Resurrecting the Dead

On April 2, 2019, Dr. Joseph Vukov spoke at Loyola University Chicago to discuss death. There are two legal definitions of death: the permanent arrest of circulatory and respiratory functions, or the irreversible halting of brain and brainstem functions. Either one of these is sufficient to declare someone dead. For brain death, it was previously required to have two brain scans done within hours of each other to constitute death. However, starting in 2010, the revised law requires only one scan to qualify for brain death. The difference between cardiac and brain death is that while a person that qualifies for the respiratory definition of death visibly looks dead, a brain-dead individual may not look obviously dead. Because of this, it is not a topic of debate to determine death by cardiac function termination. However, with brain dead patients, if they are on a ventilator, they can look as if they are simply asleep. They are visibly breathing, as can be seen through chest movements, are warm to the touch, and oftentimes look healthy. Therefore, to the families of the victim, and even sometimes the healthcare professionals, they do not immediately identify this as something that constitutes as death. However, brain death is not like a coma or persistent vegetative state; in a vegetative state, a patient does not require a ventilator to breathe. A brain-dead patient cannot breathe on their own, and this is completely irreversible — at least, for now.

New data and current research are underway that may completely change how the world views brain death. According to Medical News Today, a company based in Philadelphia named Bioquark has received approval to head experimental trials to attempt to revive brain-dead individuals. They will be recruiting twenty people who have died from traumatic brain injury and are kept on cardiopulmonary and trophic support. Interestingly, the participants must be unwilling for organ donation, meaning that the participants will not be affecting the organ donor population.

The Bioquark CEO, Ira Pastor, has stated that they will be using patient adult stem cells along with other materials to attempt a “combinatorial” approach in which they use four different techniques and drug approaches to grow connections between new neurons. They hope to bring a brain-dead individual back into a comatose state. Pastor hopes that “with the tools of 21st century regenerative medicine, that there are possibilities to push that transition [from a coma to an irreversible coma] in the opposite direction to save lives… we hope the trial will answer certain 'deeper' issues about the human mind.”

The crux of Dr. Vukov’s seminar is that there is a lack of education around the irreversibility of brain death. He spoke about how the conversation must change so that families and loved ones of victims of brain death understand that “pulling the plug” on a brain-dead individual does not terminate all efforts and hope for the individual to recover because there is no chance at recovery; in other words, the person is already dead. If this becomes a more widespread understanding, Dr. Vukov argues, the healthcare system will be able to benefit from the viable organ donor population within the brain-dead populace while still respecting the victim and their families. However, what Bioquark is attempting, if achieved, will break down Dr. Vukov’s argument, and the medical field will have to start anew in terms of treating the brain dead.

Bioquark has received ample backlash and criticism for both what they have attempted and their methods. Some have pointed out that their method has no biological basis and is unethical and immoral; critics believe that this will only stream false hope for recovery for the families of the participants. This argument plays back into what Dr. Vukov described as part of the ethical issue of brain-dead individuals; talking about “pulling the plug,” or letting these individuals stay on a ventilator, give a sense of false hope to their families and loved ones.

However, what Bioquark is proposing is slightly different. Pastor clearly acknowledges brain death as a permanent state that is irreversible, at least with today’s technology. Furthermore, others are not as quick to completely dismiss the project. Opinions on Bioquark’s experimental trials have gained slightly more optimism after thirty-two pig brains regained cellular functions after hours of being dead. These experiments, done by researchers at Yale University School of Medicine this year, have begun to change the field of neuroscience and may break down the current definitions of death.

Overall, even though Dr. Vukov’s seminar discussed a critical issue in healthcare, recent developments in science seem to break down all current concepts and knowledge surrounding brain death. While the revival of pig brain neural activity is a far cry from bringing someone dead back to life, this experiment, along with Bioquark’s mission, show that human knowledge surrounding death is nowhere near complete. Although death, on the surface, seems very black-and-white, we are slowly discovering the gray areas to it. Even so, Dr Vukov, along with critics of Bioquark’s experiment, are correct in that venturing into gray areas will only seek to provide hope that currently has no real end and may or may not be accomplished in the future. It is still crucial to properly educate people on the current circumstances of brain-dead patients, and until real evidence is shown to revive these patients, there must be a continued focus on empathizing with the living.

References:

Greshko, Michael. “Pig Brains Partially Revived Hours after Death-What It Means for People.” National Geographic, 17 Apr. 2019, www.nationalgeographic.com/science/2019/04/pig-brains-partially-revived-what-it-means-for-medicine-death-ethics/.

Powell, T. “Brain Death: What Health Professionals Should Know.” American Journal of Critical Care, vol. 23, no. 3, 2014, pp. 263–266., doi:10.4037/ajcc2014721.

Vukov, Joseph. Loyola University Chicago Neuroscience Seminar. 2 April. 2019, Chicago, Loyola University Chicago.

Whiteman, Honor. “Reversing Brain Death: Far-Fetched or Feasible?” Medical News Today, MediLexicon International, 18 Aug. 2017, www.medicalnewstoday.com/articles/319035.php.