In this episode, we are joined by Lainie Ross (University of Rochester Medical Center) and (once again!) Christos Lazaridis (UChicago Medicine), this time to talk about the different ways of defining death. Click here to download episode 149 of Elucidations.
In our previous episode with Christos, we talked about death and the vexed history of attempts to define it. Prior to the advent of modern life support technology in the 1960s, it was usually enough to check whether a person had a heartbeat and could breathe to determine whether they were dead. But once machines were invented that could breathe and circulate blood in patients whose lungs or hearts were failing, a new moral conundrum was born: how do you decide whether a medical patient is dead when it is now possible to keep their lungs breathing and their heart beating indefinitely?
In this episode, our distinguished guests talk about the actual criteria that physicians use to determine whether a patient is dead, as well as some possible criteria that no one has tried applying but which some doctors think would be more appropriate. Furthermore, Lainie Ross argues that every person has the right to choose which criteria will be used to determine whether they are dead. These two topics interact in interesting ways.
For example, I might have a strong preference for my doctor to pronounce me dead only if I have permanently lost all consciousness, even if I can still spontaneously breathe. Although we currently have no good method of objectively measuring whether a patient has permanently lost consciousness, Dr. Ross argues that I have the moral right to sign an agreement stating my preferences. Specifically: the agreement could state that if, in the future, the technology for determining whether someone has permanently lost consciousness gets invented, and, at that time, I have permanently lost consciousness, then I should be declared dead. On the flipside, some patients prefer a stricter criterion, often for religious reasons. Perhaps it is my religious belief that if I am breathing, then I should be considered to be alive. Lainie Ross argues that in that case, I have the moral right to sign an agreement stating that that is the criterion that doctors will use on me, in the event that I lose consciousness but am still able to spontaneously breathe.
As of right now, people only have the legal right to sign these types of agrreements in a handful of states in the US. Join us for this episode as Christos Lazaridis and Lainie Ross argue for making this legal right more widespread!
Further Resources
If you’d like to get a fuller taste of how Lainie Ross and Christos Lazaridis view this constellation of moral, legal, and metaphysical questions, take a look at their article:
Lainie Ross and Christos Lazaridis,
The Argument For Personal Choice In Determining Death
In fact, that entire anthology is full of interesting material on death by neurological criteria:
Ariane Lewis and James L. Bernat, eds:
Death Determination by Neurologic Criteria
Happy reading!
Matt Teichman