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Cancel Save. Orthodox Jewish and other theologians continue to debate whether a brain-dead person is truly dead. He readily admits that no one has yet explained scientifically why the destruction of the brain is the death of the person, rather than an extreme injury. Death is an event.

Stuart Youngner, of Case Western, however, rails against what he sees as bad faith in the way brain death came to be defined. The problem, as Youngner sees it, is that the veneer of scientific truth attached to the concept of brain death conceals the fact that the lives of brain-dead people have ended only by virtue of what amounts to a social agreement.

During the last decade, Youngner and other doctors and ethicists have developed protocols to allow critically ill or injured people who have no hope of recovery, but who are unlikely to become brain dead, to donate their organs after they have been declared dead by the traditional cardiopulmonary criteria. This procedure, which is known as non-heart-beating-cadaver donation and requires extremely rapid intervention and newly developed techniques, may make it possible to salvage viable organs in a wider range of cases. As it happened, Nick Breach was a candidate for this procedure.

If he was brought to the hospital, placed on a respirator, and then languished, without ever meeting the criteria for brain death—a likely scenario, given the course of his disease—only a tight orchestration of his death could conceivably give him a chance of becoming a donor. Nick would then be taken to an operating room, where he would be taken off the ventilator, and the doctors would wait for his heart to stop.

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If that took more than an hour, warm ischemia would set in as his breathing would be too compromised to supply oxygen to his organs , the donation would be aborted, and Nick would be returned to a hospital room to die. But if cardiac arrest came in time, a five-minute count would begin, at the end of which Nick would be declared dead. A transplant team standing by in an anteroom would immediately harvest his organs and rush them to their recipients.


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Even with this alternative, the window for success was fairly narrow. Non-heart-beating protocols have the potential to increase donation by as much as twenty-five per cent. But, as Youngner points out, the five-minute waiting period it ranges from two minutes in some protocols to ten minutes in others is really just a decent interval, a more or less arbitrary marker of the passage from life to death, whose significance is far more symbolic than scientific. Robert Truog, a professor of medical ethics and anesthesiology at Harvard Medical School, is even more critical of the protocol.

It awakens the same sort of fears that Nick Breach himself had about the premature removal of his organs.


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  • In return, Truog points out, patients would gain more control over the end of their lives: they would no longer have to wait until they crossed over that gerrymandered border and, instead, could specify at what point they would like to be declared dead so that they could donate their organs.

    This, however, might not be adequate consolation for those who fear that the need for organs might create a perverse incentive for doctors to give up on them, after weighing their lives against those of others who may be more worthy or less damaged.

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    Youngner expressed reservations about how his position would sound to other doctors and, most important, to potential donors. Yankovic came inside and sat for a while with Nick, who was bedridden by then. Six days later, at P. Rick, who was taking his turn by the bedside, summoned Kim, who called an ambulance and began to administer CPR.

    The plan was to revive Nick so that he could be brought to a hospital and placed on a ventilator. In the end, the only organs he was able to donate were his eyes. During a break between sessions, I got into a conversation with a philosopher.

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    He was visibly upset. It may be too much to say that the concept of brain death is an outright lie, but it is certainly less than the truth. Should a practice, however noble, be able to hold truth hostage? Perhaps the medical profession should embrace the obvious: to be an organ donor is to choose a particular way to finish our dying, at the hands of a surgeon, after some uncertain border has been crossed—a line that will change with time and circumstance, and one that science will never be able to draw with precision.

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    Those who think they are wise are as good as dead , those who think they possess understanding. Those who are champions at drinking wine are as good as dead , who display great courage when mixing strong drinks. Those who enact unjust policies are as good as dead , those who are always instituting unfair regulations,.

    Assyria, the club I use to vent my anger, is as good as dead , a cudgel with which I angrily punish. The many nations massing together are as good as dead , those who make a commotion as loud as the roaring of the sea's waves. The people making such an uproar are as good as dead , those who make an uproar as loud as the roaring of powerful waves.

    The land of buzzing wings is as good as dead , the one beyond the rivers of Cush,. Ariel is as good as dead -- Ariel, the town David besieged! Keep observing your annual rituals, celebrate your festivals on schedule. Those who try to hide their plans from the Lord are as good as dead , who do their work in secret and boast, "Who sees us? Who knows what we're doing? Those who go down to Egypt for help are as good as dead , those who rely on war horses, and trust in Egypt's many chariots and in their many, many horsemen.

    But they do not rely on the Holy One of Israel and do not seek help from the Lord. The destroyer is as good as dead , you who have not been destroyed! The deceitful one is as good as dead , the one whom others have not deceived!

    be as good as dead

    When you are through destroying, you will be destroyed; when you finish deceiving, others will deceive you! Those who devise sinful plans are as good as dead , those who dream about doing evil as they lie in bed. As soon as morning dawns they carry out their plans, because they have the power to do so. This is what the Lord says: "The prophets who mislead my people are as good as dead. If someone gives them enough to eat, they offer an oracle of peace. But if someone does not give them food, they are ready to declare war on him.

    The one who builds his house by unjust gain is as good as dead. He does this so he can build his nest way up high and escape the clutches of disaster.