Defining Death
The 1968 Harvard Committee report proposed this new criterion for death, defined by the irreversible cessation of all functions of the entire brain, including the brain stem
What is Brain Death?
This approach to care focuses on alleviating suffering and improving the quality of life for patients and their families facing life-limiting illnesses, rather than aiming for a cure
What is palliative care? (Hospice)
Timmermans uses this term to describe how medical professionals utilize their cultural authority to ensure their definitions of reality regarding death prevail
What is death brokering?
Anspach describes the NICU as this, where the organization itself influences which types of knowledge are valued and how decisions are made, potentially leading to a prioritization of medical expertise
What is the ecology of knowledge?
Dworkin discusses the complexities of respecting this for individuals with serious and permanent dementia in the context of their best interests
What is autonomy?
This historical criterion for determining death, based on observable physical signs, became complicated with the advent of life-support technology
What is the stopping of the heartbeat and the cessation of breathing? (Heart-Lung criterion)
Dworkin explores this concept where individuals might sign living wills stipulating the withholding of most medical treatment if they reach a state of permanent and serious dementia and subsequently develop another serious illness, focusing on respecting this prior expression of their wishes
What is precedent autonomy?
This professional group in Anspach's NICU study was found to more frequently cite interactive cues in their patient assessments
What are nurses?
This perspective on the justification for respecting individual choices, even when deemed imprudent, posits that each person generally possesses a superior understanding of their own well-being compared to others, making a general right to autonomy the most reliable long-term approach.
What is the evidentiary view?
This term describes a central tension observed by Anspach, where physicians and nurses, due to their different experiences and the types of information they prioritize, may arrive at divergent conclusions about a newborn's chances of survival
What is prognostic conflict?
A state characterized by the total abolition of both relational and vegetative life functions, often sustained by artificial means
What is Coma Dépassé?
According to Anspach, if practitioners are reasonably convinced that an infant is unable to survive or would survive with serious neurological defects there is broad consensus around this principle
What is withholding life-sustaining treatment?
According to Kaufman, this trajectory in medical care is marked by an unwavering commitment to employing all available technological means to sustain life, even when the possibility of meaningful recovery diminishes, potentially obscuring the acceptance of death as a natural outcome
What is the heroic intervention pathway?
This shift towards a more bureaucratized management of death in hospital settings is a social phenomenon explored in Kaufman
What is the institutionalization of death?
According to Anspach, in NICUs, medical staff often aim to achieve this from parents regarding treatment limitations, sometimes by managing expectations and presenting information in a way that encourages agreement with predetermined decisions.
What is parental assent?
This technology, which measures electrical activity in the brain, became a tool in the U.S. to confirm a diagnosis of whole-brain death, although its interpretation and necessity varied compared to practices outside the U.S.
What is an EEG?
This term, used in Baszanger to describe a shift in advanced cancer treatment starting in the mid-1980s, refers to the use of palliative cancer-directed therapy with the goal of extending life, improving symptoms, and potentially allowing for future treatments rather than solely focusing on a cure
What is ”buying time”?
An over-reliance on these can lead to the devaluation of other forms of prognostic information according to Anspach
What are technological cues?
Agamben argues that the moving borders of life and death are not just medical or biological but also these kinds of borders
What are biopolitical borders?
According to Lock, the potential to withdraw life support from individuals declared brain dead to facilitate this raises complex ethical considerations about the moral status of the body and the definition of when a person is no longer considered alive
What is organ transplantation?
According to Arney-Bergen, the formulation of the "truth of life," which subsequently influences our understanding of death, emerges from the intersection of medical discourse and this other significant societal discourse.
What is socio-moral discourse?
This term from Timmermans would be applicable here:
A patient with terminal cancer, experiencing unbearable pain and a significant decline in quality of life, makes a voluntary, informed written request for medication to end their life in a state where they maintain control and a socially acceptable sense of self until the very end, in accordance with legally established protocols.
What is a dignified death?
According to Baszanger, the pursuit of this, even if brief, with few or no severe symptoms, became a redesigned outcome of treatment, sometimes taking precedence over tumor shrinkage
What is quality prolonged survival (or prolonged survival)?
Broom highlights significant unanswered questions surrounding justice, self-determination, the individual, and the necessity of hospice to honor spiritual beliefs for this concept
What is a "good death" or "good dying"?
The challenge of balancing a currently incompetent patient's experiential well-being with their previously expressed wishes, particularly when considering whether to override prior autonomous decisions in favor of present comfort represents this tension between these two concepts
What are tensions of autonomy versus beneficence (in dementia)?