M.J.Stephey as reported in TIME September 18,2008
People commonly perceive death as being a moment — you’re either dead or you’re alive. And that’s a social definition we have. But the clinical definition we use is when the heart stops beating, the lungs stop working, and as a consequence the brain itself stops working. When doctors shine a light into someone’s pupil, it’s to demonstrate that there is no reflex present. The eye reflex is mediated by the brain stem, and that’s the area that keeps us alive; if that doesn’t work, then that means that the brain itself isn’t working. At that point, I’ll call a nurse into the room so I can certify that this patient is dead. Fifty years ago, people couldn’t survive after that.
How is technology challenging the perception that death is a moment?
Nowadays, we have technology that’s improved so that we can bring people back to life. In fact, there are drugs being developed right now — who knows if they’ll ever make it to the market — that may actually slow down the process of brain-cell injury and death. Imagine you fast-forward to 10 years down the line; and you’ve given a patient, whose heart has just stopped, this amazing drug; and actually what it does is, it slows everything down so that the things that would’ve happened over an hour, now happen over two days. As medicine progresses, we will end up with lots and lots of ethical questions.
But what is happening to the individual at that time? What’s really going on? Because there is a lack of blood flow, the cells go into a kind of a frenzy to keep themselves alive. And within about 5 min. or so they start to damage or change. After an hour or so the damage is so great that even if we restart the heart again and pump blood, the person can no longer be viable, because the cells have just been changed too much. And then the cells continue to change so that within a couple of days the body actually decomposes. So it’s not a moment; it’s a process that actually begins when the heart stops and culminates in the complete loss of the body, the decompositions of all the cells. However, ultimately what matters is, What’s going on to a person’s mind? What happens to the human mind and consciousness during death? Does that cease immediately as soon as the heart stops? Does it cease activity within the first 2 sec., the first 2 min.? Because we know that cells are continuously changing at that time. Does it stop after 10 min., after half an hour, after an hour? And at this point we don’t know.
A fellow at New York City’s Weill Cornell Medical Center, Dr. Sam Parnia is one of the world’s leading experts on the scientific study of death. Last week Parnia and his colleagues at the Human Consciousness Project announced their first major undertaking: a 3-year exploration of the biology behind “out-of-body” experiences. The study, known as AWARE (AWAreness during REsuscitation), involves the collaboration of 25 major medical centers through Europe, Canada and the U.S. and will examine some 1,500 survivors of cardiac arrest. TIME spoke with Parnia about the project’s origins, its skeptics and the difference between the mind and the brain.