“For in that sleep of death what dreams may come, When we have shuffled off this mortal coil"

Death should not be a surprising concept; everyone that has ever lived has died, and everyone alive today will die before the next 150 years have passed. Despite all religious and spiritual attempts to create a path towards a gentle death and convince us that everything will be all right, most people fear death. We are especially uncomfortable with an untimely demise because we have plans for our life: we have places to be and things to do. And Americans in particular have grown attached to their material selves, with what they feel makes them human. With all of our sentimentality towards the concept of life, and our unlimited history of dealing with death, it seems strange that we have a difficult time determining where life ceases. In different places and different times humans have (and perhaps always will) define the point of death in drastically different ways. Western medicine wants to reassure us that it can call an absolute time of death and tell us when our loved ones have ceased to exist, but the very history of the development of biomedicine tells us that we may never be so sure. And so we remain afraid of the unknown.

The mysteries of the physical body have been explored for hundreds of years. Public autopsies and dissections of corpses were common in the fourteenth century, while western medicine was learning about human anatomy, but the life saving knowledge that was gained during this time was not considerable. There were no instances of patients being brought back from the accidental brink of death, and no miracle treatments were discovered. “In 1786 Edmund Goodwyn of London received the Humane Society gold medal for his dissertation on the connection between life and respiration” (Lock 2002: 58). Before the 1930’s, people who stopped being able to breathe as a result of a massive chest injury simply died and there was nothing that scientists could do to help them. But “from the middle of the nineteenth century, numerous “breathing machines” were built…permitting the lungs, even when damaged, to continue their work of supplying oxygen to the bloodstream” (Ibid. 58). Around this same time it was discovered that hearts could occasionally be ‘restarted’, so lack of a heartbeat could no longer be said to determine absolute death. Science made discoveries before the 1930s that stopped death in its tracks, with the advent of vaccines, etc. However, inventions like the iron lung ventilator and electrical paddles to recharge the heart created a new field for the practice of medicine: intensive care. Doctors not only stitched up open wounds and reset broken bones, but they were now capable of staging a direct battle against the loss of human life. And the society that feared death rejoiced.

Even as we marveled at medicine’s power to save lives, a particularly observant bystander would have noticed a tension and a shift in our thinking about death. As Lock states in Twice Dead, “biological death has always been recognized on the basis of changes to the body that are judged irreversible; this is not new, but the use of the ventilator means that the process of bodily dying can be extended for increasing periods, very occasionally for years” (Ibid. 41). As new technologies to prevent death have arisen, so has our idea of what diagnoses are equivalent to a death sentence. At one time a death sentence was the word polio, but no one dies of polio anymore, thanks to modern medicine. At one point, it was the words severe asthma, but we have drugs and ventilators nowadays. And we have most recently done away with death by heart attack. When your heart runs out, doctors can replace it with a new one. But this latest definition of the death sentence has caused us to reconsider, once again, when the point of death occurs. If not death by disease or accidental damage to vital organs, what can take away our humanity? The latest answer that the west has presented is brain death. We can replace nearly every part of the body with a newer, better functioning machine or organ, but we cannot (yet) replace brains.

As with all death sentences, the words brain death come with a considerable amount of baggage, because a patient’s body no longer needs to cease functioning for them to be declared “dead”. With the advent of successful organ transplantation and living corpses all in the same century, doctors began to realize from where the organs for their new transplant surgeries must come. “Patients with a diagnosis of ‘irreversible coma’, as this condition was originally termed, would probably not have received much medical attention were it not for the simultaneous development of biotechnologies permitting solid organ transplants in humans” (Ibid. 64). We needed to declare brain death so that we could use the good organs within the living corpses to save lives. This practice was quickly legalized, in the United States at least, but transplant patients soon came to realize that they were not just receiving their own treatment anymore and would soon be in possession of a part of someone else’s body. (Indeed, the reason that most transplant patients were receiving organs in the first place was because families of the dead often wish for some part of their loved ones to continue meaning something.) Patients realized that they would not be losing their humanity through death, but that they would be made up of people that were not themselves. Sharp’s Bodies, Commodities and Biotechnologies discusses how “Prospective patients…overwhelmingly express a preference for mechanical parts…” (Sharp 2007: 89). They feel that to be melded with an animal could cause them to change somehow, taking on characteristics of the donor organ. It surprises me that the danger of losing ones humanity is associated less with machines than other living creatures. Do we believe that bionic machines have more humanity than people?

The difficulty that we have with life and death has everything to do with reluctance to lose our humanity. We have determined that brain death is real death because the patient will never be the same, functioning human again. It seems strange, then, that we feel no qualms about replacing parts of our bodies with material objects that have no relation to our humanity. We fear death to such an extent that we are willing to become less of our old selves to escape it, but at the same time we must maintain enough of our old body (namely our brain) that we are not considered dead. The following clip from the movie WALL-E is reminiscent of the line we walk when we perform ‘life saving’ organ transplants. At the end of the movie (go see it now if you don’t want it ruined!) WALL-E seems broken beyond repair and his friend attempts to fix him by replacing nearly all of his parts with new spare ones. When she is finished, we discover that WALL-E has lost his personality and the traits that made him seem human. At the end of the clip he is of course restored to his former self, because this is a children’s movie after all, but the adult audience should have been scared by the possibility that too much of WALL-E needed to be replaced. If we insist on defining death as a loss of our humanity through brain death, at what point do we draw the line? When can organ transplants which prolong biological life become the thing that takes away our humanity?

Works Cited

Lock, Margaret. 2002. Twice Dead: Organ Transplants and the Reinvention of Death. Berkeley: University of California Press.

Sharp, Lesley A. 2008. Bodies Commodities and Biotechnologies: Death Mourning, and Scientific Desire in the Realm of Human Organ Transfer. New York: Columbia University Press. Pp. 47-105.

Images:

http://www.imageofsurgery.com/Surgery_Billroth.jpg
http://www.youtube.com/watch?v=3HIwzZMqufg&feature=related
http://gandt.blogs.brynmawr.edu/files/2009/01/kate_moss_cyborg1.jpg
http://static.howstuffworks.com/gif/brain-death-silence.gif
http://www.silhouettesclipart.com/wp-content/uploads/2007/10/halloween-grim-reaper-clipart.jpg