Cancer Diary: Clinical Death, Biological Death, Resuscitation, and Cancer

 


When Carl, dying of cancer, said, as part of his advance directive, that he would want to be resuscitated, doctors and hospice workers always reacted with surprise. Of course, it was his right. At the time, I just wanted to support him in his preferences. In retrospect, the question arises, resuscitated into what? And, is resuscitation even possible? It would seem that the answer to the second question would eliminate the need to answer the first. In short, there are two stages (or kinds of) death: clinical death and biological death.

Clinical death occurs when a person’s heart stops beating. About four to six minutes later, brain cells start to die from the loss of oxygen and biological death occurs. Resuscitation may be possible during clinical death.

But it’s not possible during biological death, the time at which life ceases. Biological death is determined by the irreversible cessation of all functions of the entire brain, including the brainstem. This is often referred to as brain death. Here are the key criteria used to determine biological death:

  1. Irreversible cessation of circulatory and respiratory functions: This means there is no heartbeat and no breathing, even with medical intervention.

  2. Irreversible cessation of all functions of the entire brain, including the brainstem: This is confirmed through various tests, such as the absence of response to stimuli, no reflexes, and no brain activity on an electroencephalogram (EEG).

In some cases, a person may be declared dead based on the irreversible loss of brain function, even if they are on a mechanical ventilator and have a heartbeat. This is because the brain is considered the central control system for the body, and its irreversible loss signifies the end of life.

The article titled "Do-not-resuscitate orders in cancer patients: a review of literature" provides a comprehensive review of the medical and ethical considerations surrounding DNR orders in cancer patients. It discusses the challenges doctors and patients face when making these decisions, the timing of DNR orders, and their impact on medical care.


For other Cancer Diary posts, click HERE.

Blog editor's note: As a memorial to Carl, and simply because it is truly needed, MSI Press is now hosting a web page, Carl's Cancer Compendium, as a one-stop starting point for all things cancer, to make it easier for those with cancer to find answers to questions that can otherwise take hours to track down on the Internet and/or from professionals. The CCC is expanded and updated weekly. As part of this effort, each week, on Monday, this blog will carry an informative, cancer-related story -- and be open to guest posts: Cancer Diary. 



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