Changing the Standard View of External Markers of Life and Death

Written by: Corey Washington

Primary Source: Zero Ideology

A series of recent studies in animals suggest that physicians may need to revise their views about the validity of markers for patient life and death. It has been common to pronounce a person dead after efforts to reestablish a heart beat have failed. This point in time is typically recorded as “time of death” on death certificates.

The practice seems seems intuitively reasonable. Even even if the patient is not fully brain dead after extended resuscitation attempts are terminated, she will be soon due to the lack of oxygenated blood reaching the brain.

Now two researchers are suggesting that the standard approach to resuscitation may be part of the cause of death. Their work has shown that lowering the body temperature of patients resuscitated after cardiac arrest improves survival rates. Peter Rhee and Samuel Tisherman are suggesting that the proper approach is to cool bodies down shortly after a life threatening injury, without active resuscitation efforts, inducing a state that looks very much like death. Treating the patient in this condition may allow for healing that permits a return to active physiology. As the BBC quotes Rhee:

“When you are at 10C, with no brain activity, no heartbeat, no blood – everyone would agree that you’re dead,” says Peter Rhee at the University of Arizona, Tucson. “But we can still bring you back.”

Rhee isn’t exaggerating. With Samuel Tisherman, at the University of Maryland, College Park, he has shown that it’s possible to keep bodies in ‘suspended animation’ for hours at a time. The procedure, so far tested on animals, is about as radical as any medical procedure comes: it involves draining the body of its blood and cooling it more than 20C below normal body temperature.

Once the injury is fixed, blood is pumped once again through the veins, and the body is slowly warmed back up. “As the blood is pumped in, the body turns pink right away,” says Rhee. At a certain temperature, the heart flickers into life of its own accord. “It’s quite curious, at 30C the heart will beat once, as if out of nowhere, then again – then as it gets even warmer it picks up all by itself.” Astonishingly, the animals in their experiments show very few ill-effects once they’ve woken up. “They’d be groggy for a little bit but back to normal the day after,” says Tisherman.

The research has clear policy implications. Tisherman and colleagues plan to test their procedure on gunshot victims in Pittsburg, PA, in the coming months.

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