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Cellular Life

Once medical techniques and technology have failed to keep a person fully (or mostly) functioning, that person is declared dead (and would have been declared dead earlier in a situation where technology was even more limited). However, the rest of the body continues to live on a cellular level. Like the body, cells die in stages; without nutrients the cell has no energy to maintain connections with other cells, the nucleus stops functioning and the cell swells as the mitochondria (which powers a living cell) becomes polluted by acids from the cell which then destroy it. This process, like brain and other organ decay, takes time and during that time we have the opportunity to save a person's body by arresting decay through cryopreservation of the body. This allows us to indefinitely suspend the person on the threshold of total death (the obliteration of the body, caused by decay) in the hope that medical progress can repair the damage that initially caused bodily collapse.

However, today's medical authorities are not concerned with the speed of the deteriorating life of the body or of the condition of the brain after official death. As part of their statement on death (the declaration of Sydney), the 22nd World Medical Assembly states that "clinical interest lies not in the state of preservation of isolated cells but in the fate of a person. Here the point of death of the different cells and organs is not so important as the certainty that the process has become irreversible by whatever techniques of resuscitation that may be employed." But despite the declaration, the deaths of cells and organs are indeed important because of how they define and constitute a person and the "fate of a person". Physicians need to look differently at what a person is as informed by their cellular life and death. For example, Shiavo's personhood is understood in different physical, legal, and existential ways at each stage of her life, and these understandings depend on particular cellular states (i.e. what kind of person is a gestating embryo, or a healthy woman, or a brain-dead patient?).

Because of these ambiguities of dying brains and cells, of living organs and supported bodies, there is an ambiguity about death itself. The medical declaration of death seems rather arbitrary, partly dependant on available medicine and partly according to how a living person is defined. Was the comatose Terri Schiavo a living person or was she just a living body? Is not a medical declaration of death another way of saying that available medicine is simply inadequate to solve the problem (though adequate enough to harvest living organs for donation)? Continued progress beyond current medical limits is the surest way to better health and longer life and it is the state of the living cells - especially those of the brain - that matter the most in determining or avoiding death. Death would be better understood as a matter of the magnitude and type of cellular death rather than as brain death.

In summary, dying and death are medically understood in the following ways:

The body collapses and medical technology can revive the person and help them move, breath, and circulate blood. The person is revived and they live on (perhaps with decreased quality of life), or the brain is seriously damaged and the person's life must be supported with machines.

Or:

The body collapses and medical technology cannot revive the person nor help them breath or circulate blood. The person is declared dead and some sort of funeral ritual later takes place, or the body is utilized for experimentation and/or organ donation before a funeral.

In all cases of declared death, the body, including the brain, continues to live on a cellular level until the process of decay is complete.

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