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Technology promises to change the meaning of death — at least for some

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[Whentheartificialkidneywasfirstusedasamedicaltoolin1945itbecameastonishinglyclearthathumanorganshithertointegraltothehumanconstitutioncouldbereplacedSoonaftertheheartonceconsideredthecornerstoneofhumanitywasrapidlyreplacedbyanexternaldeviceandtheinexplicablecomplexityofhumanmusclewasreplacedbymuchsimplersyntheticparts[1945年に人工腎臓が医療ツールとして初めて使用されたとき、それまで人間の構成に不可欠であった人間の臓器が交換可能であることが驚くほど明らかになりました。その後すぐに、かつて人類の要と考えられていた心臓は、外部装置に急速に置き換えられ、人間の筋肉の不可解な複雑さは、はるかに単純な合成部品に取って代わられました。

This month, a team of Yale University scientists partially restored cell function in pigs an hour after their brain and heart waves flattened out. With the help of their OrganEx system, they restored some cellular activity in the pig’s heart, liver, and most significantly for the bioethics debate. Researchers at Yale University have shown that vital organs may remain curable for longer than most scientists thought. Although this discovery has not yet had clinical application, it may soon provide new challenges to medical claims about the end of life and the beginning of death.

The pig was dead for an hour. Scientists made their hearts beat again.

The brain is the last human organ whose parts cannot be replaced artificially. As philosopher Daniel Dennett writes, a brain transplant is one type of surgery in which you should want to be a donor. At one point our minds represented human idiosyncrasies, but today the sticky floating mass within our skulls depicts what we understand as human life. increase.

Until the mid-20th century, death was indisputably pronounced when a patient’s heart stopped and his lungs failed. But new ventilators and defibrillators meant that checking for chest rise, fall, or flapping was no longer a valid way to diagnose death. Physicians concerned about the viability of healthy organs proposed a new metric for thinking about mortality. That metric focused on brain death rather than the function of other organs. Their approach quickly took hold, and when doctors today record a patient’s time of death, it means the moment the medical device can no longer record or restore consciousness.

As Harvard bioethicist Robert Truog suggests, we formally“Death” consists of “a moral judgment rather than a biological fact.” In other words, brain death is not the point at which an organism has completely disappeared, but an arbitrary limit designed to allow legal and medical systems to move forward. Although there are no well-documented cases of recovery of consciousness following an accurate diagnosis of brain death, Truog argued that advances in medicine at some point made the term “brain death” a legal requirement for the definition of the US Presidential Council on Bioethics. We anticipate that it may become unusable as a legally binding abbreviation. As “human death”: the irreversible cessation of the “fundamental workings of the organism.”

A green burial can change your relationship with death

With the success of reviving cellular activity in mammalian brains and hearts, we are just a little closer to the day when medical technology will once again force us to update our definition of death in humans.

This promise is both thrilling and terrifying. Extrapolating the potential of his OrganEx system at Yale University, it may eventually be able to revive a silenced brain and reboot organs once thought to be irreversibly dead. (After all, “irreversible death” is not plenasism.) In just a few decades, we may be forced to admit that death is an administrative process rather than a biological absolute. I can’t. A death certificate could indicate that the deceased’s family could not afford to reboot a loved one, or that their bodies could not be preserved long enough for such technology to take hold. Yes. With advances in cryonics and new technologies such as OrganEx, this is no longer just a science fiction hypothesis, but a possible reality during this century.

In other words, the distinction between life and death can be a more painful kind of moral judgment. In other words, it is a question of who can afford to keep their bodies functioning.In such a future, health inequalities will worsen. Many times the wealthy were able to forestall death, while the least wealthy were forced to accept an actual “irreversible cessation” of bodily functions. This future should not be unfamiliar to the least wealthy. todayBy 2022, almost every hour, one person will die while waiting for an organ transplant. Patients of color are particularly vulnerable to such deaths and have less systemic opportunity to delay their fate.

The idea that death can, and in some cases will, become a management hurdle as a result of the lack of ventilators, organs, or better yet expensive OrganEx equipment in the future, is not the same as funerals. making it difficult to swallow. We might ask ourselves if technologies that extend lifespans should continue to be developed if they risk exacerbating already dire inequalities.

The answer is yes. In the 1940s, the majority of patients with renal failure were unable to receive dialysis. Since then, millions of low-income patients have been saved thanks to embracing this period of inaccessibility. In 2022, we are far from equitable distribution of artificial kidneys, and people without health insurance often cannot afford one. But the only way to increase access to cutting-edge health interventions is to boost funding for them, even if inequality temporarily worsens.

If the philosopher William MacAskill is correct, and if we do our part to ensure what we can expect in the future, then mankind has just entered puberty, and we have morals that will improve the lives of future generations. In fact, given the current pace of technological progress, it is hard to believe that these futuristic, life-extending medical technologies could become available to the low-income people living today. And, as the philosopher John Rawls has implied, the quickest and most ethically acceptable way to bring down the price of extraordinary medical treatments is to have the wealthy give them as their first customers. Some might argue that it is to subsidize

DNA testing is fundamentally reshaping the definition of family

DNA sequencing is a good example. The first incomplete sequence cost him $2.7 billion in 2003 and had no clinical relevance. In 2011, Steve Jobs paid his $100,000 to learn the genome sequence and tumor genes, but without promising results. Today, thanks to Harvard University geneticist George Church, who has advocated for the democratization of genome sequencing since the 1990s, this is his $299 go-to Christmas gift for America’s upper-middle class, and the clinical benefits. is just beginning to bring Tomorrow, insurance companies and European governments may offer his DNA sequencing for free, allowing vulnerable people to benefit from this once-luxury tool.

The act of preventing death is so old that it cannot be separated from the concept of medicine. As history shows, today’s extraordinary measures will become tomorrow’s measures, saving real human lives, both rich and poor. This is true even if we tweak the definition of the end of life and the beginning of death again.