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Thursday, March 18, 2010

Defining Death

In my Biomedical Ethics class we talk a lot about death, and how it is defined; though no one can ever seem to truly define it in a way that can be agreed upon. There are a few different theories: higher-brained death, whole-brained death, and cardiopulmonary. Higher-brained also being known as "loss of person-hood", is when the higher functions of the brain cease, yet there still is some brain function. Whole-brained death being when all brain function stops, and lastly, cardiopulmonary being when heart and lung function fail.  New Jersey is one of the only states that does not oblige by the whole-brained standard of death.

As medical professionals we are instructed to form our own ethics and morals and utilized them in the practice of medicine, we are supposed to do no harm, and to help people to the best of our ability. Though, how are we supposed to conform to a definition of death when every person we treat is different? How are we supposed to know when to disagree with the family's decision because we know it isn't what the patient would want/ we know that it isn't what is best for the patient? As medical professionals instructed to do know harm and to do whatever it takes to help a patient, how are we supposed to decide for that particular patient if they would consider themselves dead or not? Are we supposed to trust a family that for all we know wants to "pull the plug" to gain an inheritance (or some other unknown motive)? Also, if you do not believe in the whole-brain standard of death, are you supposed to sacrifice your moral code?

Over the past few years, specifically while completing my patient contact hours, I have come up with a pretty set-in-stone morality that I believe in, and from what I have been taught I should not compromise that because my moral code is what makes me the future medical professional that I am/will be. Luckily, I do believe in the whole-brain standard of death, though I also believe in doing what is right for the patient and honoring their wishes. At the moment, I am conflicted between these beliefs, what am I supposed to do when not all ethics can be honored?

I know that I will ALWAYS, undoubtedly, honor the patients wishes, and I will fight for the patient if their is a discrepancy with their wishes; especially since I want to work in pediatrics and the child's wants are often forgotten. Is there anything else, as a medical professional, that I could do?

What is your opinion on defining death and upholding personal moral ethics while giving the patient what they want and obliging to state legislation?

Is there any advice for future medical professionals?

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