The Line Between Life and Death - New York Times: "LATE last month, New York's major newspapers reported that a 13-year-old boy had 'died' after he was taken off 'life support.' That assertion reflected a fundamental misunderstanding of death as defined by the laws of all 50 states. In fact, the boy had died more than a week earlier - from a severe brain infection - after transfer to the hospital where we work. In the interim, advanced medical technology supported his organs, not his life.
Death shouldn't be this hard to understand, yet it often is. According to the 1987 New York State Public Health Regulation, death occurs when either the heart or the brain irreversibly ceases to function. Before medical technology provided breathing machines, there was no meaningful distinction between brain and cardiac death. Once the brain stopped sending signals to the lungs to breathe - on account of a stroke or head injury, for example - the heart would stop within minutes. Now that machines can deliver oxygen to the lungs, however, the heart can continue to beat for days without any signal from the brain.
For centuries we understood death, whatever its cause, as the cessation of heart and lung function. A person was dead when the pulse faded, the heartbeat became inaudible and the chest ceased to rise. Brain death is harder to discern. A brain dead person whose heart and lungs are sustained by machines looks as if he's in a coma. For a family who has lost a loved one, often from an acute illness or terrible accident, it is unspeakably difficult to accept that this warm body with a heartbeat is lifeless. And yet, to imply that a brain-dead person is still alive only prolongs the loved ones' anguish. Such misunderstanding gives false hope and preys on the survivors' feelings of guilt."