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Death is the cessation of physical life in a living organism, or the state of the organism after that event.
Defining the moment of human deathThere is an asymmetry between life and death. While cells and organisms may die, they have never been observed to arise from non-living material (spontaneous generation), as found by Louis Pasteur in the late 19th century. In human affairs, we are normally concerned with the life and death of a person, not the death of his or her components. Identifying the exact moment of death is important for a number of reasons. From a legal standpoint, it allows for the establishment of a consensus time of death, and thus helps ensure that a person's legal Will is executed only after he or she is truly deceased. Identifying the moment of death is even more important in cases of transplantation, as organs for transplant (the brain excluded) must be harvested as quickly as possible after the death of the body. Historically, attempts to define the exact moment of death have been problematic. Death was once defined as the cessation of heartbeat (cardiac arrest) and of breathing, but the development of CPR and prompt defibrillation posed a challenge. The previous definition was inadequate. This earlier definition of death is now called "clinical death", and even after it occurs, breathing and heartbeat may be restarted in some cases. Events which were causally linked to irreversible mortality in the past are now prevented from having an effect; even without a functioning heart and lungs, a person can be sustained with life-support devices. In addition to such extremes, there is a growing number of people who would quickly die if their organ transplants or cardiac pacemakers failed. Today, where a definition of the moment of death is required, doctors and coroners usually turn to "brain death" or "biological death": people are considered dead when the electrical activity in their brain ceases (cf. persistent vegetative state). It is presumed that a stoppage of electrical activity indicates the end of consciousness. However, suspension of consciousness must be permanent, and not transient, as occurs during sleep, and especially coma. In the case of sleep, EEGs can easily tell the difference. Brain activity is a necessary condition to legal personhood in the United States. "It appears that once brain death has been determined … no criminal or civil liability will result from disconnecting the life-support devices." (Dority v. Superior Court of San Bernardino County, 193 Cal.Rptr. 288, 291 (1983)) However, those maintaining that only the neo-cortex of the brain is necessary for consciousness sometimes argue that only electrical activity there should be considered when defining death. Eventually it is likely that the criterion for death will be the permanent and irreversible loss of cognitive function, as evidenced by the death of the cerebral cortex. All hope of recovering human thought and personality is then gone. However, at present, in most places the more conservative definition of death — cessation of electrical activity in the whole brain, as opposed to just in the neo-cortex — has been adopted (for example the Uniform Determination Of Death Act in the United States). In 2005, the case of Terri Schiavo brought the question of brain death and artificial sustainment to the front of American politics. Generally, in such contested cases the cause of death is anoxia. Oxygen deprivation for about seven minutes is sufficient to kill the cerebral cortex. Even in these cases, the determination of death can be difficult. EEGs can detect spurious electrical impulses when none exists, while there have been cases in which electrical activity in a living brain has been too low for EEGs to detect. Because of this, hospitals often have elaborate protocols for determining death involving EEGs at widely separated intervals. There are many anecdotal references to people being declared dead by physicians and then coming back to life, sometimes days later in their own coffin, or when embalming procedures are just about to begin. Stories of people actually being buried alive (which must assume no embalming) led one inventor in the early 20th century to design an alarm system, with a bell and a cord that could be pulled from inside the coffin. Because of the difficulties in determining death, under most emergency protocols, a first responder is not authorized to pronounce a patient dead; some EMT training manuals, for example, specifically state that a person is not to be assumed dead unless there are clear and obvious indications that death has occurred, such as mortal decapitation, rigor mortis (rigidity of the body), livor mortis (blood pooling in the part of the body at lowest elevation), decomposition, or incineration, or other bodily damage clearly inconsistent with life. If there is any possibility of life and in the absence of a do not resuscitate (DNR) order, emergency workers are instructed to begin rescue and not end it until a patient has been brought to a hospital to be examined by a physician. This frequently leads to situation of a patient being pronounced dead on arrival (DOA). In cases of electrocution, CPR for an hour or longer can allow stunned nerves to recover, allowing an apparently-dead person to survive. People found unconscious under icy water may survive if their faces are kept continuously cold until they arrive at an emergency room. This "diving response", in which metabolic activity and oxygen requirements are minimal, is something we share with cetaceans. The process of dyingCell deathA. Normal cellular function
B. Needs of cell
Physiological changesA. Events leading to death:
B. Cerebrovascular system:
C. CNS problems:
D. CNS decompensation:
E. Respiratory system:
Signs of approaching death
Physical death is a progressive process, during which there are some signs that usually indicate that death is imminent. Not all of the following changes occur, nor do they necessarily occur in any particular order, as the body shuts down during the dying process. In general, the following information may help anticipate and understand changes that appear as an individual approaches death and is “actively dying.”
Causes of human death in the USIn 2002, in the United States, various common or noteworthy causes of death were:
Statistical data from Prebirth deaths in the USThese entries are controversial, as they are based on the premise that personhood begins at conception rather than birth or a particular prenatal development (See abortion debate; there are various opinions as to whether or not a fetus is an independent organism or fully human, for this reason abortion and miscarriage are not normally considered when compiling death statistics).
Statistical data from The Alan Guttmacher Institute, and Miscarriage Statistics. Consciousness after deathBelief in consciousness continuing after death is common and has endured throughout history. Almost every civilization in history has had some belief system relating to life after death. This point of view holds the belief that conciousness is more than simply a function of the brain. Physiological consequences of human deathHuman remains found in scrub, circa 1900-1910.For the human body, the physiological consequences of death follow a recognized sequence through early changes into bloating, then decay to changes after decay and finally skeletal remains. Soon after death (15–120 minutes depending on various factors), the body begins to cool (algor mortis), becomes pallid (pallor mortis), and internal sphincter muscles relax, leading to the release of urine, feces, and stomach contents if the body is moved. The blood moves to pool in the lowest parts of the body, livor mortis (dependent lividity), within 30 minutes and then begins to coagulate. The body experiences muscle stiffening (rigor mortis) which peaks at around 12 hours after death and is gone in another 24 (depending on temperature) as enzymes begin to break down the tissues. Within a day, the body starts to show signs of decomposition (decay), both autolytic changes and from 'attacking' organisms—bacteria, fungi, insects, mammalian scavengers, etc. Internally, the body structures begin to collapse, the skin loses integration with the underlying tissues, and bacterial action creates gases which cause bloating and swelling. The rate of decay is enormously variable; a body can be reduced to skeletal remains in days, or remain largely intact for thousands of years. Settlement of dead human bodiesIn most cultures, before the onset of significant decay, the body undergoes some type of ritual disposal, usually either cremation or deposition in a tomb that is often a hole in the ground called a grave, but may also be a sarcophagus, crypt, sepulchre, or ossuary, a mound or barrow, or a monumental surface structure such as a mausoleum (exemplified by the Taj Mahal) or a pyramid (as exemplified by the Great Pyramid of Giza). In Tibet, one method of corpse disposal is sky burial, which involves placing the body of the deceased on high ground (a mountain) and leaving it for birds of prey to dispose of. Sometimes this is because in some religious views, birds of prey are carriers of the soul to the heavens, but at other times this simply reflects the fact that when terrain (as in Tibet) makes the ground too hard to dig, there are few trees around to burn and the local religion (Buddhism) believes that the body after death is only an empty shell, there are more practical ways of disposing of a body, such as leaving it for animals to consume. In certain cultures, efforts are made to retard the decay processes before burial (resulting even in the retardation of decay processes after the burial), as in mummification or embalming. This happens during or after a funeral ceremony. Many funeral customs exist in different cultures. In some fishing or navy communities, the body is sent into the water, in what is known as burial at sea. Several mountain villages have a tradition of hanging the coffin in woods. A new alternative is ecological burial. This is a sequence of deep-freezing, pulverisation by vibration, freeze-drying, removing metals, and burying the resulting powder, which has 30% of the body mass. Space burial uses a rocket to launch the cremated remains of a body into orbit. This has been done at least 150 times. Graves are usually grouped together in a plot of land called a cemetery or graveyard, and burials can be arranged by a funeral home, mortuary, undertaker or by a religious body such as a church or (for some Jews) the community's Burial Society, a charitable or voluntary body charged with these duties. In some places this has created a land-use problem. For example, in Japan all people are cremated after death. About 10% of the arable land in China is taken up by graves.[citation needed] Personification of death
Death is also a mythological figure who has existed in popular culture since the earliest days of storytelling. The traditional Western image of Death, known as the Grim Reaper—usually resembling a skeleton, wearing black robes and carrying a scythe—is employed on a tarot card and in various television shows and films. Some examples:
Unwritten customs and superstitionsSince writing someone's name with a range of years, such as John Doe (1950 - 2000), implies that the subject has died, it would be inappropriate to do this on someone's birthday cake or card. This is unlike an anniversary of something. In China, Japan, Korea, and Taiwan the number 4 is often associated to death due to the sound of the Chinese, Japanese, and Korean words for four and death being similar. For this reason, hospitals and hotels often omit the 4th, 14th, etc. floors. However, ISO 3166-2 codes for Japan does have JP-04 for Miyagi Prefecture.
See also
External linksWikiquote has a collection of quotations related to: Death
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