Dead Complicated

By Elisabeth Rosenthal
Oct 1, 1992 5:00 AMNov 12, 2019 4:43 AM

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In a recent test case a Florida couple sued a local hospital to have their doomed newborn child declared dead. Their daughter Theresa was an anencephalic infant, born with only a brain stem, a tiny stump of a brain. Since virtually all her brain was missing, she would never be aware of her existence. In addition, her faltering heart and lungs were bound to give out in a matter of days. If she was pronounced dead, her parents would at least be able to donate her organs to help other sick infants survive.

It was a reasonable request made by well-meaning parents. But a Florida circuit court rejected it on the grounds that the baby still had a brain stem. According to state law, she was therefore alive. Ten days later, while a fierce debate raged among doctors, ethicists, and lawyers, the infant’s breathing stopped and her organs petered out for lack of oxygen, making them useless for transplantation.

As the sad case of baby Theresa demonstrates, the line between life and death is today often blurred. Once it was simple. A person was alive if his heart could beat and his lungs could breathe, and dead if they did not. It was an intuitive and satisfying definition. Who among us does not accept the lub-dub of a heart and the gentle rise and fall of a chest as reassuring signs of life? But now that machines can do the job of a heart or lung, these vital signs are no longer sufficient to define a living human being. Modern medicine has made the notion of heart-lung death increasingly inadequate, and we doctors must now rely on the much more abstract concept of brain death.

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