USA Africa Dialogue Series - - Recurrent Technical Death Sentence

He said the cabinet mortuary is the worse, as you see some of them with hands up their chest, as if trying to push off the covering. I then said why can't you just help those people, and bemused he said "that is ultra-vires". The point then is, since our technologies have their failings, "CAN THE MEDICAL PROFESSION PROFER AN ARRANGEMENT WHEREBY PEOPLE ARE KEPT IN-TRANSIT FOR MAYBE 12HRS BEFORE THE FINAL MORTUARY DESTINATION?" Nothing compares to the pain of losing a close person.--Bola Aina

--

"A fortnight   ago, I lost my 97 year old aunt in our hometown while I was in Abuja. Upon arrival about three hours later
I asked if they had called in a physician to pronounce her dead and issue a Death Certificate. I was told they had called
a Dr X, a colleague and friend who lives in town but unfortunately he had just traveled out of town. I asked how they were able
to obtain a death certificate and a burial certificate considering arrangements for her burial and internment
were already at an advanced stage. I was informed that issues like 'death and burial certificates' are the concerns
of city dwellers--they are not mandatory in the villages and the small towns!

It is still possible even in 2011 in many remote regions of Nigeria to be born without one's parents ever being issued
a Birth Certificate and for one to live into advanced old age without one's relatives ever obtaining either a Death and or Burial
Certificate upon death. In other words one could officially pass through life in Nigeria without any official records
if one never attended school, visited any healthcare institutions, never needed a driver's licence and was law abiding
 and died in the same remote region of Nigeria
one was born in. This is what I would call a stealthy life--no taxes either!:)"-Ola Kassim--excerpt from below

Dear Bola:

The issue you raised brings to mind some pertinent questions relating
to the transition of a mortal human being, animal or plant to the great beyond--i.e. what
we normally refer to as death.

The troubling issues relating to DEATH, some easy and some difficult, are the following:

 When is a person truly dead?--considering that we have a legal definition of death and a medical one
and the two are not always in sync, at least chronologically.

http://euthanasia.procon.org/view.answers.php?questionID=000197

The legal definition of death relies on the inability to obtain any brain waves
on an EEG (electroencephalogram--the so called flat line) and a response when a column of cold water
 is introduced into the ears of the deceased and when no other reflexes are obtained
upon physical examination.

For practical reasons the medical definition of death requires at bedside only that there should be
no more heart beats i.e. no pulse and that the pupils must be fixed and dilated.
This simple medical definition of death does not always satisfy
the more stringent requirement for legal death as not all physicians can read an electroencephalogram
(which requires the expertise of neurologists and internists) and when the equipments are not readily available.
Also in practical terms one is not officially dead until a death certificate is issued--another legal document!

The above two scenarios bring us to the issue of the 'brain dead' individual with a
functioning and beating heart and lungs (controlled by the lower (or posterior) brain
even though the fore brain is no longer functioning and the individual is unlikely to ever
wake up and be human again--notwithstanding the fact that he or she may remain
in this vegetative for days, weeks, months or years with or without the help of respirators.
For example Ariel Sharon, former Prime Minister of Israel is still considered alive, even though his fore
brain (cerebral hemispheres) would by now been completely liquefied--considering he has been
in deep coma for many years,

 (Uniform Determination of Death Act (UDDA). Today all fifty states and the District of Columbia follow the UDDA
 in recognizing whole-brain death - irreversible cessation of all functions of the entire brain - as a legal standard of death…
If a patient's entire brain is nonfunctioning, so that breathing and heartbeat are maintained only by artificial life-supports, t
hat patient meets the whole-brain standard of death.")

Even when all the conditions --of legal and medical death are satisfied we are still left with this
enigmatic issue: When a living organism dies--not all the cells (which make up the tissues which in turn
make up the organs) die at once. This is the reason we can transplant kidneys from  a dead person
hours after death into another (i.e. from cadaverous kidney donors) and even simpler, transplant corneas from
donated eyes days and weeks after they have been enucleated from a dead person to cure
blindness due to corneal disease in another human being.

Philosophically is an accident victim whose major organs including the heart, lungs, liver, kidneys, corneas,
bones, bone marrows have been transplanted into multiple other human beings truly dead when
most of his or her organs and tissues are still alive --providing scores of useful and healthy
life to others in whom those organs has irretrievably failed?

As you can see from the above the process of dying is just as complicated if not more complicated than
the process of living beginning from birth.

Just like in everything else, death has also become a technology -intensive process.

It used to be standard procedure that only physicians can pronounce a person officially dead. However nowadays
many jurisdictions are letting common sense prevail by empowering other paramedical personnel including ambulance
attendants, nurses, and police officers at the scenes of accidents to make a declaration (at least temporarily)
that a person has died and proceed working under that assumption. Thus an an ambulance attendant who arrives
at the scene of a Motor Vehicle Accident and finds a decapitated body (head traumatically removed from the torso)
need not start setting up and IV line and start rushing the victim at breakneck speed to the emergency department
of the hospital. The same goes for a police officer or lay person who encounters such a gory scenario.

Just as death has become so technologically more complicated,  Africans have been moving backwards.
There was a time not too long ago when  larger towns or district capitals in Nigeria would have well maintained mortuaries with
functioning refrigerating units. Most jurisdictions in Nigeria currently do not have such facilities. If we had such refrigerated units instances
of supposedly dead people waking up in the middle of the night would decrease--considering a supposedly dead but actually
sleeping human being or one who is in coma is bound to react adversely to the cold conditions in a refrigerated
morgue.

A fortnight   ago, I lost my 97 year old aunt in our hometown while I was in Abuja. Upon arrival about three hours later
I asked if they had called in a doctor to pronounce her dead and issue a Death Certificate. I was told they called
a Dr X, a colleague and friend who lives in town but who had just traveled out of town. I asked how they were able
to obtain a death certificate and a burial certificate considering arrangements for her burial and internment
were already at an advanced stage. I was informed that issues like 'death and burial certificates' are the concerns
of city dwellers--they are not mandatory in the villages and the small towns!

It is still possible even in 2011 in many remote regions of Nigeria to be born without one's parents ever being issued
a Birth Certificate and for one to live for a long time without one's relatives ever obtaining either a death and or birth
certificate. In other words one could officially pass through life in Nigeria without any official records
if one never attended school, visited any healthcare institutions, never needed a driver's licence and was law abiding
 and died in the same remote region of Nigeria
one was born in. This is what I would call a stealthy life--no taxes either!:)

Bye,

Ola

http://euthanasia.procon.org/view.answers.php?questionID=000197

What is the medical definition of death?

General Reference (not clearly pro or con)

Dorland's Illustrated Medical Dictionary, 31st Edition, republished on the website of Merck & Co, defined death as (accessed May 11, 2007): "death (death) (deth) the cessation of life; permanent cessation of all vital bodily functions. For legal and medical purposes, the following definition of death has been proposed-the irreversible cessation of all of the following: (1) total cerebral function, usually assessed by EEG as flat-line (2) spontaneous function of the respiratory system, and (3) spontaneous function of the circulatory system... brain d[eath]. irreversible brain damage as manifested by absolute unresponsiveness to all stimuli, absence of all spontaneous muscle activity, including respiration, shivering, etc., and an isoelectric electroencephalogram for 30 minutes, all in the absence of hypothermia or intoxication by central nervous system depressants. Called also irreversible coma and cerebral d[eath]." May 11, 2007 - Dorland's Illustrated Medical Dictionary

Robert Kastenbaum, PhD, Professor of Communications at Arizona State University, wrote in a 1989 encyclopedia entry titled "Definitions of Death," published in the Encyclopedia of Death and Dying, that: "In the past, death has often been defined with a few confident words. For example, the first edition of Encyclopaedia Britannica informed its readership that 'DEATH is generally considered as the separation of the soul and body; in which sense it stands opposed to life, which consists in the union thereof' (1768, v. 2, p. 309). The confidence and concision had dissolved by the time the fifteenth edition appeared in 1973. The entry on death had expanded to more than thirty times the original length. The earlier definition was not mentioned, and the alternative that death is simply the absence of life was dismissed as an empty negative. Readers seeking a clear and accurate definition were met instead with the admission that death 'can only be conjectured' and is 'the supreme puzzle of poets' (1973, v. 5, p. 526). This shift from confidence to admission of ignorance is extraordinary not only because death is such a familiar term, but also because so much new scientific knowledge has been acquired since the eighteenth century. Actually, the advances in biomedical knowledge and technology have contributed greatly to the complexity that surrounds the concept and therefore the definition of death in the twenty-first century. Furthermore, the definition of death has become a crucial element in family, ethical, religious, legal, economic, and policy-making decisions." 1989 - Robert Kastenbaum, PhD

David DeGrazia, PhD, Associate Professor of Philosophy at George Washington University, in a 1998 article entitled "Biology, Consciousness and the Definition of Death," published by the University of Maryland's Institute for Philosophy and Public Policy Quarterly, wrote: "When does a human life end? This question used to be answered quite easily. According to the traditional standard, which has only recently been questioned, a human being is dead when her heart and lungs have irreversibly ceased to function… Today, however…a patient may lose consciousness a decade or more before his heart and lungs fail, for example...  Two landmark reports helped to generate a movement away from exclusive reliance on the traditional standard: the 1968 report of the Harvard Medical School Ad Hoc Committee and a 1981 presidential commission report, Defining Death. This second document included what became the Uniform Determination of Death Act (UDDA). Today all fifty states and the District of Columbia follow the UDDA in recognizing whole-brain death - irreversible cessation of all functions of the entire brain - as a legal standard of death… If a patient's entire brain is nonfunctioning, so that breathing and heartbeat are maintained only by artificial life-supports, that patient meets the whole-brain standard of death." 1998 - David DeGrazia, PhD

---- Original Message ----
From: Pius Adesanmi <piusadesanmi@yahoo.com>
To: usaafricadialogue@googlegroups.com <usaafricadialogue@googlegroups.com>
Sent: Thu, Jul 28, 2011 4:54 pm
Subject: Re: USA Africa Dialogue Series - Recurrent Technical Death Sentence

Bola Aina:

An elderly mortuary attendant who may soon join Nigeria's notorious pension queues actually said: "that is ultra-vires"? If we are not careful, your roadside mechanic in Okokomaiko may say: "ceteris paribus, I will repair your car gratis tomorrow".

Pius

 

---

From: Bola Aina <ainabola@googlemail.com>
To: USAAfricaDialogue@googlegroups.com; shokunbiade@yahoo.com; dayoids@yahoo.com; dayoids@yahoo.co.uk
Sent: Thursday, 28 July 2011, 15:15
Subject: USA Africa Dialogue Series - Recurrent Technical Death Sentence

This may not be the appropriate forum to discuss this issue but I crave the indulgence of the medical experts and apologize to non-medicals. There is an emerging trend of people being pronounced dead waking up again. The latest is that of South-African man that wakes up in the mortuary, prelude to that was of a woman that woke up at her funeral only to truly die "back" after 15minutes due to shocks in Russia few weeks ago. The husband threatens legal action, but of course it wouldn't bring the woman back. A friend nearly lost his wife early this year to same fate. The woman woke up in transit to the mortuary. I felt bad hearing that, because another friend lost his wife to childbirth complications at the University College Hospital, Ibadan, Nigeria, last year. What I don't understand is that the said woman died at daybreak and we buried her around 6:00pm, yet the body was so fresh, bending in the hands of those carrying her. It was a day I will never forget as it haunts me as if we buried her alive, and ever since I don't visit grave sites again. I discussed the incidence with an elderly mortuary attendant. His response is that there are many of such in his diary. He furthered that, few hours after some are brought in into the mortuary, he hears sounds as if someone is banging something, only to discover that the position of such people would have changed as if trying to stand up. He said the cabinet mortuary is the worse, as you see some of them with hands up their chest, as if trying to push off the covering. I then said why can't you just help those people, and bemused he said "that is ultra-vires". The point then is, since our technologies have their failings, "CAN THE MEDICAL PROFESSION PROFER AN ARRANGEMENT WHEREBY PEOPLE ARE KEPT IN-TRANSIT FOR MAYBE 12HRS BEFORE THE FINAL MORTUARY DESTINATION?" Nothing compares to the pain of losing a close person.

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