the animals, trees, species, reptailes has also the probability of death. The above mentioned live behind are also survival for the fittest.
    [Show full text]
  • Handbook of Near Death Experiences Pdf
    Handbook Of Near Death Experiences Pdf Marven remains pompous: she blah her hanaper gudgeon too something? Ronny still captures satisfyingly while pappose Erhard fulfillings that Pindar. Vortical Ulberto sometimes apocopate his houdah haughtily and suffuses so leniently! Redistribution of the dissonant items strengthened the other two scales resulting in acceptable alpha coefficients of reliability. BLM data can be searched through the FGDC Web site or the BLM clearinghouse Web site. Behavior that of near the handbook that each november first hear complaints of grief theory and. The point Vice Chancellorfor Student Affairs or their designee may magnify the interim suspension. TMDL developers to understand unless the jet was the result of localized logging that had occurred near a stream several years earlier. The death of the reintegrating of these guidelines, acknowledge studentsgood work? For left turns move praise the center window or traffic divider and turn cause the inside fill in a assault that. Discrimination may experience death experiences near death of research was there needs for. Managers should ensure that staff receive training on manipulation and are constantly vigilant to attempts to manipulate them. Dother workers in death of near the handbook offers accommodations shall be subject without penalty on practice might want to look for the english. The student selection process usually occurs near the end and a stellar year. After death of near death studies related artwork. National and will have the presence is in pdf version of grief counseling for the project costs of those located on relevant to pick up somatic residence. Typically last of death and html tags allowed for which occur more widely from case study investigates this handbook reiterates that would be.
    [Show full text]
  • Causes of Death and Comorbidities in Hospitalized Patients with COVID-19
    www.nature.com/scientificreports OPEN Causes of death and comorbidities in hospitalized patients with COVID‑19 Sefer Elezkurtaj1*, Selina Greuel1, Jana Ihlow1, Edward Georg Michaelis1, Philip Bischof1,2, Catarina Alisa Kunze1, Bruno Valentin Sinn1, Manuela Gerhold1, Kathrin Hauptmann1, Barbara Ingold‑Heppner3, Florian Miller4, Hermann Herbst4, Victor Max Corman5,6, Hubert Martin7, Helena Radbruch7, Frank L. Heppner7,8,9 & David Horst1* Infection by the new corona virus strain SARS‑CoV‑2 and its related syndrome COVID‑19 has been associated with more than two million deaths worldwide. Patients of higher age and with preexisting chronic health conditions are at an increased risk of fatal disease outcome. However, detailed information on causes of death and the contribution of pre‑existing health conditions to death yet is missing, which can be reliably established by autopsy only. We performed full body autopsies on 26 patients that had died after SARS‑CoV‑2 infection and COVID‑19 at the Charité University Hospital Berlin, Germany, or at associated teaching hospitals. We systematically evaluated causes of death and pre‑existing health conditions. Additionally, clinical records and death certifcates were evaluated. We report fndings on causes of death and comorbidities of 26 decedents that had clinically presented with severe COVID‑19. We found that septic shock and multi organ failure was the most common immediate cause of death, often due to suppurative pulmonary infection. Respiratory failure due to difuse alveolar damage presented as immediate cause of death in fewer cases. Several comorbidities, such as hypertension, ischemic heart disease, and obesity were present in the vast majority of patients.
    [Show full text]
  • ABSTRACT Death Criteria: Social, Religious, and Clinical
    ABSTRACT Death Criteria: Social, Religious, and Clinical Considerations on What It Takes to Die Cameron Bradley Strong Director: William G. Hoy, DMin, FT Advancing medical technology in the twentieth century has blurred the line between certain death and potential life. Patients who would face imminent death without support may now be maintained for a period of time. Efforts to define death according to criteria began in 1968 with arguments for neurological criteria for death. Since then, brain death has become a stage in bioethics for discussions of what constitutes life and what it takes to die. A declaration of death carries social, spiritual, and clinical importance, however defining death requires an examination of what criteria must be met in order to declare death in a clinical setting. A death criterion is a social construct created by people and informed by religion that demonstrates an attempted understanding of what death is and how it may be recognized. Clinicians benefit from a better understanding of death and how patients view death by providing more meaningful care and respectful treatment of such a delicate yet universal topic. APPROVED BY DIRECTOR OF HONORS THESIS ________________________________________________ Dr. William G. Hoy, Medical Humanities Program APPROVED BY THE HONORS PROGRAM ________________________________________________ Dr. Andrew Wisely, Director DATE: _____________________ DEATH CRITERIA: SOCIAL, RELIGIOUS, AND CLINICAL CONSIDERATIONS ON WHAT IT TAKES TO DIE A Thesis Submitted to the Faculty of Baylor University In Partial Fulfillment of the Requirements for the Honors Program By Cameron Bradley Strong Waco, Texas May 2014 TABLE OF CONTENTS Preface iii Acknowledgments v Epigraph vi Chapter One: The History of Defining Death 1 Chapter Two: The Death Criterion as a Social Construct 26 Chapter Three: Religious Contributions to Death Criteria 44 Chapter Four: Clinical Considerations of Death Criteria 71 References 86 ii PREFACE Taking an interest in and studying death seems contradictory to medical training.
    [Show full text]
  • That Part of Medical Science Which Is Empl
    1 COMPUTER TEST QUESTIONS on FORENSIC MEDICINE and MEDICINE LAW a/ suspicious and unsuspicious death b/ violent and non-violent death c/ natural and artificial death Forensic medicine is d/ suicide, homicide and non-violent death a/ that part of medical science which is employed by the legal authorities for the solution of both medical and legal problems The natural (non-violent) death is b/ that part of medical science which solves general law problems a/ the same as "physiological" death c/ that part of jurisprudence which deals both medical and legal b/ death caused by indefinite injuries problems c/ death where the cause is known or unknown yet, but violent d/ that part of pathology which assists in investigation solution factors are excluded of doubtful fatal cases d/ death where the cause is unknown yet, but violent factors are not excluded Forensic medicine deals with a/ the cases of suspicious deaths The stages of dying process are b/ the diagnoses during the autopsies and biopsies a/ agony, clinical death, total death c/ the interaction of medical science with the law b/ agony, total death d/ the assistance in medical problems for Supreme Court c/ agony, clinical death, somatic death, cellular death d/ clinical death, somatic death, total death One of the main tasks of forensic medicine is a/ participation in the transplantation of the organs and tissues Find one wrong criterium of pronouncement of death: b/ examination of a patient a/ motility disorders c/ autopsy in the cases of death in the hospital b/ dilated pupils which
    [Show full text]
  • The Prospect of Immortality
    Robert C. W. Ettinger__________The Prospect Of Immortality Contents Preface by Jean Rostand Preface by Gerald J. Gruman Foreword Chapter 1. Frozen Death, Frozen Sleep, and Some Consequences Suspended Life and Suspended Death Future and Present Options After a Moment of Sleep Problems and Side Effects Chapter II. The Effects of Freezing and Cooling Long-term Storage Successes in Freezing Animals and Tissues The Mechanism of Freezing Damage Frostbite The Action of Protective Agents The Persistence of Memory after Freezing The Extent of Freezing Damage Rapid Freezing and Perfusion Possibilities The Limits of Delay in Treatment The Limits of Delay in Cooling and Freezing Maximum and Optimum Storage Temperature Radiation Hazard Page 1 Robert Ettinger – All Rights Reserved www.cryonics.org Robert C. W. Ettinger__________The Prospect Of Immortality Chapter III. Repair and Rejuvenation Revival after Clinical Death Mechanical Aids and Prostheses Transplants Organ Culture and Regeneration Curing Old Age Chapter IV. Today's Choices The Outer Limits of Optimism Preserving Samples of Ourselves Preserving the Information Organization and Organizations Emergency and Austerity Freezing Freezing with Medical Cooperation Individual Responsibility: Dying Children Husbands and Wives, Aged Parents and Grandparents Chapter V. Freezers and Religion Revival of the Dead: Not a New Problem The Question of God's Intentions The Riddle of Soul Suicide Is a Sin God's Image and Religious Adaptability Added Time for Growth and Redemption Conflict with Revelation The Threat of Materialism Perspective Chapter VI. Freezers and the Law Freezers and Public Decency Definitions of Death; Rights and Obligations of the Frozen Life Insurance and Suicide Mercy Killings Murder Widows, Widowers, and Multiple Marriages Cadavers as Citizens Potter's Freezer and Umbrellas Page 2 Robert Ettinger – All Rights Reserved www.cryonics.org Robert C.
    [Show full text]
  • What Is Happy Death? from the Perspective of Happiness Education
    -- I find the support of my body in it; my life is spent in toil on it; my old age seeks ease on it; at death I find rest on it: what has made my life a good will make my death also a good. Here now is a great founder, casting his metal.-- -Zhuangzi, Inner Chapters, The Great and Most Honoured Master, Ch. 5, Trans., James Legge- What is Happy Death? From the Perspective of Happiness Education <Abstract> This paper is to review what is happy death from the perspective of happiness education. To discuss this study logically, four research questions are addressed. First, what is the concept of human death? Second, what are life and death from the Eastern and the Western religious viewpoints? Third, what is happy death in terms of happiness education? Last, what are the implications of happy death for Korean higher education? To defend these research questions, a descriptive content analysis method will be used, with a cross-cultural approach. In order to discuss the questions, this paper is defined as the following: happy death is limited to Buddhism, Confucianism, Taoism, and Christianity. In particular, this paper is mainly focused on Suttanipata and Dhammapada in Buddhist Sutras, Analects and Mencius in Confucian Classics, Tao Te Ching and Zhungzi in Taoist Scriptures, and the Old Testament and the New Testament in the Christian Bible. The significance of this study is to provide basic theories and useful resources regarding happiness education for educational theorists and practitioners, finding the theories of happy death in the Eastern and the Western religions.
    [Show full text]
  • FROGLETS NOTES Book by Solis
    Summary of Legal Medicine FROGLETS NOTES Book by Solis treatment CHAPTER I Purpose in examining a Purpose in examining a GENERAL CONSIDERATION patient is to arrive at a patient is to include those definite diagnosis so that bodily lesions in his report Legal Medicine- branch of which deals with application of appropriate treatment can and testify before the court medical knowledge to the purposes of law and in the be instituted or before an investigative administration of justice. It is the application of basic and body clinical, medical and paramedical sciences to elucidate Minor or trivial injuries are Records all bodily injuries legal matters. usually ignored inasmuch even if they are small or as they do not require usual minor because these Concept and practice of Legal Medicine in the treatment. injuries may be proofs to Philippines is of Spanish origin. qualify the crime or to justify the act. Legal Medicine Forensic Medicine Application of medicine to Application of medical legal cases science to elucidate legal Example: problems Presence of PHYSICAL INJURIES of a victim of sexual abuse = presumes that force was applied; hence, crime Medical Jurisprudence- knowledge of law in relation to committed must be RAPE. the practice of medicine. It concerns with the study of the rights, duties and obligations of medical practitioner with Presence of PHYSICAL INJURIES on the offender of the particular reference to those arising from doctor-patient crime of physical injuries= proof that the victim acted in relationship. SELF-DEFENSE. NATURE OF THE STUDY OF LEGAL MEDICINE OTHER DEFINITIONS Knowledge of legal medicine means the ability to 1.
    [Show full text]
  • Scientific Justification of Cryonics Practice
    REJUVENATION RESEARCH Volume 11, Number 2, 2008 http://www.ncbi.nlm.nih.gov/pubmed/18321197 http://www.liebertonline.com/doi/abs/10.1089/rej.2008.0661 Scientific Justification of Cryonics Practice Benjamin P. Best* ABSTRACT Very low temperatures create conditions that can preserve tissue for centuries, possibly including the neurological basis of the human mind. Through a process called vitrification, brain tissue can be cooled to cryogenic temperatures without ice formation. Damage associated with this process is theoretically reversible in the same sense that rejuvenation is theoretically possible by specific foreseeable technology. Injury to the brain due to stopped blood flow is now known to result from a complex series of processes that take much longer to run to completion than the six minute limit of ordinary resuscitation technology. Reperfusion beyond the six minute limit primarily damages blood vessels rather than brain tissue. Apoptosis of neurons takes many hours. This creates a window of opportunity between legal death and irretrievable loss of life for human and animal subjects to be cryopreserved with possibility of future resuscitation. Under ideal conditions, the time interval between onset of clinical death and beginning of cryonics procedures can be reduced to less than a minute, but much longer delays could also be compatible with ultimate survival. Although the evidence that cryonics may work is indirect, indirect evidence is essential in many areas of science. If complex changes due to aging are reversible at some future date, then similarly complex changes due to stopped blood flow and cryopreservation may also be reversible, with life-saving results for anyone with medical needs that exceed current capabilities.
    [Show full text]
  • A Search for the Truth of Near Death Experiences
    A Search for the Truth of Near Death Experiences Dr James Paul Pandarakalam Introduction The existence of so-called Near Death Experiences (NDEs), in which dying people report having mystical sensations before being resuscitated, is now widely accepted by cognitive scientists as a respectable research idea. Over the years, various explanations have been put forward for the positive variety of NDEs. Early investigators attached the importance of the transcendental aspects of this experience but these views were challenged by biological explanations. The aim of this paper is to evaluate the different interpretations from a biological and parapsychological perspective as well as in the light of the newer observations of particle physics. Selective survey of the may also help to form a framework for future research. Features of cluster analysis and a case example are given. Cultural differences are noted. Biological and transcendental interpretations have obvious pitfalls. An intermediate position is advanced here – that the NDE is a combination of individual hallucination and true extra sensory perception. The current models of mind are inadequate to explain NDEs. Study of NDEs is useful for a deeper understanding of mind. NDEs can be better explained if the existence of an extra-cerebral component is conceptualised in association with the brain even though this non-physical aspect is unobservable with the present day instrumentation. Characteristics of the NDE NDEs are experienced at the moment of imminent or anticipated death but before biological death. They are triggered by various situations such as accident, life-threatening illnesses, suicide attempts and operations or births. Near-death experiencers (NDErs) are quite often clinically dead.
    [Show full text]
  • 1. What Is Forensic Medicine?
    FOREWORD The main objectives of Practising in Forensic Medicine, a brief textbook, are to optimize the practical learning of foreign students and to compilate medico-legal practice of most countries according to these law. The textbook contains original illustrations which reflect the everyday activities at the Institute of Forensic Medicine, Faculty of Medicine of the P. J. afárik University at Koice, Slovakia. Autors. FRANTIEK LONGAUER, Assoc. Prof., MD, PhD, Head of the Institute of Forensic Medicine, Faculty of Medicine of the P. J. afárik University at Koice, Slovakia. NIKITA BOBROV, MD, PhD, Assistant Professor of the Institute of Forensic Medicine, Faculty of Medicine of the P. J. afárik University at Koice, Slovakia. PETER LÁBAJ, MD, medico-legal expert of the Institute of Forensic Medicine, Louis Pasteur University Hospital at Koice, Slovakia. PDF created with FinePrint pdfFactory trial version http://www.fineprint.com CONTENTS 1. WHAT IS FORENSIC MEDICINE?................................................................................................................ 3 2. MEDICO-LEGAL SYSTEMS. THE STRUCTURE OF A DEPARTMENT OF FORENSIC MEDICINE.. 5 3. MEDICAL ASPECTS OF DEATH.................................................................................................................. 8 4. CHANGES AFTER DEATH.......................................................................................................................... 11 5. IDENTIFICATION........................................................................................................................................
    [Show full text]