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Background reading material for Year 1 Semester 1 medical student PPSD session on 13th September 2006 by Professor Omar Hasan Kasule Sr.
DEFINITION OF DEATH
Death can be defined as moral, legal, or biological death. Death becomes permanent with cessation of all physiological functions.
NATURE OF DEATH
There is a continuous cycle involving life and death. Life arises from death and vice versa. All human endeavors cease with death. All humans will eventually die. Modern biotechnology discoveries of artificial life support, cloning, and frozen embryos are not in essence prolongation of normal human life.
ATTITUDES TO DEATH
Death and its occurrence are in the hands of the Creator. Some people welcome death as a rite de passage to a better existence in the hereafter. They look at death as a transition to another form of life which could be better than earthly life. Some others are apprehensive about death and fear it. In view of the inevitability of death it is futile to attempt to avoid death or think of its elimination. Some wish for death to escape physical and psychological stresses of terminal illness or of life. Committing suicide is escapist and is immoral. Death is a trial and is a calamity for the surviving relatives.
PROCESS OF DEATH
The process of death is long. It starts with the humanly understood causes like infection, trauma, tissue degeneration, metabolic derangements, or neoplastic changes. The body functions progressively fail until a point of no return is reached. The process of terminal death following the physical laws cannot be reversed except in exceptional cases of divine intervention.
CRITERIA OF DEATH
Technological developments in intensive care units have blurred the demarcation between life and death that was taken for granted before. Many brain-dead people can be kept apparently alive on artificial respirators. The increase in transplantation has given momentum to the need to develop new criteria for death. This is because organs have to be harvested quite early in the death process to prevent them from further degeneration. The traditional criteria of death were respiratory failure, cardiac failure, and loss of consciousness. Use of brain death as a criterion gives rise to ethical and legal problems because in cases of brain death, many other organs and functions of life are still alive. There are also controversies about the definition of brain death as a pathological entity. There is controversy whether it is death of the whole brain or specific parts of it. There is also disagreement whether criteria used for adults can be used for children.