A book to read and weep, weep and read. And to think – what is the definition of death? An argumentative point of course.
Medical Definition of death. : The irreversible cessation of all vital functions especially as indicated by permanent stoppage of the heart, respiration, and brain activity (Merriam Webster)
Definition of brain death
Final cessation of activity in the central nervous system especially as indicated by a flat electroencephalogram for a predetermined length of time
Two categories of legal death are death determined by irreversible cessation of heartbeat and breathing (cardiopulmonary death), and death determined by irreversible cessation of functions of the brain (brain death).
The official signs of death include the following:
- no pupil reaction to light
- no response of the eyes to caloric (warm or cold) stimulation
- no jaw reflex (the jaw will react like the knee if hit with a reflex hammer)
- no gag reflex (touching the back of the throat induces vomiting)
- no response to pain
- no breathing
- a body temperature above 86 °F (30 °C), which eliminates the possibility of
resuscitation following cold-waterdrowning
- no other cause for the above, such as a head injury
- no drugs present in the body that could cause apparent death
- all of the above for 12 hours
- all of the above for six hours and a flat-line electroencephalogram (brain wave study)
- no blood circulating to the brain (medical dictionary)
A persistent vegetative state (PVS) is a disorder of consciousness in which patients with severe brain damage are in a state of partial arousal rather than true awareness. After four weeks in a vegetative state (VS), the patient is classified as in a persistent vegetative state. This diagnosis is classified as a permanent vegetative state some months (3 in the US and 6 in the UK) after a non-traumatic brain injury or one year after a traumatic injury. For some patients with this condition it is possible to reverse some of the effects and some people can, it has been demonstrated become aware and thus control either some muscle functions of some brain functions.
It is not recognised as death in most legal systems unless brain death can be also diagnosed. However, if medical intervention is required to keep the person alive, are they really still alive? And by removing the medical intervention are you killing them? An ethical question not just for this condition but for all relatives and medical personnel when a person is being kept alive by extreme medical interventions. At what point do you stop the medical intervention?
This story tells the real-life experience of a family when the son is put into a persistent vegetative state by an accident when he was a teenager. An accident witnessed by his sister who was very close to him and who is the person telling her story and the profound impact her accident and medical condition had on her life.
I suspect that most people, myself included, would not want to be kept alive in this condition despite all the potentialities. Which are just that. Potential and not always or even often, occurring.
For each person the amount of disability that they can cope with varies. There is a difference between bodily disabilities and mental disabilities.
Personally, if I am no longer aware and my brain is not function, even if my body could be kept alive by medical means, I would not want to live on I that condition, hence the fact that I have signed a ‘Do Not Resuscitate’ letter and a ‘Living Will’.
But if it was my child, or my husband, at what point would I be willing to let them die? And if they haven’t stated anything and medical miracles are happening regularly it seems, at what point am I ready to let them go?
So this book shows very clearly the impact on the family life. It is not just about the definition of death. Cathy pulls no punches in telling how self-destructive her life became until she finally found a way through with her love of books and eventually writing her story.