Or upon what the meaning of "is" is:
"Contrary to perception, death is not a specific moment but a potentially reversible process that occurs after any severe illness or accident causes the heart, lungs and brain to cease functioning. If attempts are made to reverse this process, it is referred to as 'cardiac arrest'; however, if these attempts do not succeed it is called 'death'. In this study we wanted to go beyond the emotionally charged yet poorly defined term of NDEs to explore objectively what happens when we die."I'm not interested in shoehorning all human experience into an empirical or positivistic frame, the better to explain that "love ain't nothin' but sex misspelled" or even that love is nothing more than neurochemistry. The above, however, is a statement about that study of death I mentioned earlier, and the statement there is so full of ideas it needs to be unpacked slowly.
First, the real result of this study is to redefine our definition of death. This isn't really new; we've been at that definition since the 19th century, at least. Poe leaves us the most accessible legacy of the condition we now call "comatose," in his stories about premature burial (a key plot point in "The Fall of the House of Usher" and "The Black Cat") and, of course, his story "The Premature Burial." People declared dead were not, after all, dead; and there was something of a cottage industry in supplying burial places the interred could escape from, should they wake up in their coffins. We've been struggling pretty much since then to decide when someone is really, truly dead, and when they are just non-responsive.
But we've always assumed death was a moment. Tolstoy subtly challenged that reasoning in "The Death of Ivan Ilyich," but the events of Ilyich's death point more to "death in life" as Ilyich descends into misery and despair, only to find just before the moment of death that he is at peace, and reconciled (though they may never know it) with the family he neglected long before his slow slide to oblivion. The story ends with Ilyich embracing his fate, and leaving little doubt the last moment of the story, is Ilyich's last moment of life. Death-in-life may be the product of Ilyich's fears and anxieties, but death itself is still that instant between the last breath, and never drawing breath again.
Now, this study tells us, we may need to reconsider our definition of death as an irreversible instant. As Dr. Parnia says:
If attempts are made to reverse this process, it is referred to as 'cardiac arrest'; however, if these attempts do not succeed it is called 'death'.Death is announced when attempts at resuscitation are said to have failed; but when did death occur? Before the efforts? When they were abandoned? Somewhere during? We aren't really left with the question "What is death?" Death is the cessation of life, or animation, of breath (pneuma, spirit, breath, geist). No, the question now is: "When is death?" And the answer may be not a moment: but a series of moments. Ilyich's death begins the moment he injures his hip; his agony is self-inflicted and terrifying, until his last moments when he ceases to struggle and accepts the end of life. In those moments he is at peace, and more, he suddenly understands his family as people he loves, wholly and unconditionally. These last moments, his spiritual struggle turned to spiritual revelation, Tolstoy implies, are the moments of his death.
Perhaps Tolstoy got it right after all.
This study, conducted over 4 years, in 15 hospitals, in many countries, is an examination of what happens in death; but not at the moment of death. Near death experiences present empirical evidence of life after death, or of hallucinations in the extremis of death which are only recovered by the "miracle" of modern science, only if death itself is an instant, a boundary line, truly that bourne from which no traveler returns and which to step over is to make an irrevocable step. But if death is understood more carefully, it is a process of existence, truly a matter of time; and of time in its fullness.
Which may challenge our notions of euthanasia, of death-in-life, of suffering and prolonging life. The argument for euthanasia presumes death is a simple cessation of life. But what it if is not so simple after all?
I have to add, having put in that link to the Salon article, that end of life decisions are not as simple as we imagine they will be. You may tell everyone you love exactly how you want to die; but you leave them with the burden of acting on your wishes, and that burden isn't a real one until the time comes.
I stood in the basement of a hospital with a woman whose husband had just been brought in by ambulance, the victim of a stroke that took his life a few hours later. As I spoke to her (as her pastor), the doctor came in to ask he she wanted to keep her husband on life support, as that was all that was keeping him breathing. She looked at me in panic and asked: "What do I do?"
What would you tell her?
She clearly didn't want to consider herself responsible for her husband's death, even if he was all but dead already. When is death? It can be when you decide it is, and she wasn't ready to take that responsibility. We imagine our loved ones will act for us as we would act, but do we really understand what that means to them, when they face the decision? (To end the story, she denied the request and her husband went upstairs, where he died a few hours later.) We want to be responsible for our deaths, but in the end, we can't be. And maybe that's another lesson: despite appearances, (and Tolstoy's story supports this, too, in the end; although Ilyich anguishes for much of the story that death is only his), none of us dies alone. Our death is a part of our life, and our life is lived among others.
If we are truly blessed, among others who truly care for us, and for them our death is their loss, too.