The ethics of death

Partly as a follow up to the saga of Kaylee Wallace at Toronto's Sick Kids Hospital and partly because I have been thinking about the issue for a while, I wrote a couple of stories published in the Toronto Star today looking at death, how we handle it and how we define it.

Dead is dead, except when it's not.

"Death used to be a little more self-evident," says Kerry Bowman, a medical ethicist specializing in end of life issues at the University of Toronto's Joint Centre for Bioethics.

"Today, you're dead when the doctor says you are."

Deciding when somebody is dead or about to die is quickly emerging as one of the top ethical issues in medicine today as technology makes it increasingly possible to keep people alive who would otherwise have died not so long ago.

"The technology has far outstripped the ethics," says Tim Falconer, author of That Good Night: Ethicists, Euthanasia and End-of-Life Care. "Feeding tubes and ventilators weren't designed to keep people alive for 15 years, but that's what they're being used for."

As well, says Bowman, with organ transplants more common, deciding the precise moment of death has become vital, since under the "dead donor rule" organs can only be harvested once the donor has died. And the sooner after death that happens, the healthier the organs will be.

Fro the rest of the story, click here.

In a companion piece, I also take a closer look at Falconer's book, which I blogged about last week.

Tim Falconer didn't set out to write a book about death. It just worked out that way.

He planned to write about ethicists and the growing role they seem to be playing in our modern lives – from business to government to medicine – and explain how they do their jobs.

But like any journalist, he was attracted like a bug to light to the most intriguing stories. Those were the ones about death and end-of-life ethical issues.

In That Good Night: Ethicists, Euthanasia and End-of-Life Care, which takes its name from the Dylan Thomas poem Do Not Go Gentle Into That Good Night, Falconer takes the reader on his journey through the increasingly ethically complicated ways death is handled in modern society – particularly in hospitals.

Few of us, he says, are prepared.

"We go through life knowing we are going to die, and then it's a surprise when it happens," says Falconer, a magazine writer and journalism professor at Ryerson University.

With all the machines that can keep us alive today, the medications and the medical advances, death, Falconer says, is increasingly more of a "negotiated event" than a sudden thing.

For the rest of the story, click here.