Life support and brain dead

Your question underscores the benefits and challenges, in this case, that advancements in medical technology have given us.  Allow me to pass along information that Rev. Robert Fleischmann, National Director of Christian Life Resources, shared with me on the subject:

There is considerable disagreement in society about “what is death.”  A diagnosis of “brain dead” used to mean the complete cessation of all measurable activity in the cerebral cortex and the brain stem.  Failure in both of those areas of the brain causes the lungs to stop processing air, the heart to stop pumping blood and, without a circulation of oxygen throughout the body, there is death.

What has happened, however, is that defining death has become more a process of measuring quality of life.  Patients deemed to be in a “persistent vegetative state” (PVS) are often called “brain dead” but, in actuality, while showing minimal or no activity in the cerebral cortex, their brain stem is functioning, the lungs are processing air and the heart is migrating that air throughout the blood by means of the blood system.  A recent study has demonstrated that PVS patients actually show awareness of their surroundings but are unable to respond.

Some people are moving quickly to a purely quality of life measurement.  Maladies like dementia, Alzheimer’s or trauma to the brain which reduce its activity is interpreted by some to be “essentially dead” because of the declined quality of life.

Scripture tells us that God breathed life into the first man (Genesis 2:7) and that breathing (the process of taking in oxygen) is life (Job 33:4; Ezekiel 37:5; Acts 17:25).  Elsewhere Scripture instructs us that death comes with the last breath – the removal of life-sustaining oxygen (Genesis 25:8; 1 Kings 17:17-18; Mark 15:37; Luke 23:46).

Some object to ventilator support because it is “artificial.”  Yet, we use all sorts of artificial equipment and medicine to help us breath better, take in more oxygen and be healthy.

Biologically, death is present when the body as a whole no longer takes in and processes oxygen.  Close encounters with death always involve the interruption of oxygen to a portion of the body.  With a stroke, a clot cuts off oxygen-rich blood to portions of the brain.  With a heart attack, a chamber of the heart stalls in its task of cycling oxygen-rich blood throughout the body.  With cancer, we see infected cells that no longer transport and process oxygen.  That is why the death of Christ was confirmed with the spear stab to the abdomen.  The outpouring of blood and water provided evidence that the body was no longer circulating blood and that it had begun to settle in the lower parts of the anatomy (John 19:34).  Other organs had also failed.

Final death comes when all of this is irreversible.  Through the blessing of technology God has permitted  us to more closely observe near death and death.  That same technology is often God’s instrument of protecting and prolonging life.

In summary, if there truly was brain death, the body would not be cycling and processing the oxygen received through the ventilator.  The body would not be staying warm.  There would be no measurement of activity in either the cerebral cortex or the brain stem.

Ventilator support is assistive in nature.  It requires the “cooperation” of the other body organs to make bringing in oxygen effective.  Death, therefore, becomes near not only with diminished brain activity, but you will see other indicators as well, such as failure of the kidneys, liver, pancreas and heart.

Simply stated, life is the body taking in oxygen (an unborn child does this by getting all of her oxygen through the umbilical cord from the placenta) and disseminating it throughout the body.  Death, therefore, would be the opposite.  As the body dies, the absence of oxygen can be observed through the cascading effect of multiple organ failures.  And when death takes place, the body and soul separate (Ecclesiastes 12:7; Luke 23:43, 46; Acts 7:59).

You will find more information on end of life issues on the Christian Life Resources website.