
The macabre fate of ‘beating heart corpses’ - ohjeez
http://www.bbc.com/future/story/20161103-the-macabre-fate-of-beating-heart-corpses
======
logronoide
Believe me, you read this kind of articles from a complete different
perspective when the "beating heart corpse" is your mother and the decision to
disconnect her is on you. I hope nobody has to do it in her lifetime.

~~~
cbennett
I know. I had to endure the same with my sister. She was only 24- tragic bike
accident. We gave her one day that way after all the tests- apnea, ear flush,
even an additional EEG which we requested and was sparse as the night sky-
came back negative. We looked at the weekly costs and made an informed
decision as well as choosing some organ donation options.

Watching her wheeled out of that hospital room heart still beating was
certainly the hardest moment of my life so far. We never saw the actual 'plug'
pulled and i actually prefer(red) it that way.

I deeply empathize that the decision was all on you. doing it collectively was
a hair easier. hope your emotional/personal recovery has been as swift as
possible.

~~~
walshemj
_hugs_ a terrible position to be in - I am on the other side waiting for the
call for a new kidney.

~~~
oaktowner
Thanks for sharing that cbennett, and good luck to you walshemj.

I lost one of my closest friends a few years ago to an accident but was
heartened to know that his organs went on to help others.

------
asib
Going off on a bit of a tangent, it's interesting to think about how 100 odd
years ago if your heart stopped, you were declared dead. Then we got
defibrillators and CPR, etc. and suddenly if your heart stopped you could
still be resuscitated.

Further, nowadays, if you have a heart attack and no one makes an effort to
resuscitate you, and there's someone who knows how to nearby, most people
would argue that that person has forgone a moral obligation.

This is one of the arguments made for cryonics[0], in two ways. If in the
future it's possible that we'll be able to revive a cryopreserved body, then
you can't really consider someone dead if they're cryopreserved within a
certain timeframe after their heart stops (just as today you can't consider
someone dead within the ~5 minutes after their heart stops, because of CPR,
etc). What's more, the people of the future will have a moral obligation to
revive cryopreserved bodies, because not doing so would be the equivalent of
not attempting CPR on someone who just had a heart attack. This is the
response given when someone asks why anyone in the future would be bothered to
go through the hassle of reviving cryopreserved bodies.

Food for thought.

[0]:
[https://www.alcor.org/FAQs/faq01.html#dead](https://www.alcor.org/FAQs/faq01.html#dead)

~~~
astrodust
Cyronics are a waste of money, it's junk and a way to sponge money out of the
too-rich-too-vain crowd. The number of animals that can survive being frozen
are pretty slim, and those that can survive being frozen for an indefinite
period of time are almost zero.

What _could_ work is developing some kind of human version of torpor
([https://en.wikipedia.org/wiki/Torpor](https://en.wikipedia.org/wiki/Torpor)),
slowing down biological processes to a crawl, which would not only help with
space travel but could buy people enough time for medical treatments to mature
to the point of being feasible. It has the advantage of being fairly common in
the mammal world, so genetically it's a lot closer than, say, what frogs do to
survive being frozen.

You can't buy decades, but you can buy five to ten years, and for some people
that would be all the difference they need.

~~~
jcoffland
> You can't buy decades, but you can buy five to ten years, and for some
> people that would be all the difference they need.

I like the idea but this seems highly impractical. "Some people," in this case
likely means a tiny faction of a percent. I.e. those who nearly die of a
disease for which a cure is less than a decade away. The remaining majority
are huge drains on resources. It hardly seems ethical when so many living
people go with out basic medical care.

~~~
astrodust
It's actually a lot of people. The most common diseases are genetic in nature,
and there's so many of them in the long tail that the combined effect of these
is staggering.

It won't be long before they've mapped out the genome to the point where tools
like CRISPR allow them to swap out broken genes or re-enable genes that were
erroneously disabled. When that happens there's going to be literally
thousands and thousands of diseases that go from a death sentence to an
inconvenience.

Some conditions aren't immediately fatal, but you are living on borrowed time,
and those people might benefit by being put in a form of suspended animation.
Those faced with the choice between toughing it out to a death that's going to
be undignified and painful and, where applicable, some kind of assisted
suicide could have a third choice: Sleep it out and hope it works. If it
doesn't, you still have the other options, but the decay could be slowed down
enough you've bought some time.

If done right, torpor or something like it would be very inexpensive. You'd
just need someone to monitor vital signs, no big deal, as there's no expensive
cryogenic equipment involved. Just a cozy place to rest that's kept at a
comfortable temperature and fresh air. I can imagine this is like the most
chill "coffin hotel" you've ever been in since people only wake up once every
few months.

------
forrestbrazeal
For a lot more on this topic than you ever wanted to know, I highly recommend
Dick Teresi's "Brain Dead". It's a scary and fascinating look at the so-called
"death determination" industry that addresses one of our society's least-asked
questions: in an era of unprecedented medical skill and technology, who draws
the line between life and death, why do they draw it there, and how much are
they getting paid?

[https://www.amazon.com/Undead-Harvesting-Ice-Water-
Beating-H...](https://www.amazon.com/Undead-Harvesting-Ice-Water-Beating-
Heart-Cadavers-How/dp/1400096111)

~~~
rwmj
"Stiff" by Mary Roach is also a good read on the many things that happen to
dead bodies.

[https://www.amazon.co.uk/Stiff-Curious-Lives-Human-
Cadavers/...](https://www.amazon.co.uk/Stiff-Curious-Lives-Human-
Cadavers/dp/0141007451)

------
cowpewter
My mom was an ICU nurse for a good twenty or more years. In her words, people
in the ICU either just got out of surgery, or they are there to die, and the
ones that just got out of surgery don't stay there long.

She also told me that after a while, you could tell when a person was dead,
and their body just a piece of meat kept alive by machines. She said she
wasn't sure if there really is a "soul" but whatever it was that made the
difference between a human and a pile of meat was gone. She hated the families
that kept the meat alive, while feeling sorry for them at the same time. She
eventually burned out from so many years in the ICU and switched to a
different type of nursing.

~~~
kpil
I watched my dad die and it was obvious. In that case the bloodflow to the
brain collapsed due to swelling so it was rather abrupt.

Before the body reacted to pain in ways I recognised and even the breathing
was somehow 'his' even if he could not breathe on his how. The higher
functions of the brain was hopefully gone at this point.

Afterwards, it was nothing left. Just a mechanical thing.

------
ChuckMcM
As medicine gets better and we develop a better understanding of how our
bodies work this question will only get more difficult. At some point it will
be possible to program your cells to repair any damage to your body including
regenerating limbs or organs. And when you can do that, taking someone who is
"dead", hooking them up to the "autodoc"[1] and having it repair the damage
and restart them, then the only question might be how many short term memories
did you lose? And if you can download those some how then even a partly
decomposed body could be the source material for reconstructing the original,
not a clone per se because parts of the original are re-used but certainly a
full retrofit. Then a lot of built in human assumptions get really challenged.

[1] This is a name used in science fiction stories to describe the machine
that mechanically repairs tissue damage.

~~~
seanp2k2
Wth the current rate of stem cell research, I doubt I'll see that for at least
60 years.

~~~
ChuckMcM
As a mental exercise, look up the medical state of the art from 60 years ago
(1956), look at what was known and unknown, and compare it to the current
state of the art.

The only thing slowing down this development timeline is the FDA approval
process, and that doesn't slow down research much at all.

Given that, I would be surprised if it took 60 years. It may not be 6 but I
would put it more around 12 - 15 when we start human trials of organ or limb
re-generation.

------
SeanDav
Just recently there was a report in a national newspaper of a patient going
from officially "Brain dead" to recovering and going on to live fairly
normally. I will try find the link to this.

EDIT: Not the specific link I was thinking about, but here are 2 of many
others:

[http://www.dailymail.co.uk/health/article-2134346/Steven-
Tho...](http://www.dailymail.co.uk/health/article-2134346/Steven-Thorpe-
Teenager-declared-brain-dead-FOUR-doctors-makes-miracle-recovery.html)

[http://www.dailymail.co.uk/news/article-3081882/It-hand-
God-...](http://www.dailymail.co.uk/news/article-3081882/It-hand-God-work-
Meet-brave-teenage-girl-suffered-irreversible-brain-injury-pulled-life-
support-awoke-coma-recovery.html)

~~~
13of40
Something like 90,000 people die every year from simple medical mistakes in US
hospitals, so at some point you have to decide where to throw your money. Do
you spend $200K per patient keeping dead people on ventilators just in case
one occasionally comes back to life, or would that money be better spent on
something else, like teaching nurses to follow sterilization checklists?

~~~
maxerickson
Note that it is key to go further than training the nurses. You have to change
the culture so that it is expected by everyone involved for a nurse to tell a
doctor to stop what they are doing and wash their hands.

~~~
walshemj
Don't US hospitals do that the NHS in the uk is fanatical about it

~~~
maxerickson
I honestly don't know what is typical. There are things like this (I went and
searched it up, I have dim recall of other discussions of the culture not
embracing the lists):

[https://www.advisory.com/daily-briefing/2015/01/16/jama-
why-...](https://www.advisory.com/daily-briefing/2015/01/16/jama-why-surgical-
checklists-arent-saving-lives)

------
adrianN
I for one would be completely fine with doctors harvesting my organs after my
brain is sufficiently damaged that I won't experience conscious thought again,
even if my lizard brain is still alive and supports all bodily functions.

~~~
tgb
Probably the way to make this happen is to let your close family know and to
put it in writing in your will.

~~~
komali2
Wills aren't accessed until well into the process of handling a person's
death. It would still be a sort of chicken and egg scenario - does their will
apply, as they're not technically _deceased_ by this State's laws?

You can get medical bracelets for certain things, maybe something along those
lines?

~~~
ChrisClark
I believe that's what a living will is for. Should make sure you have one of
those as well.

------
diggernet
Is there a medical person here who can help me out with this? Take these
excerpts from the article:

"He suggested using the newly invented stethoscope to listen for a heartbeat –
if the doctor didn’t hear anything for two minutes, they could be safely
buried."

"An electrical engineer from Brooklyn, New York, had been investigating why
people die after they’ve been electrocuted – and wondered if the right voltage
might also jolt them back to life."

"Starting in the 1950s, doctors across the globe began discovering that some
of their patients, who they had previously considered only comatose, in fact
had no brain activity at all."

"They had discovered the ‘beating-heart cadavers’, people whose bodies were
alive though their brains were dead."

"In some cases, their hearts kept beating and their organs kept functioning
for a further 14 years – for one cadaver, this strange afterlife lasted two
decades."

Now... If the brain were dead (by my understanding of a 'dead' organ - its
cells have died), wouldn't the brain start either decomposing or being
absorbed by the body? If that happens, it's a pretty clear indication that the
brain is truly dead. But if it doesn't happen, doesn't that mean the brain
cells are still alive (just not communicating for some reason)? And in that
case (living cells with a blank EEG), couldn't there be a way to jump-start
their communication, as was previously discovered with hearts?

I'm sure that I'm completely ignorant of some critical factor, and look
forward to your thorough discussion of it...

~~~
jawilson2
Brain death usually only occurs after severe injury, either from trauma or
from asphyxiation. Large portions of the brain ARE dead tissue; search for
Terri Schiavo's MRI (or CT). Most of the skull is filled with fluid.

On the other hand, rarely comatose or persistent vegetative patients do wake
up, or, more frighteningly, were awake and aware for years. I did some of my
PhD research with a person who had a brain-stem stroke in 1980, who lived in a
care center, and they didn't realize he was still awake and trying to
communicate until 1992.

~~~
diggernet
Interesting. So it sounds like after some period of time, an MRI or CT should
be able to show that a 'beating-heart cadaver' is truly brain dead.

My understanding of comatose/vegetative patients is that it is a different
case, where an EEG would actually show some activity. Is that correct?

As for the patient you mention... Wow! Fascinating! What is the definition of
'awake' in his case, how did they not know, and how did they discover??

~~~
notanote
A mostly fluid filled skull is not an indication of brain death, in fact there
are cases of people with most of their brains spread in a thin layer against
their skull. [1]

The name for aware but apparently comatose cases is locked-in syndrome. [2] A
nightmare scenario for sure.

[1]
[http://www.rifters.com/crawl/?p=6116](http://www.rifters.com/crawl/?p=6116)

[2] [https://en.m.wikipedia.org/wiki/Locked-
in_syndrome](https://en.m.wikipedia.org/wiki/Locked-in_syndrome)

------
random_upvoter
The brain cells love to believe that the brain cells are all that matter. The
cells of your heart, your liver, your gut would disagree, but they're not
designed to do the talking.

------
robbiep
Food for thought for people reading the above: if a pregnant woman has a
cardiac arrest, you have 3 minutes to decide if you are going to perform an
emergency Caesarean section to save the child's life, or else you kill it too.

~~~
zaroth
I would say, ...or else the fetus dies with her.

~~~
joncp
I would say, ...or you've let the child die with her.

~~~
wahern
A trolley is out of control, barreling toward 6 unaware adult strangers,
including 2 parents with children at home. The only person who recognizes the
impeding tragedy is you. Fortunately, the lever for a switch is within reach.

Scenario #1: If you pull the lever, you'll divert the trolley toward a
6-month-old infant in a carriage, killing it instantly. Do you hesitate such
that you risk missing the opportunity to save the 6 people?

Scenario #2: If you pull the lever, you'll divert the trolley to a 9-week-old,
1-inch long fetus in a petri dish (being transported and kept viable outside
the womb due to new science). Do you hesitate such that you risk missing the
opportunity to save the 6 people?

If you answered yes to #2, you're either delusional or a morally troubled
person. The modern anti-abortion movement requires adopting a disgusting
equivocation. Sane, honest people can value fetal life without equivocating it
to an actual child.

Granted, the trolley problem has many flaws. There are many ways to
legitimately weasel out of answering the question, but I think it fairly
exhibits the senseless equivocation people make in the debate.

~~~
ars
Appropos to how someone would answer #2, your insults and denigration of
someone who would disagree with you are utterly repugnant and repulsive.

~~~
wahern
I'm unashamed to say that allowing (even hypothetically) 6, innocent,
conscious human beings to die for the sake of an _idea_ (that is, that a fetus
is equivalent to a born human child) is gross. Allowing ideas to dismiss one's
obligation to respect individuals' humanity and to life is indefensible; and
any view that equivocates such a nascent fetal life to that of a born human is
indisputably and fundamentally a philosophical, if not religious, proposition.
Using such a proposition to excuse death is anathema to civilized society and
everything humanity has painfully learned in the past two centuries.

The same logic that permits one to claim a fetal life is equivalent to a born
human (or, especially, a conscious human) is the same logic that permits one
to claim that Jews are subhuman. Both cases discard the necessity for any
objective standard (whatever that standard is, and whether it's definite and
knowable in all cases).

In as much as I impugned the poster's personal character, I apologize. I'll
leave my posting unedited as it's a fair criticism, and editing it would be
self-serving. I endeavour to criticize specific behavior and opinions, not
individuals. My post was sloppy and wrong in that regard.

------
jcoffland
> By loosening up the definition a little further, transplant doctors would
> have access to a much larger pool of potential donors than they do at the
> moment and save countless lives.

For some cases, we can never loosen this definition enough.

------
wyldfire
> “It goes back and forth as to what people call them but I think patient is
> the correct term,” says Eelco Wijdicks, a neurologist from Rochester,
> Minnesota.

I can't tell if this is an error, as if it should have been "[...] patient is
the correct term" or if the neurologist is trying to be funny, or make a
point. IMO the writer/editor should've omitted this quote or clarified its
context and overall meaning to the article.

~~~
greenshackle2
Why do you think there's an error?

It's not 100% clear why the author included the quote there, but the sentence
itself makes sense to me, and doesn't sound funny or non-serious.

------
whybroke
Such caution to avoid misdiagnosing death is probably good.

Too bad we put up with a worse than 4% error rate when applying the death
penalty.

------
paxcoder
I guess it's time again to spend some points. Killing/euthanizing people in
any stage of development or condition is murder.

~~~
bashinator
I agree, but I also think that there are circumstances where some humans are
not/are no longer people. Encephalitic fetuses, accident victims with zero
higher brain function, etc.

~~~
paxcoder
I think you were thinking of anencephaly. But I disagree. Likewise for the
comatose. Ask the guy pronounced brain dead by four doctors.

