Defining death

Defining death

Article:

1. Journalist Anjali Thomas discusses the need for a uniform definition of death in India

Important Analysis:

2. Recently, the Kerala government has issued protocols to confirm brain death. This is expected to ensure transparency in the procedure of organ transplantation.

3. Issues with definition of death:

• Lack of clarity in defining death
• Traditionally, death was identified by cardio-respiratory failure i.e. when heart stops pumping blood. Lack of pulse and breath considered as signs.
• However with medical advancement, defining death became complex. Ventilators could artificially keep the heart pumping.
• At present, death is defined as “death of nervous system”, “coma depasse” i.e. irreversible state of coma or apnoea
• Several cases have challenged the brain death concept and procedures in declaring so-

Example:

In USA, 13-year-old Jahi McMath was declared brain dead. However, her parents had advocated the revoke of this declaration.  In 2017, she had reached puberty while on life support. This has raised questions on procedure of declaring brain death

Issues in India

• Inconsistency in definitions- Death differently defined in 2 Acts
• Transplantation of Human Organs Act, 1994 defines death as “permanent disappearance of all evidence of life, by reason of brain stem death or in a cardiopulmonary sense”
• On the other hand, Registration of Birth and Death Act, 1969 do not include diagnosis of brain death. It defines death as” permanent disappearance of all evidence of life at any time after live-birth”.Therefore, a person on ventilator support may not be considered dead

Suggestions:

• Formulate clear standard operating procedures
• Put forward a consistent, clear legal definition of death