Blurring the Line Between Life and Death

It wasn’t very long ago that no one questioned the finality of death. A person died when they were no longer breathing and their heart stopped beating — period. There was no such thing as CPR, and mechanical ventilators didn’t exist. Even large, well-equipped hospitals did not have intensive care units, and virtually 100 percent of patients who suffered a cardiac arrest outside of an operating room, where doctors occasionally performed “open” heart massage, died.

Credit:startcpr1st.com

Then, in 1956, Peter Safar and James Elam invented mouth-to-mouth resuscitation. And in 1960, the American Heart Association officially introduced the practice of CPR. A few years later, in 1967, Dr. James Bedford, a professor at the University of California, became the first human to be cryonically preserved in a steel capsule with liquid nitrogen. With these three events, the “hard stop” between life and death was forever altered. And our cultural perspective of what is means to be “dead” began to evolve.

Today, technological advancements have further blurred, and in some cases erased, the line between life and death. Patients with a heartbeat but no evidence of brain function can be kept alive indefinitely with the aid of a mechanical ventilator and feedings given through a stomach tube. And hundreds of people have been successfully resuscitated — brought back after minutes and, in rare cases, hours of “death.” One example: Gardell Martin, a three-year-old boy who drowned in an icy stream, was “dead” for 101 minutes while receiving CPR. Shortly before doctors were about to give up, his heart began beating again. He went home from the hospital three days later — fully recovered and neurologically intact. (Submersion in cold water can sometimes stimulate the “diving reflex,” which slows bodily functions to a near-standstill to minimize the need for oxygen.)

Gardell Martin was successfully resuscitated after being dead for over and hour and a half
Credit: globalnews.ca

What’s more, researchers continue to delve into new ways to blur the line between life and death. In Seattle, Washington, biologist Mark Roth is putting animals into a state of suspended animation using chemicals that slow their metabolism to a crawl. He eventually hopes to use the same process on humans who are having a heart attack so doctors have time to repair the defect and restart the heart. Similar studies are going on with human subjects in Baltimore and Pittsburgh, where trauma surgeon Sam Tisherman is conducting clinical trials on victims of stabbings and gunshot wounds. But instead of using chemicals, Tisherman and his team are supercooling the bodies of mortally wounded patients to give surgeons time to close their wounds before they bleed to death.

Meanwhile, in Arizona, the Alcor Life Extension Foundation claims to have developed a new form of cryonic preservation called vitrification that preserves tissues that have been cooled to temperatures of minus 120 degrees Centigrade. The process uses chemicals that prevent the formation of ice, thus keeping the structure of the cells intact. Alcor claims the process protects the structure of organs as large and complex as the brain. (Alcor can’t say whether it preserves function yet.) To date, Alcor has preserved over 100 bodies and has applications on file from 100s more.

Progress or Fantasy? 

Still, the question remains: Is modern society’s preoccupation with postponing and, perhaps, eliminating death a good thing? Are we moving forward into a brighter future or deepening a culture of death avoidance that makes it difficult for us to embrace dying as a part of life? Is life-extending technology a miracle, as some would claim? Or is it just another way to extend the process of dying, putting patients on what ICU physician Dr. Jessica Zitter aptly calls the “end-of-life conveyor belt.”

Cryopreservation tanks
Credit: farodiorama.it

For Gardell Martin and others like him, the answer is clear. Modern science pulled off a “miracle,” and because of that miracle, a young boy is alive and well. But for every “miracle” there are hundreds of tragedies — people who survive CPR only to stay in an artificially maintained limbo between life and death until some untoward event brings their suffering to an end. And the promise of cryopreservation is just that — a promise, and an incredibly costly one at that. 

The answer to this incredibly complex question is not at all clear. There’s no doubt that advances in medicine and technology will continue. And the work of researchers like Dr. Roth and Dr. Tisherman will help some people who would otherwise have died to live long, productive lives. But I can’t help but wonder if our society could find better ways to use our limited resources than by constantly trying to perpetuate the myth of eternal life.