Death Ethics Statement
The Bible speaks of both physical and spiritual death. Physical death is the irreversible cessation of bodily functions. Spiritual death is a lack of responsiveness to God as a result of mankind’s natural alienation from and hostility to God due to sin. Both physical death and spiritual death are the consequences of and penalty for sin. They are the universal lot of all mankind because all have sinned.
Because of Christ Jesus’ atoning sacrificial death on the cross and subsequent resurrection, and through the indwelling of the Holy Spirit, believers have been given new spiritual life. All believers still experience physical death.
God created human beings as ensouled bodies (or embodied souls). Together the physical and spiritual aspects of human beings bear the single image of God and constitute the single essential nature of human life. Human physical death can be defined as fundamentally a biological phenomenon whereby the human organism as a whole ceases to function.
The Bible clearly demarcates physical life and death; death is not a process, nor is there a transitional physical state between life and death. Death can therefore be defined as the point in time when the critical functions of the organism as a whole permanently and irreversibly cease. These critical functions include all of the following: 1) The vital functions of spontaneous breathing and autonomic control of the circulation; 2) the integrating functions that assure homeostasis of the organism; 3) the neurological function of consciousness. Death should not be defined in terms of a “loss of personhood” or by appeal to the loss of “higher functions” of the organism, such as loss of self-awareness, rationality, self-control, or social interaction.
Based on the above definition of death, the necessary and sufficient criterion of death is the irreversible cessation of all clinical functions of the entire brain (whole-brain concept). Although both a higher brain (cortical) and brain stem criteria are necessary for death, neither alone is sufficient for death.
Patients in permanent vegetative state or irreversible coma, and anencephalic infants do not meet the necessary criterion for this definition of death and are therefore to be considered and treated as living human beings.
Tests of the above criterion will be dependent on the current state of medical knowledge and technology. These tests should be valid and reliable, accurately determining death by neurologic criteria, and should have an extremely low incidence of false-positive results (high specificity). Tests should be readily applicable at the bedside, focusing on neurological examination: apnea, profound coma and unresponsiveness, and the absence of brain stem function in the absence of reversible causes or pathology. In some situations, additional tests may be indicated.
The traditional bedside tests of death, which include examination for the presence or absence of breathing, responsiveness and pupillary reaction to light, are all measurements of brain function. Heartbeat is an indirect measurement since heartbeat stops shortly after the cessation of breathing. The whole-brain definition and criterion of death is consistent with both the traditional concept of death and the Biblical definition of physical death.
The bodies of the dead return to the “dust of the ground” and yet are destined to be resurrected. Because the bodies of all men and women have once displayed the image of God, however marred by sin, they deserve to be treated with loving care, dignity, decorum and respect. Post-mortem procedures such as dissection (except in the case of legally sanctioned autopsies), organ retrieval, and medical procedures should not be done without respecting the wishes and views of the patient (as in an advance directive), family or guardians.
*Make note of Permanent Vegetative State.
Approved by the House of Representatives
June 11, 2004 2 abstentions