The work of the brain determines the very existence and all the qualities of the human personality, so the death of the brain is the line separating existence from non-existence.
How does a person die?
Dying is not a one-time event, but a whole process during which all organs and systems stop functioning. The duration of this process depends on many factors: the initial level of he alth, ambient temperature, the severity of the injury, and hereditary factors. In practice, it is required to know exactly whether the death of the brain as an organ has occurred.
A brain-dead person can no longer be fully considered alive, although his heart, lungs and other organs may be he althy and function perfectly. The personality of such a half-corpse ceases to exist. At the same time, intact organs can be used for donation, saving several other lives. This is a complex legal and ethical issue in which everything should be crystal clear. Every person has relatives, and the issue of life and death is extremely important for them.
The concept of clinical and biological death
Death is considered clinical when a person can still be brought back to life. Moreover, the return shouldoccur in full, with the preservation of all personal properties. Clinical death is a borderline form of existence between two worlds, when it is equally possible to move both in one direction and in the other.
Clinical death begins from the moment of stopping breathing and heartbeat. The person no longer breathes and his heart does not beat, but the pathological processes have not yet become irreversible. The metabolic processes of destruction have not yet gone through, and revival without loss is possible. If within 5-6 minutes it is possible to restore vital functions, then the person simply wakes up, as if from a dream. But being left without help in a state of clinical death leads to true or biological death, when the body becomes an open ecosystem for the development of bacteria. The surrounding people have no more than 5 minutes to prevent the person from dying. At the same time, brain death stands out as a separate species because after this event a person can continue a vegetative life, but not a personal one.
Signs of brain death
Although the criteria for determining brain death have been studied enough, after ascertaining this fact, a person is left under observation in an intensive care unit for at least 24 hours. At the same time, artificial ventilation of the lungs and maintenance of cardiac activity continue. Cases of returning to normal life after brain death are unknown, but the decision to disconnect from equipment for life support is too responsible, and rush is unacceptable here.
Accepted worldwidethe following criteria for brain death:
- lack of consciousness and independent movements;
- absence of any reflexes, including such ancient ones as oculomotor and swallowing;
- lack of spontaneous breathing, special tests with hyperventilation are performed to check;
- isoline (zero axis) on the electroencephalogram;
- additional signs in the form of a sharp decrease in muscle tone, a rise in the sugar curve and the like.
The presence of independent heart beats is only confirmation that there are autonomic ganglions or pacemakers in the heart. However, the central regulation of the heart rate is lost, and blood circulation cannot be efficient. The heart rate usually fluctuates between 40-60 beats per minute, and this lasts for a very short time.
Is it possible to live without a brain?
Life and death are states that continuously follow each other. Complete brain death means the onset of a chronic vegetative state - one that is popularly called a "vegetable" or life on machines. Outwardly, a person may not change in any way, but everything that was human in him - thoughts, character, lively speech, sympathy, knowledge and memory - are lost forever. In fact, the extension of the vegetative state depends on the voltage in the electrical network. As soon as the devices stop working, the vegetative existence of a person with a dead brain also ends.
Very important is the reason for the destruction of the brain, without its clarification is impossibledeclaration of death. It can be an injury, a hemorrhagic stroke, dropsy or deep cerebral edema, poisoning incompatible with life, and other unquestionable conditions. In all cases where there is even the slightest doubt about the cause of brain death, the person's condition is considered coma and continued resuscitation is required.
Does a coma always end in death?
No, this is how only the ultimate coma ends. Doctors distinguish 4 stages of coma, the last stage is beyond. In a state of coma, life and death are balancing on the verge, there is the possibility of recovery or deterioration.
Coma is a sharp inhibition of the functions of all parts of the brain, a desperate attempt to survive due to a change in metabolism. The cortex, subcortex and stem structures are involved in the development of coma.
There are a huge number of causes of coma: diabetes, severe kidney disease, dehydration and loss of electrolytes, cirrhosis of the liver, toxic goiter, intoxication with external poisons, deep oxygen starvation, overheating and other severe life disorders.
Doctors of antiquity called a coma a “sleep of the mind”, because in a state of even a shallow and reversible coma a person is inaccessible to contact, communication with him is impossible. Fortunately, modern medicine has many options for treating coma.
How is death declared?
In the Russian Federation, the declaration of death and the termination of resuscitation are regulated by Government Decree No. 950 of 2012-20-09. ATThe regulation details all medical criteria. A council of 3 doctors with at least 5 years of work experience can declare death in a medical institution. No one from the council can be involved in organ transplantation. The presence of a neurologist and an anesthetist is mandatory.
Death occurring at home or in a public place is confirmed by ambulance staff. In all cases where death has occurred without witnesses, police officers are called to examine the body. In all disputable situations, when the cause of death is unknown, a forensic medical examination is performed. This is necessary to establish the category of death - violent or not. Upon completion of all actions, relatives are issued the main official document - a death certificate.
Can the day of death be delayed?
Scientists answer this question positively or negatively with approximately equal frequency. In numerous forecasts, the day of death is associated with lifestyle, bad habits and type of diet. In many religious movements, death is considered as a stage of transition to a new kind of existence of the soul without burdening the body.
Buddhism and Hinduism are inextricably linked with reincarnation or the incarnation of the soul in a new body. At the same time, the choice of a new body depends on what kind of life a person led in his earthly incarnation.
Christianity views the day of death as the beginning of spiritual life, the heavenly reward for righteousness. The presence of an afterlife spiritual life - better than earthly - fills the life of a believer with highmeaning.
In practice, intuition plays a big role in avoiding mortal danger. It is intuition that explains the numerous cases of being late for planes and watercraft, which subsequently suffer fatal crashes. People know too little about their nature to be able to explain how and why they leave the death place seconds before the tragedy.
What are the types of death?
Doctors distinguish 3 types of non-violent death:
- physiological or from old age;
- pathological or disease;
- sudden or from sudden acute conditions.
Sudden death is one of the most tragic, when a person ceases to live among complete well-being. Most often, this end is caused by sudden cardiac arrest, which can occur in both an adult and a child.
The heart is a very complex organ, comparing it with a simple pump is incorrect. In addition to specially organized cells - cardiocytes that form cavities - it has an autonomic nervous system. All this is controlled by the brain and spinal cord, and also responds to hormones and electrolytes contained in the blood. Failure of any of the components can lead to an abrupt stop.
In fact, sudden cardiac arrest is the collapse of all life support systems. The blood stops carrying oxygen and removing metabolic products, life just stops.
Anyone who happens to be nearby should start manual cardiopulmonary resuscitation. Through the effortssurroundings can be kept alive for up to half an hour. This time is enough for the arrival of doctors who will provide specialized assistance.
The cessation of the functioning of the brain is a separate type of death
Medics consider brain death to be a separate diagnosis, fatal to humans. The fact is that the brain consists of two main sections: the hemispheres and the brain stem. The hemispheres are responsible for higher nervous functions: speech, thinking, memory, logic and emotions. The loss of these functions can be seen in people who have had a stroke: the lack of speech and tearfulness are the consequences of the destruction of the hemispheres by the outpouring of blood. It is possible to live with damaged hemispheres, and for quite a long time.
Unlike the hemispheres, the brain stem is a more ancient formation. It was formed when people did not yet know not only writing, but coherent speech. The brain stem controls vital functions such as breathing, heartbeat, muscle tone, and reflexes. Any, the most insignificant damage to the brain stem causes a state of clinical death. However, people survive precisely thanks to the brain stem. All its structures are the most resistant to external influences and are the last to be damaged.
So when does brain death occur?
When the brain stem dies. The brain does not die overnight either. There is a general rule for the whole organism: what was formed later in the process of evolution dies first. This rule also applies to the brain. The hemispheres - younger formations - are more vulnerable in a moment of mortal danger. They perishfirst from lack of oxygen. If the severity of the condition is too deep and resuscitation is ineffective, complete brain death occurs within minutes.
Have scientists solved all the secrets?
Every day at least one publication appears in specialized publications about new discoveries that accompany the process of dying. Thus, scientists argue that the time of brain death can be recorded on the EEG as a burst of electrical activity, characteristic of intensive learning processes. Other scientists characterize such activity as recording bioelectric waves from collapsing neurons. There is still no definite answer.
Consolation for all living can be the words of the ancient Greek philosopher Epicurus that we will never meet with death: when we are, there is no death, and when it comes, then we are no more.
