Hey there, time traveller!
This article was published 16/3/2012 (2768 days ago), so information in it may no longer be current.
With apparent blissful ignorance on the one hand, and wilful self-assuredness on the other, our "super-size me" consumer culture, and the medicine that it at once endorses and is informed by, continues to behave as though it is obvious that a long life is better than a short one, and that a good death is a death deferred.
Statistics (remember Mark Twain's opinion of them) and actuarial tables will confirm that we live longer today than did our predecessors. This will reassure many, and give others pause.
American author Dick Teresi is in the latter camp. His new book, The Undead, raises threatening and interesting questions about humanity's quest for longevity and the many paradoxes and compromises it inevitably entails.
Not a scientist, he is the former editor and co-founder of Omni magazine, and with his wife, Theresa Hooper, co-authored The Three Pound Universe, a layman's tour of neuroscience. He nevertheless refers, in one of the few moments of humility in this book, to his "untrained eye."
It is at times difficult to see this book as anything other than a diatribe against organ transplantation, and say what one might about the benefits often derived from giving conventional wisdom a smack, Teresi's tone can be extremely off-putting.
Referring to a pregnant woman, apparently dead (at any rate "brain-dead") kept on "life-support" (need new terminology?) as "a meat incubator" is unlikely to endear him to many.
That said, he makes some troubling and therefore important observations. Most disturbing is his chapter The Brain-Death Revolution, in which he suggests that the now famous Harvard Committee to Examine the Definition of Brain Death "lower[ed] the bar for deadness," and that the perceived need to redefine death was driven in large part by two related technological developments: the ICU, and organ transplantation.
Although he is at pains to suggest that he is neither for nor against the "$20-billion-per-year business" of organ transplantation, he notes more than once being screamed at by physicians "that it was irresponsible of [him] to write about brain death because it would discourage donors."
One suspects, certainly, that families of potential organ donors may struggle more than they already do if they believe Teresi's assessment of ambiguous definitions and declarations of brain-death.
The book is well-researched, with an index and bibliography. There is a chapter on so-called "near-death experiences," in which this phenomenon is treated with more respect than it deserves. But there is a wonderful chapter entitled A History of Death, that alone is worth the price of the book. (Here Teresi notes that "[n]ature cleans up after herself, concealing the fact of death," and that in medieval Europe, when "people were resuscitated, it was, at least officially, often attributed to miracles rather than poor methods of determining death.")
Teresi's subtitle speaks to the fact that as people are coming to be alive longer, there is a commensurate and increasingly lengthening time when it is not clear whether they are living or dying, and perversely, that our many technological innovations have made it sometimes difficult to ascertain whether a person is dead.
Teresi's discussion about legal determinations of death must be acknowledged as pertaining only to America, where "[t]he unborn, fetuses, have plenty of political clout" but where "no one speaks for donors." What is striking, and unlikely to be changed by borders, is Teresi's contention that it may now be much easier to define death in terms of law than medicine or biology.
"It seems," he writes, "that the more closely we look at death, the more mysterious it gets. Buddhists, who believe that moving the corpse before three days pass will disturb subtle death processes that are still occurring, may be onto something after all."
Winnipeg physician Ted St. Godard continues to sign his organ donor card.
Organ Harvesting, The Ice-Water Test, Beating Heart Cadavers — How Medicine is Blurring the Line Between Life and Death
By Dick Teresi
Pantheon Books, 368 pages, $27