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In postmodernism, facts don’t matter as much as desired narratives, and now this view is being proposed as a way to define death itself—which would permit people to choose ahead of time when they were to be considered to have, as the Bard had it, shuffled off this mortal coil.

This is not a new idea and its most prominent advocate is probably the Georgetown University bioethicist Robert Veatch, who suggests that people decide for themselves when they will be considered dead for organ harvesting. From the story about all this in Reuters:

Most ordinary people, including most physicians, assume whether you’re dead or alive is a science question,” Veatch, a Georgetown University medical ethics professor who has lectured about death and dying for over three decades, told Reuters.

“In my view, it’s a philosophical and religious issue and different people have different views on the matter,” he said at a bioethics seminar at Georgetown’s Kennedy School of Ethics. Thanks to medical progress, terminally ill patients or victims of severe accidents can be kept on life support far beyond the point where they would have died naturally.

Veatch asked if being permanently unconscious and dependent on feeding and hydration tubes is still really life. If not, then people taken off that support are not killed, he argued, but are “made dead” or they “become dead”.

The traditional view is that death occurs when the heart and lungs stop. Since the 1970s, Western countries have defined it as the irreversible loss of the entire brain’s functions.But the brain stem can keep basic functions going — such as breathing — even in a permanent vegetative or comatose state.

So since 1973 Veatch has been advocating a third definition saying that death sets in when the higher brain functions—the thinking and feeling that make us human—are lost.This means death comes when consciousness is permanently lost, he said: “If you’ve got the substratum in your brain for consciousness, you’re alive. If that’s gone, you’re dead.” Veatch suggests the law set a default definition, most likely whole brain death, and let individuals opt out and sign a statement saying they want to be declared deceased either by cardio-respiratory death or higher brain death.

Except that it would be a fiction, based on a narrative that would have the effect of transforming death from a biological event into a sociological one. Moreover, it could well lead to the confusing circumstance of one living, breathing person being declared dead, while the patient in the next bed with the same symptoms would still be considered alive. And once we get to decide when we are dead, why limit it to the profoundly disabled. There are plenty of people who suffer terrible tragedies who consider their lives over: Why not just make it official? Worst of all, if some dead people were actually living, we couldn’t bury them—which I guess would create the need for someone to knock them on the head with a hammer or inject a drug to the “cadaver’s” beating heart to actually get the job done so that organs could be harvested. Hey, Jack Kevorkian is looking for work!

Maybe we should just ask plumbers what to do. At least they tend to have common sense.


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