Practical Ethics

The point of death

The Guardian yesterday reported the death of the man who had been so tragically shot in Antigua, with his wife, three weeks after their wedding. It began like this:

"Ben Mullany, the newlywed who was shot on honeymoon in Antigua in an attack that killed his wife, Catherine, died in hospital in Wales yesterday after his life support machine was switched off.  The 31-year-old trainee physiotherapist, who had suffered a fractured skull and had a bullet lodged in the back of his head, was flown back to Britain while in a coma on Saturday. Tests carried out when his condition stabilised after the 24-hour journey established he was brain dead." 

This is a familiar way of describing such happenings, even among clinical professionals.   Brain death is pronounced, so the life support machine is switched off, and the patient dies.   The clear implication is that brain death is not death.  The machine is still keeping the patient alive, and it is switching off the machine that causes real death. 

Do we own our bodies? Should we?

There was a sad story last week about a young woman who died unexpectedly at the age of 19.   She was on the organ donor register, and her own mother was on the waiting list for a kidney donation, but the mother was refused one of the kidneys.  Even the transplant coordinator was ‘crying her eyes out’, but there was apparently no escape.  Rules were rules.  Cadaveric donations must go impartially and anonymously to the most compatible people at the top of the waiting list, and the authorities decreed that these organs must go to three strangers – whose identity the mother will never even know.