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Advanced technology complicates decisions about life and deathcomment (0)

January 23, 2014


Advanced technology complicates decisions about life and death

Making the decision to take a loved one off life support will likely never get any easier, and the questions that swirl around the decision will remain.

But “Scripture says that there is a time to live and a time to die. It is appointed for man to die so there comes a time when a person dies, and I don’t think it is wise to continue that life without hope and justify technology to sustain a life just to sustain a life,” said Jeff Riley, professor of ethics and chairman of the division of theological and historical studies at New Orleans Baptist Theological Seminary.

Acknowledging that every case should be evaluated on its own merits, Riley said, “No set of standards will cover every case. We will never have a straightforward list of criterion. As Christians we seek wisdom from God as we consider the counsel of medical professionals.”

And while technology allows for so many more options, it also is the advancement of technology that has complicated the decision-making process, he said.

“We don’t want to avoid technology. It is good,” he said. “However, prior to the 1960s, we didn’t have the technology to keep us alive without at least lower brain function. Significant brain trauma, cardiac arrest or lung failure would typically lead to death. If there were trauma to the head, particularly the brain stem, then the heart or lungs would shut down. The person would die because of the relationship between the heart, lungs and brain.” 

Today “technology has allowed us to resuscitate the heart and stimulate the lung function,” he said. “When there is a disconnect between the brain, lungs and heart … we can be put on a machine to breathe and force blood through the body.

“The question is, ‘What is death and what is life and how does technology fit into this?’” Riley explained.

And just because technology can keep a person breathing even without brain activity, removing someone from life support would not equate to killing the person, he said. “It would allow death to run its course. 

“If the condition of the brain would be the cause of death, you are not contributing to the person’s death if you take the ventilator off after 24 hours of no brain activity.”

Still it is hard to make the final call even with official test results indicating cessation of brain activity. And in all cases the person who is dying should be afforded value and dignity until the end, Riley said.

“We can see the breathing going on and the heart beat, but brain activity can’t be seen without significant tests.

“Death is defined as the cessation of body functions or irreversible cessation of [circulatory and respiratory functions or all functions of the entire brain],” Riley said. “If there is no upper or lower brain activity, then is it possible for the heart and lung to function? In rare cases, it might for a short period of time. ... If the brain stem is not functioning correctly or is dead, then the normal way our body works is that we would go into cardiac arrest and die.”

Riley suggested one gage to use in making the decision about whether a person should be kept on life support is whether the person truly has a chance of recovery. Is there a way for the person’s brain to recover and for the person to live apart from technology?

“Cessation of life is the question,” he said. “How much brain activity is necessary for life, for consciousness? What is the relationship of consciousness to being a human being, a person? 

“Even so, as long as the heart is pumping and the lungs are functioning, a person as a person is alive. Death occurs when all shut down.”

(TAB)

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