When are you dead?

We had an in-depth conversation on organ donation on The Daily Circuit this morning and the ethics associated with age and transplant recipients. It was a great discussion that mainly focused on the news peg of Dick Cheney’s recent heart transplant, but our guests also briefly talked about how doctors determine the end of life for potential donors, and that question intrigued me.

Earlier this month, our guest Dr. Richard Freeman spoke about this fuzzy line between life and death with Terry Gross on Fresh Air. Rob Stein, with National Public Radio, also wrote about this topic.

My own research to prep for the show turned up a number of fascinating articles on some of these broader issues associated with organ donation. One of my favorites was John Sanford’s piece in the Stanford Medicine journal. Don’t let the fact that this piece is published in a medical journal scare you away, it’s a great read that talks about a move toward organ donation after cardiac death, as opposed to the more traditional donation after brain death. There are a lot of tricky lines that doctors associated with donation must walk every day and the big question Sanford asks is, when is a person really dead?

This question certainly isn’t as clear cut as it may seem on the surface. Are we dead after our heart stops beating, or after our brain shuts down – and can one be enough without the other?

Once I started thinking about the medical definition of death I fell deeper and deeper down the Google rabbit hole. In 2008 the President even convened a council on bioethics who released a report titled, Controversies in the Determination of Death.

So when are we dead? We have guidelines to tell us, but the real life applications of those guidelines are always messier than the rules appear on paper.

We have great conversations on The Daily Circuit, but sometimes the time we have on air doesn’t always allow us to dig all the way into these multi-layered topics. Hopefully the discussions you hear on the show will get you interested in asking even bigger questions.