The work of the brain determines the very existence and all the qualities of the human person, so the death of the brain is the line separating being from non-being.
How does a person die?
Dying is not an instantaneous event, but a whole process during which all organs and systems cease to function. The duration of this process depends on many factors: the initial level of health, the ambient temperature, the severity of the injury, and hereditary factors. In practice, you need to know exactly whether the death of the brain as an organ has occurred.
A person with a dead brain can no longer be fully considered alive, although his heart, lungs and other organs can be healthy and function perfectly. The identity of such a half-body ceases to exist. However, intact organs can be used for donation, saving several other lives. This is a complex legal and ethical issue in which everything should be extremely clear. Each person has relatives, and the issue of life and death is extremely important for them.
The concept of clinical and biological death
Death is considered clinical when a person can still be brought back to life. Moreover, the return should occur in full, with the preservation of all personal properties. Clinical death is a borderline form of existence between two worlds, when it is equally possible to move both one way and the other.
Clinical death begins from the moment of respiratory arrest and heartbeat. A person no longer breathes and his heart does not beat, but pathological processes have not yet become irreversible. The metabolic processes of destruction have not yet passed, and recovery without losses is possible. If within 5-6 minutes it is possible to restore vital functions, then a person simply wakes up, as if from a dream. But leaving without help in a state of clinical death leads to true or biological death, when the body becomes an open ecosystem for the development of bacteria. People around them have no more than 5 minutes to prevent a person from dying. At the same time, brain death is distinguished as a separate species because, after this event, a person can continue a vegetative life, but not a personal one.
Signs of brain death
Although the criteria for brain death have been studied sufficiently, after stating this fact, a person is left under observation in the intensive care unit for at least 24 hours. At the same time, artificial ventilation of the lungs and the maintenance of cardiac activity continue. Cases of a return to normal life after brain death are unknown, but the decision to disconnect from the equipment to maintain vital functions is too responsible, and the rush here is unacceptable.
The following criteria for brain death are accepted worldwide:
- lack of consciousness and independent movements;
- the absence of any reflexes, including such ancient ones as oculomotor and swallowing;
- lack of spontaneous breathing; special tests with hyperventilation are performed to check;
- isoline (zero axis) on the electroencephalogram;
- additional signs in the form of a sharp decrease in muscle tone, a rise in the sugar curve, and the like.
The presence of independent heart contractions is only confirmation that there are autonomous nerve nodes or pacemakers in the heart. However, the central regulation of heart rhythm has been lost, and blood circulation cannot be effective. The heart rate usually ranges from 40-60 beats per minute, and it lasts a very short time.
Is it possible to live without a brain?
Life and death are states that continuously follow each other. Complete brain death means the onset of a chronic vegetative state - one that is popularly called a “vegetable” or life on devices. Outwardly, a person may not change in any way, but everything that was human in him - thoughts, character, living speech, sympathies, knowledge and memory - are lost forever. In fact, the extension of the vegetative state depends on the voltage in the electric network. As soon as the devices stop working, the vegetative existence of a person with a dead brain ends too.
The cause of brain destruction is very important, without its ascertainment death cannot be ascertained. This may be a trauma, hemorrhagic stroke, dropsy or deep cerebral edema, incompatible with life poisoning and other conditions beyond doubt. In all cases where there is even the slightest doubt about the cause of brain death, a person’s condition is considered comatose and requires resuscitation.
Does a coma always end in death?
No, only the beyond coma ends. Doctors distinguish 4 stages of coma, the last stage is the beyond. In a coma, life and death balance on the brink, there is the possibility of recovery or worsening of the condition.
Coma is a sharp inhibition of the functions of all parts of the brain, a desperate attempt to survive due to a change in metabolism. The processes of coma development involve the cortex, subcortex, and stem structures.
There are a lot of reasons for coma: diabetes, severe kidney diseases, dehydration and loss of electrolytes, cirrhosis, toxic goiter, intoxication with external poisons, deep oxygen starvation, overheating and other gross disorders of life.
Doctors of antiquity called someone a “dream of reason”, because in a state of even a shallow and reversible coma, a person is inaccessible to contact, communication with him is impossible. Fortunately, modern medicine has many possibilities for treating coma.
How is death stated?
In the Russian Federation, the declaration of death and the termination of resuscitation are regulated by Government Decision No. 950 of September 20, 2012. The Decree describes in detail all medical criteria. A consultation of 3 doctors with at least 5 years of experience can ascertain death in a medical institution. None of the consilium can be related to organ transplantation. Necessarily the presence of a neurologist and anesthetist.
The death occurred at home or in a public place, ambulance officers state. In all cases where death occurred without witnesses, police officers are called to inspect the body. In all disputed situations, when the cause of death is unknown, a forensic medical examination is carried out. This is necessary to establish the category of death - violent or not. At the end of all actions, the relatives are issued the main official document - a death certificate.
Is it possible to delay the day of death?
Scientists answer this question positively or negatively with approximately equal frequency. In numerous predictions, the day of death is associated with a lifestyle, bad habits and type of food. In many religious movements, death is seen as a stage in the transition to a new kind of being of the soul without being weighed down by the bodily shell.
Buddhism and Hinduism are inextricably linked with reincarnation or the embodiment of the soul in a new body. Moreover, the choice of a new body depends on what lifestyle a person led in his earthly incarnation.
Christianity sees the day of death as the beginning of spiritual life, a heavenly reward for righteousness. The presence of an afterlife spiritual life - better than earthly life - fills the life of a believer with high meaning.
In practice, intuition plays a large role in avoiding mortal danger. It is intuition that explains the numerous cases of delays in aircraft and watercraft, which subsequently suffer fatal crashes. People know too little about their nature in order to be able to explain how and why they leave a deadly place seconds before the tragedy.
What are the kinds of death?
Doctors distinguish 3 types of nonviolent death:
- physiological or from old age;
- pathological or from a disease;
- sudden or from sudden acute conditions.
A sudden death is one of the most tragic when a person ceases to live in the midst of complete well-being. Most often, sudden cardiac arrest, which can occur in both an adult and a child, leads to this end.
The heart is a very complex organ; comparing it with a simple pump is incorrect. In addition to the specially organized cells - cardiocytes forming cavities - it has an autonomous nervous system. All this is controlled by the brain and spinal cord, and also responds to hormones and electrolytes contained in the blood. Failure of any of the components can lead to a sudden stop.
In fact, sudden cardiac arrest is the collapse of all life support systems. Blood ceases to carry oxygen and remove metabolic products, life just stops.
Anyone who is nearby should begin manual cardiopulmonary resuscitation. The efforts of others can maintain life for up to half an hour. This time is enough for the arrival of doctors who will provide specialized assistance.
Cessation of brain function - a separate type of death
In doctors, brain death is considered a separate diagnosis, fatal to humans. The fact is that the brain consists of two main departments: the hemispheres and the brain stem. The hemispheres are responsible for higher nervous functions: speech, thinking, memory, logic and emotions. The loss of these functions can be seen in people who have had a stroke: lack of speech and tearfulness - the consequences of the destruction of the hemispheres with poured blood. You can live with damaged hemispheres for quite some time.
Unlike the hemispheres, the brain stem is an older formation. It was formed when people did not yet know not only writing, but coherent speech. The brain stem controls vital functions, namely breathing, palpitations, muscle tone and reflexes. Any, the smallest damage to the brain stem causes a state of clinical death. However, people survive precisely thanks to the brain stem. All its structures are most resistant to external influences and are damaged in the last turn.
So when does brain death occur?
Then when the brain stem dies. The brain does not die in an instant either. There is a general rule for the whole organism: that which was formed later in the process of evolution dies first. This rule applies to the brain. Hemispheres - younger formations - are more vulnerable in a moment of mortal danger. They die first from a lack of oxygen. If the severity of the condition is too deep and resuscitation is ineffective, complete brain death occurs within minutes.
Are all secrets revealed by scientists?
Every day in specialized publications appears at least one publication about new discoveries that accompany the process of dying. So, scientists say that the time of brain death can be fixed on the EEG as a surge in electrical activity, characteristic of intensive learning processes. Other scientists characterize such activity as recording bioelectric waves from collapsing neurons. There is still no definite answer.
The words of the ancient Greek philosopher Epicurus that we will never meet death can serve as a consolation to all living creatures: when we are, there is no death, and when it comes, then we are no longer there.