Does the death of the body constitute death of the person Essay Example

Does the death of the body constitute death of the person? Essay Death of the body and death of the person hold different meanings according to physicians, theologists, transplant surgeons and the public. Since the eighteenth century, biological death has focused on either the centralist or decentralist theory, which have shifted from the cessation of the heart to define death, to a more overall view of the body. Firstly, it is important to outline the historical and contemporary definitions of death, including a consideration of the recent term brain-stemmed death (BSD) in relation to fears of confounding factors (Powner et al, 1996: 1219). When the body dies medically, all links with a former life are eradicated and the focus rapidly shifts to the next patient or donor recipient. However, for friends and relatives the deceased was a person with an identity, a past which will not be forgotten and this causes many to grieve and the persons social presence continues in their daily lives. The idea of a social death in relation to an actual death will be examined using examples of past and present rituals and beliefs such as, vampires and persistent vegetative state. Additionally, a brief consideration of the cultural differences between Japan and USA is necessary to question the passive acceptance of organ procurement and BSD in most of the developed world. 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This led to greater physician involvement and their role was to help preserve life and confirm death when necessary. Since the 18th century, two fundamental questions persist within the current cycles of debate, including centralist and decentralist theories, and the problem of apparent death or confoundling factors (Powner et al, 1996: 1219). Centralism is concerned with the body as a whole, which means that one organ, previously the heart, is the centre of all bodily functions and once it stops death is certified. This theory is linked to the contemporary term of brain stemmed death that is socially considered the centre of personhood which represents life, and once dead can often continue to exist in society. Decentralists consider the body as perhaps a more complex system and the whole organism represents life, therefore, all main organs need to cease functioning before burial and grieving can proceed. Throughout the 19th and 20th century, definitions of death have altered between a centralist and decentralist approach, but overall, neither has caused major debate, nor are they exceptionally diverse in context. More importantly, this reflects not only the ambiguous nature of death and unclear life/death boundaries, but the relatively passive acceptance that consciousness is what makes an individual recognisably alive a nd fully a person (Lock, 2002: 45). Ambivalence A false positive diagnosis of death further conveys the suggestion by Lock (2002), that the American and European public have been surprisingly trustworthy of the medical profession. Defining death is a complex process, especially when it is impossible to exclude moral, philosophical and religious attitudes towards life and death, regardless of scientific objectivity. However, in 1968 the Harvard Committee proposed a universal term, including a set of tests, to confirm the end of life and avoid confusion since resuscitation techniques became available for the heart and lungs (Powner et al, 1996: 1221). Brain stemmed death means that the brain no longer pumps blood and oxygen and the patient is in an irreversible coma, but this is controversial. If one can clearly diagnose death from one organ then the rest of the body becomes irrelevant, despite its complex biological make-up and symbol of life in society. This definition was announced a year after the first heart transplant and brain stemmed death is the optimal time to transplant organs, whereas if physicians were to wait for the heart to stop beating, most organs would not be suitable. However, from a moral perspective, the cadaveric donor could still be alive in terms of a beating heart and warm body, suggesting a conflict between biological death and cultural definitions of the person. If a daughter had recently been pronounced dead, a mother may physically and emotionally still see a much loved, living person who is sleeping and find to it hard to perceive the corpse as an organ donor. Organ transplantation and death have since been intricately linked, yet one must also separate the notion of a dying donor and the needs of an organ recipient. There is clearly a differentiation between death as an event for physicians and death as a process for those grieving, which highlights the ambiguity of a dead body and dead person. To avoid confounding factors, in 1981 the Presidents Commission Report (USA) ensured there would be no confusion between persistent vegetative state (PVS) and BSD (Powner et al, 1996: 1220). PVS is medically different from BSD as the lower brain continues to function by pumping blood to the brain and breathing unaided, whereas whole brain death is similar to decapitation. PVS can persist for years with no improvement, but the person is still capable of reflexes and minimal communication and cannot, therefore be declared dead. However, other conditions, such as cartalepsy and hypothermia, have highlighted the difficulty doctors have in ensuring a patient is actually dead. In 1984, Diane Leslie spent hours in a morgue due to her condition of cartalepsy which portrays a death-like appearance, yet returned home four hours later and now lives in Canada (Scream, Discovery Channel). Life after death? If the medical profession can confuse life and death, then it is understandable that different cultures often have interesting and divergent perceptions of the death of a body and death of a person. Death is defined by the whole brain ceasing to function, but the brain is also where personality, identity and social interaction are processed and expressed. A person has a biography which involved contact with friends and relatives, thus, even if the body is immediately a corpse after diagnosis, it would be impossible to expect bereavement to simply involve counselling to detach and move on from the dead (Walter, 1996: 10). Grief is not universal and can vary from talking to those who knew the deceased to inner emotional turmoil. Therefore, one must consider the social definition of death and to what extent the dichotomies of life (culture)/ death (nature) can be defined by physicians. Belief in the afterlife is a psychological response to a fear of the unknown, but social values often eradicate this instability by developing stories and myths surrounding death. Hence, human beings envisage a degree of continuation of the person that lived inside the body for their own sanity in the real world, or one would have to question whether the individual has any superiority over a corpse. In Chrisitianity, there is a firm belief that ones path is chosen and believers can find peace when they die, perhaps explaining why 90% of British people believe in some form of religion. Ideologies of vampires, clairvoyancy and ghosts are further examples of past and present attempts to either extend the life of an individual, or to physically express fear of the dead. Tarot cards and clairvoyants are constructions of late-modern society that attempt to contact the dead, conveying a strong disassociation between the death of the body and death of the person for many. Vampires have had a long history and the myth continues today in the media and childrens imagination, emphasising a connection between life and death from a young age. This indicates the possibility of a social presence for disembodied persons, which although imaginary, can be felt by hallucinating or even praying to a spirit, that helps to keep alive the memory of someone recently deceased (Hallam et al, 1996: 6). Like PVS, they are hybrids that confuse the boundaries between life and death, that is; vampires are biologically dead but socially alive to a child, yet vegetables can be biologically alive but socially dead to a relative. This suggests the construction of a social presence after death and once the body dies, new meanings are attached to attempt a continuation of the mind or soul to delay the transition from life to death. Japan In Japan the cultural understanding of nature is different from the West and many dislike or fear the unnatural. Some Japanese believe that the body must be treated with utmost respect, and if tampered with or disrespected, spirits never settle and become immortal (Lock, 1995: 15). A human being is a complex social being with a capacity to express individuality through emotional and physical performances. Everyday choices allow one to express there self-identity physically through clothes, exercise and mannerisms, yet its symbolic value becomes nothing when dead. However, it is important to consider why Japan has such a traditional sentiment towards the body, whilst the USA and Europe pursue organ transplantation with little contemplation of the religious or natural meaning of the body. In Western societies, improvements in techniques of preserving and transplanting cadaveric organs have emphasised how greatly the dead can contribute to the living (Lamb, 1990: 117). USA and European objectified approach to death is part of an overall acceptance to protect the living by organ donation. However, Japan only recently legalised BSD in 1997, as the medical definition of death. For 25 years, it has caused much controversy and debates based on the meaning of culture and nature in relation to life and death. Despite parallel technological advancement and modernisation, Japan has often feared Westernisation and fought to retain their uniqueness. As the social significance of individual death has not been subordinated to a medicalised, objective death, Japanese culture clearly have different connotations of the death, the body and a social identity when one dies (Lock, 1995: 35). BSD has been reluctantly accepted by some, due to the ambiguous nature of death which means that a heart-beating cadaverer can still have its organs transplanted. Japans first and last heart transplant in 1968 resulted in the premature death of the recipient and consequent arrest of the surgeon for six years (Lock, 1995: 13). Despite an overall distrust of the medical profession, Japanese have a history of tradition, nostalgia and ancestry to suggest a deep rooted cultural meaning of culture and nature. Life is separated from death in terms of it being a natural process, and many [neurologists] hesitate to encourage relatives to think of brain-dead patients as dead (Lock, 2002: 38). This conveys a society still divided by cultural attachments to the body and whether it deserves a similar respect to the spirit that can exist after death. Social death Aging is a good example of a death that is an event for physicians, but for those grieving it is a process which entails a clinical death of the body and a social death of the person. As one gets older, a retirement home is often the first stage of the death sequence, beginning with social exclusion by staff and relatives. Children gradually prepare themselves for a parent to die once they have retired or ill health is evident. Once biological death has occurred, social death, that is the final stage of emotional involvement with the person, may coincide. This is because friends and relatives may have sufficiently prepared themselves to find an appropriate place for the dead in ones life (Watter, 1996: 12). However, this is not always possible for a parent who loses a child or widow who loses a lifelong partner. In the 19th century, social death was treated extremely differently from late-modern rituals, especially for the middle class. Grieving was the responsibility of Victorian women who were to keep alive the memory of the dead for as long as deemed necessary by societal values. Each relative would be assigned a suitable period of mourning and at the extreme, as a widow, the lady was expected to be socially isolated for 3 months and wear black for 1 year (Mulkay ; Ernst, 1991: 183). This emphasises the difference between a biological death and a social death, which for many can take from months to years. Furthermore, grief is obviously an individual process but in the 19th century, mourning was a cultural ritual that was to be conveyed physically and emotionally to lengthen the social presence of the dead. A contemporary understanding of disembodiment was described in a recent study of widows in mid-Wales called The Hallucination of Widowhood. Rees (1971; in Mulkay ; Ernst, 1991) interviewed 227 widows and 137 reported some sort of hallucinations or experiences of the dead partner, some for years after. Death is clearly an complex, socially infused activity and for those who lose a partner they cannot immediately move on due to the close bonds developed over time. Like the loss of a child, grieving takes on different forms, including talking to the deceased or visiting a grave, but this is not to be confused with insanity or belief in the supernatural. Social death is a natural process that in late modernity, society should allow individuals to decide whether they want to move on or simply adjust and find a place for the loved one in their lives. Ultimately, those bereaved should be reassured that they may retain the deceased instead of moving on as presumed by bereavement counselling (Walters, 1996: 23). Conclusion Death clearly has different meanings for the physicians treating the patient and those who were related to, or friends with, the deceased. Its definition has involved controversial discussions for centuries to determine the what constitutes death and ensure no mistakes are made in determining the end of life. Recent adoption of the term BSD in Japan, compared to the USA and Europe, has highlighted a more traditional attachment to the body and uncertainty surrounding cadaveric organ donors. Social and cultural death will rarely coincide with biological death and for an elderly person, they may be socially dead but biologically alive. In contrast, a widow or parent accepts the absence of a body but continues a social bond with the deceased through a variety or rituals. In conclusion, since the afterlife is unknown and the body decomposes, cultures establish different ways of continuing the existence of the dead due to the complexity of the death of a body and the attached social and se lf-identity.