About | HeinOnline Law Journal Library | HeinOnline Law Journal Library | HeinOnline
LOG IN
LOG IN

32 Med. Sci. & L. 2 (1992)

handle is hein.journals/mdsclw32 and id is 1 raw text is: 2 Med. Sci. Law (1992) Vol. 32, No. 1 Editorial: About Death M P McHUGH Former HM Coroner INTRODUCTION The pattern of existence for all living species on this earth, from the womb to the tomb, is: to be begotten, to be born, to blossom and then to die. No doubt the formula is nature's method of ensuring that only the fit and healthy people the planet and that the species does not become extinct. This can only be achieved by a constant weeding of the aged and fatally sick - when the latter condi- tions prevail, death intervenes. Of the four phases in the cycle of life, death is the most mysterious and the ultimate arbiter; we all fear death, but it is a fear that seems to be a necessary condition for our survi- val. All living creatures, with the exception of those deranged souls and the lemmings of course, will fight for their life if it is threatened. Flora and fauna have their own procedures for avoiding untimely destruc- tion. The chameleon, some moths and butterflies will change their colour to merge into the background of their surroundings, to avoid detection by predators. The period of gestation of foeti in the kangaroo's pouch instead of intra-abdominally, will facilitate a female and her young's flight from danger. And who is brave enough to pick up the balled hedgehog in his garden? Even flowers will close their petals at night- fall to protect their precious germinal areas. Homo sapiens has developed greater powers of keeping the unwelcone reaper at bay - one might almost say that modern man is attempting to abolish death. MEDICINE, SCIENCE, LAW AND DEATH Laws are geared to the safeguarding of life. Medicine and science are orientated towards prolonging life beyond its 'natural' span. The elaborate organ trans- plantation programmes and arsenals of life-saving and rejuvenating drugs flooding the markets of today bear testimony to this. However these limited meth- ods only serve to postpone the evil day. Death is inevitable and comes to us all sooner or later - and it is of little comfort to the individual that survival of the species depends on the continuing elimination of its dead wood. Why do we fear death? Because the unknown is always frightening, but also because the concept of no longer existing is incomprehensible to the conscious mind. 'Je pense doncje suis', said Descartes. Taken in that context the action of life is the effort to survive. We console ourselves for having to die by clothing our egocentricity with a spiritually interpreted im- mortality after death. For most of us this idea of Valhalla fulils a very real human need because it allows us to live equitably with our fears; it removes the sting of death. Most cultures and religions cater for this requirement. In reality, death is little else than sleep from which we do not awaken. Patients who have been resuscitated after being diagnosed as clinically dead will testify to this analogy with sleep. Death is both an act and a process. The act is when the self or spirit cuts its earthly ties and leaves the body; the process is marked physically by cessation of heart beat and respiration. If the cessa- tion of these functions is irreversible, then the person has died. Modern technology now makes it possible to maintain ventilation by respirators, cardiac function by life support devices and feeding and disposal of waste products by dialysis. These methods of sustain- ing the physiological life of a body indicate the progressive process of dying, so that if, when the supportive devices are withdrawn, the bodily func- tions can no longer operate unaided, then the patient is dead, but if the bodily functions resume inde- pendently of any help, it can be said that the patient has been brought back from the dead, However, this depends on whether the brain stem is still functional. The brain stem is the power house which controls and operates the bodily functions. If it is destroyed then the process of death, despite attempts at resuscita- tion, will continue relentlessly until putrefaction - the ultimate criterion - sets in. There are many myths about death and dying: one is a rather widespread conviction that the dying person puts up a fight when death grips him by the throat: 'Will he struggle when the time comes, doc- tor?' is not an uncommon question voiced by anxious relatives. This unfortunate concept of the dying man battling his way back to life in his death throes is no doubt fostered by the fact that the patient often de- velops stertorous breathing. This rather noisy, hissing respiration, known in common parlance as the death rattle, is due to an accumulation of mucous and fluid in the bronchi - infallible signs of a failing

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.



Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

Purchase Access

Contact us for annual subscription options:

Contact Us

Already a HeinOnline Subscriber?

Log In

profiles profiles most