X-Message-Number: 1054
Date: 23 Jul 92 23:00:33 EDT
From: "Steven B. Harris" <>
Subject: Clinical vs Legal Death

Lola McCrary says:

  >> I incline towards "legal death", especially since the
definition of "clinical death" does, as pointed out, keep
changing.  <<

   Comment: if somebody pointed that out, they were wrong.  The
definition of "clinical death" stays the same, while it is the
definition of LEGAL death which keeps changing.   "Clinical"
comes from a Greek word meaning bed, and refers in the practice
of medicine to work done at the bedside with ordinary physician's
tools (as opposed to work done in the lab, or with fancy mac-
hines).  Thus, "clinical death" is diagnosed with a stethoscope
and a penlight.  EEG machines and angiography play no part in it,
though they may (or may not) play a role in the definition of
legal death in some places and under some circumstances.

   Please note that the Venn diagram of "legal death" and
"clinical death" is one of two partly intersecting circles.  Some
people are clinically dead but not legally dead (i.e., all those
who haven't been pronounced, and even a few who are going to be
yet resuscitated); some people are legally dead but not clin-
ically dead (i.e., brain dead people on ventilators who've been
pronounced); and finally some people are BOTH legally dead and
clinically dead.  Cryonics in practice requires legal death (the
last time cryonicists began the procedure with a patient who was
clinically dead but not yet legally dead, a lot of people got
into a lot of trouble).  So far, all cryonics patients have been
clinically dead at the start of the procedure as well, but there
is no reason to think that this may always be the case.

   As terms, legal death and clinical death each have problems,
and which one you use depends on the job you want to do.  Legal
death, of course, does not describe an objective state-- it
merely represents some kind of formal social stamp of approval. 
Thus a person is REALLY legally dead only in the sense that he is
REALLY married, or REALLY a doctor.  Clinical death, on the other
hand, describes a more objective phenomenon: circulatory cessa-
tion, implying (at higher temperatures) rapid ischemic damage. 
It does not imply or require permanent loss of the person, but on
the other hand, no one can say just when (objectively) such a
thing occurs.  Without doubt, in fact, it occurs gradually in
most cases as a sort of slow fading.  In one sense, all the
people that Alcor cares for as patients are not dead, but dying. 
When the cryonics process starts they were all dying quite fast,
but by the time they get to -196 Centigrade, they're dying quite
slowly.

                                      Steve

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