The essay is designed to reveal distinction between the death, brain death, and persistent vegetative state. The essay will achieve this goal by reflecting on the arguments presented by Jeff McMahan in the article entitled “Death, Brain Death and Persistent Vegetative State.” The essay will then analyze a case of a 33-year-old man presumed to be death and determine whether he is indeed death or not.
McMahan (2010) revealed key distinction between the death, brain death and persistent vegetative state. The vegetative state is a manifestation of unconsciousness that goes much further than a coma, since the patient's organism retains vital functions in its organs. People in a vegetative state may be unconscious, but their senses are still working; they can hear, smell and feel when touched, even some open their eyes. The patient alternates periods of apparent sleep, with closed eyes, with periods of wakefulness, with open eyes. In the latter, the patient performs eye movements but lacking purpose or intention and independent of the stimuli. The duration of the vegetative state is varied; It can go from a few days to years, being able to wake up, in most cases with sequelae, although these may be minor. Of course, someone in a vegetative state requires a lot of care.
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According to McMahan (2010), the brain death is an irreversible state. The body of the person continues to function through machines that assist him in his vital functions. Without those machines, the person's heart and breathing will stop; It can be in a few minutes or hours. In people with brain death, there is a slight function of the lower brain (brainstem), but it is an automatic response to the assistance of the machines. Because of the sensitivity of the issue, brain death is not a diagnosis that is quickly, but takes hours of observation, examinations of all kinds and agreement between at least two doctors. The minimum observation time to declare someone brain dead is 6 hours and, to make sure that it really is an irreversible state, tests such as electroencephalograms are used to measure brain activity. Two doctors must agree before declaring a person brain dead. Depending on the country, the family can request the withdrawal of assistance from machines. The patient with brain death can continue with vital functions for a few hours after being disconnected, although that does not mean that it is improving, since it is automatic functions of a brain that is completely shutting down. Evidently, vegetative state and brain death are very different conditions , one is life and the other means a certain death and from which you can not return despite any medical effort.
On the other hand, death is not understood as a moment, but as a gradual and complex process that exceeds the purely biological and medical where all agreement on this point needs, in addition to an intense philosophical, ethical, legal and social inquiry, be assumed and understood by all the society (McMahan 2010).
The case of 33-year-old man shows that there was no sign of life when he was deposited at the door of the emergency department. However, in the next morning, his heart was functioning normally while respiration was being maintained by machinery. Neurologist discovered that there were no signs of any brain activity. The consensus made by the medical staff is that the patient would never again recover consciousness. However, three groups emerged. One group sided with neurologist that the patient is death. The second group said that the patient is not death because his heart is still beating. The third group took the traditional position of medical ethics that the medical professional's duty is to preserve life when it can be preserved.
Based on McMahan’s arguments, the third group is right. First, we have to rule out the second group. The second group argued that the patient is not death because his heart is still beating. This is because the patient with brain death can continue with vital functions for a few hours after being disconnected, although that does not mean that it is improving, since it is automatic functions of a brain that is completely shutting down. We also have to rule out the first group that argued that patient is death. Based on McMahan’s arguments, the patient’s brain is death but the patient is not death yet (McMahan 2010).
Consequently, the medical personnel who held on to the patient is not dead simply because the brain is dead are right. They followed the medical professional ethics that hold on to the fact that they ought to preserve life as long as they still had the capacity to do so. They hung onto the fact that a patient is still considered alive as long as the heart is still beating. They felt that they should continue giving the old man medical care as long as the heart still beats.
In conclusion, it is quite clear that there is a huge difference in the concept of death, a dead brain and a Persistent Vegetative State. With the recent technological advancements, it is wise for the medical personnel to uphold their professional codes of conduct and consider the fact that a person in the Persistent Vegetative State and the one with prolonged unconsciousness should receive the required medical attention as long as the heart still beats.
Reference
McMahan, J. (2010). Death, Brain Death, and Persistent Vegetative State In A Companion to Bioethics , Second Edition, pp.286 - 298
