Death: The Cessation of Life
Death is the end of life. Death occurs when the vital organs stop functioning as a result of physical injury, illness, or the effects of old age. The vital organs include the lungs, the brain, the kidneys, the liver, the adrenal glands, and the heart. Although all these organs are essential to life, death is particularly associated with cessation of the heartbeat. When any other vital organ ceases to function adequately to meet the body's needs, the heart soon stops beating. Once the heart stops, the blood stops circulating, and the body's cells no longer receive the oxygen they need to survive. As a result, the cells begin to die at varying rates. The first to die are the brain cells, which have the greatest need for oxygen. Among the last to die are the hair and nail cells, which may survive for several hours.
During a brief period known as clinical death, the heart and lungs have stopped functioning, but the cells of the body still survive. With prompt medical attention, a person who is clinically dead may sometimes be revived by restoring the heart and lung functions. The person may then continue breathing on his own, or he may be kept alive by means of respirators and other life supports. Usually, however, after six or seven minutes of clinical death the brain cells are irreversibly damaged and die. Soon after other cells in the body are also irreversibly damaged and die. Death is then final, with no possibility of revival.
After death, body temperature slowly cools to that of its surroundings, and the blood settles in the lower body parts where the skin becomes discolored. Gradually, the muscles become rigid, a condition called rigor mortis. Sometime later the muscles lose their rigidity and become limp. After these changes, the body's tissues begin to decay.
In the past, the absence of a heartbeat and respiration was generally considered evidence of death. Today, however, this traditional view of death is being questioned. Many physicians and others now believe that the most conclusive evidence of death is brain death. Brain death is the absence of all electrical activity in the brain for a period of 24 hours as recorded on a device known as the electroencephalograph.
With the introduction of human organ transplantation, the problem of defining death has become increasingly important. For successful transplantation, donated organs must be viable, or capable of living, which means that they must be removed immediately after the donor's death. This has led to serious legal and ethical problems in trying to determine under what circumstances and when life supports should be removed.
Many other traditional views are also being challenged. Some people believe in what is generally termed "the right to die." According to its supporters, a person who is incurably ill, or members of his family, can ask that treatment be stopped and the person allowed to die with dignity. Some people, to insure that their wishes are carried out, have made living wills. A living will is a written statement rejecting any treatment that simply sustains life.
The right to die is opposed by some on moral and religious grounds. Some believe that life is sacred and no one has the right to choose to die. Others object because they fear recognition of the right to die might lead to euthanasia, or mercy killing.
To aid the dying and members of their family, many hospitals, churches, and other organizations now make available counseling, "self help" groups, and other assistance. Such assistance is intended to enable the patient and his family to talk about the coming death and to resolve their fears and feelings about it.
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