When am I dead?

When I’m dead I won’t be writing these columns. But other than that, indication of my demise might not be certain. The problem is that our definitions of death vary according to legal, cultural, religious and philosophical perspectives.

  image: slideserve.com

There was some dispute about whether Taquisha McKitty of Brampton was dead. Doctors said she was but her parents disagreed. She went into cardiac arrest following a drug overdose and was declared neurologically dead. A death certificate was issued.

McKitty’s father said: “My daughter is not dead -she shows that every day.” He maintains that his daughter shows signs of life: squeezing the hands of loved ones and even shedding tears.

Whether she was living was finally decided through a court decision. A judge ruled that McKitty was, in fact, dead.

Keeping someone alive with life support is not an issue. Canadians are kept alive with pacemakers, kidney dialysis, mechanical hearts and lungs while awaiting transplants. The issue is whether we should maintain one’s bodily functions when they are dead.

McKitty’s family might disagree with my last sentence. If they believe that bodily functions define life, then the squeezing of hands indicates that Taquisha was alive.

Others could argue that breath itself is life. If so, breathing is an indication of life. Genesis 2:7 says: “The LORD God formed the man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being.”

Still others believe that the soul, the essence of life, resides in the heart. The ancient Egyptians thought that the heart was vital. During mummification, they discarded the brain by removing it through the nose but kept the heart. They likely believed that as long as the heart is pumping, a person is alive.

In Western culture, the brain defines life because it’s the seat of the mind. Some philosophers suggest that it’s the mind that defines life. They argue that since the mind resides in the brain, and because the brain is a (biological) machine, the mind could reside in any machine. If complex computer could be built, the mind could continue to live in a solid state environment without a body.

The Japanese would disagree. They see the body and mind as a single unit so that the mind is not independent of the brain. To be alive is to experience bodily sensations and desires as well as cerebral thoughts.

The judge in McKitty’s case ruled that the brain is central in determining death. If the brain is dead, so is the mind. This opinion coincides with doctors’ assessments. Dr. Sonny Dhanani, a pediatric critical care physician in Ottawa, concludes:

“When brain death occurs, there is no blood and oxygen going to it. The brain ceases all function. There are no functions left to be lost. This means there is the irreversible loss of any ability to have thoughts or feelings or memories (Globe and Mail, July 6, 2018).”

I won’t know when I’m dead and given the definitions of life, maybe no one else will be sure any time soon.

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Legalize heroin and save lives

Legal opiates are being use to adulterate illegal ones with tragic consequences. More than 800 British Columbians were killed in fentanyl-related overdoses last year. Many of them were ordinary Canadians you might find living next door. One of them was my nephew who died a few years ago.

Calgary Herald

Calgary Herald

They injected what they thought was heroin, or some other illegal drug. If they had injected legal heroin, of known purity and strength, they would still be alive. I’m not naive; they would still be addicted but their quest for bliss would not have ended in death.

It’s a question of harm prevention. Legalization of heroin may seem like a radical idea but not long ago so did giving drug addicts clean needles and a safe place to inject.

Like the prohibition of alcohol, the prohibition of drugs has been a dismal failure. Prohibition simply pushes the drug trade underground. When a trade is unregulated, who knows what junk users will end up taking? Drug manufacturers don’t intend to kill users: it’s bad for business to kill your customers. They just want to maximize profits.

Fentanyl is perfectly legal. It’s prescribed by doctors for controlling pain. Fentanyl is just one the opium family. It turns out that all of them are addictive.

A brief history of legal opiates is a guide to the intersection of illegal ones. Opium from Persian poppies has been used for pain control since the fourth century. Researchers discovered the active components of opium -morphine, codeine and theobain- in the 1800s. In an attempt to find a non-additive painkiller, heroin was derived from morphine. The manufacturer of heroin, Bayer, pulled it from shelves in 1913 once it was found to be addictive.

In the quest for a non-addictive pain killer, Perdue Canada filed a patent in 1992 for OxyContin, a pill that would treat pain “without unacceptable side effects (Globe and Mail, Dec. 30, 2016).” Perdue encouraged doctors to prescribe the pill and soon it was a blockbuster hit with billions of dollars being made.

But OxyContin turned out to have terrible side effects and thousands of were hooked. Canadians consume more prescription opiates on a per-capita basis than any other country in the world according to a United Nations report.

As in all opiates, those hooked on OxyContin become habituated so that they needed more pills to control pain. Purdue attempted to control the problem with the replacement OxyNEO in 2012, a tamper-resistant alternative that is difficult to crush, snort or inject. And that same year, the provinces stopped paying for both opiates.

Both factors drove addicts to the streets to find a fix. Illegal drug manufacturers care not how their clients get hooked, whether it be from the pursuit of bliss or the relief of pain.

Fentanyl is now the universal opiate. Manufactured in China in concentrated form, it can be ordered on the internet and sent through the mail. From there, it is pressed into pills to mimic OxyContin and other opiates.

Making fentanyl illegal is not the solution. Drug abuse is a medical problem, not a criminal one. All opiates should be legalized and safe doses prescribed. Education, as in tobacco and alcohol abuse, is the only solution.