EpilogueDiscussion IchosemysubmissiontotheEpilogueDiscussionasmySignatureAssignment.Itrepresents mybestworkinthisclass.Ispentmuchtimethinking,readingandwritingaboutthetopic.For me,itisadeeplyphilosophicalandreligiousissue.Isoughtoutopinionsfromdiscussionsin popularmediaaswellasacademics.IfeelIwasabletocomeupwithasubstantiveandwell organizedessay.Whilemycompletionoftheassignmentdidnot"answer"thequestionforme, itmadememoreawareofthedifficultiesofthequestion,aswellashelpingmetounderstand thereasoningbehindother'sanswers.Ifeelthetopicisdeeplypersonal,withnotwoviews beingexactlythesame,showcasingthecomplexityofthehumanexperience.Theassignment iswrittenbelow,alongwithmyessay.

Application#3,"IntroductiontotheLifeSpan,"Berger,2010,p.589 Everyaspectofdyingiscontroversialinmodernsociety.DoanInternetsearchforakeyterm suchaseuthanasiaorgrief.Analyzetheinformationandtheunderlyingassumptions.Whatis youropinion,andwhy? Ifeeldeeplyforthosewhomustmakedeterminationsaboutwhethertocontinuelifesupportfor theirlovedone.Thedilemmaontheothersideofthehumanexperiencealsointerestsme: whenisazygote/fetus/prenatalhumanalive?Forthisapplication,Ichosetodoaninternet searchaboutdefinitionsoflifeanddeath,specificallytoanswerthefollowingquestions:Whenis someonealiveandwhenissomeonedead? Moralandmedicaldilemmasaboutapersonsalivenessordeadnessarearelativelymodern phenomenon.Formostofhistory,determiningwhethersomeonewasaliveordeadwas comparativelystraightforwarditwasessentiallyaneither/ordetermination.Advancesin medicalknowledgeandtechnology,however,hasintroducedwhentothequestion.Insteadof askingwhethersomeoneisaliveordead,thequestioniswhenissomeonealiveordead,or whenhasonesstatuschanged.Thisisprimarilyduethecurrentabilitytosupplementoreven replacethefunctionsoforgansthathavestoppedfunctioning,particularlytheheartandlungs. Modernmedicalknowledgehasintroducedathirddilemmaaswell,specificallythatofthe changeofstatusfromprelifetolife,i.e.,thequestionofwhenisazygote/fetus/prenatal humanalive.Thisisacentralpointofcontentionindiscussionspertainingtovoluntary abortion.Sonowtherearethreechoices:prealive,alive,anddead.Andagain,thesearenow allquestionsofwhen.

Whenisapersonalive,orwhendoeslifebegin? Letsstartatthebeginning:whenisapersonalive?AnarticlefromtheBBCstates:

There'snoagreementinmedicine,philosophyortheologyastowhatstageoffetaldevelopment shouldbeassociatedwiththerighttolife.Thatisn'tsurprising,becausetheideathatthereisa precisemomentwhenafetusgetstherighttolive,whichitdidn'thaveafewmomentsearlier, feelsverystrange.(http://www.bbc.co.uk/ethics/abortion/child/alive_1.shtml) Theconundrumisthis:isthereanexactmomentwhenthefetusisalive,thusgivingitarightto continueliving? Themostexactandmeasurablemomentinthebeginningsofhumandevelopmentis conception,thejoiningoftheeggandsperm.ProLifeadvocatesarguethisshouldbethe momentthatdefineslife.Theadvantageofthisargumentisthatthereisawelldefinedand easilymeasurablechange,whereamomentbeforetherewasnopotentialforhumanexistence, nowthereisthepossibility.Whilethisiswellresearchedandeasilyseeninthelaboratory,the exactmomentconceptionoccursinthewomanispracticallyimpossibletodetermine.Thefact thatconception/fertilizationcantakeplaceinthelaboratorypresentsadilemmaforProLife advocates.Takethecaseofartificialinsemination.Thisisaccomplishedbyjoiningeggsand sperminthetesttubeandplacingtheminthewomansbody.Toincreasechancesofsuccess, multiplefertilizedeggsareplaced.Thequestionisthis:areallthesetesttubefertilizedeggs alive?Dotheyallhavetherighttotheprotectionoflife?Oristheonethatimplantsitselfinthe wombtheonlyonethatisalive? ProChoiceadvocatesfaceanevenlessprecisemeasurement.AbortionlawsacrosstheU.S. arebasedonpregnancytimelines,beinglegalwithinacertaintimepostconception.The difficultyhereis,asmentionedabove,itisdifficulttodeterminetheexacttimeofconception. Further,pregnancymilestonesarentexactmoments,i.e.,thereisnotaprecisemomentwhen thefetusdoesnothaveabrainandthensuddenlydoes.Ratherthanaddressingthedichotomy oflife/nolife,ProChoiceadvocatesusuallyspeakintermsofviability,specifically,thatthefetus doesnothaverightsthatoverridethemothersuntilitisviable.Butisthereanexactmoment? Isthereanexactdayinwhichabortionismorallyandlegallyacceptablewhenthefollowingdayit isnot? Afterconception,thenextmostexactlymeasurablemilestoneistheactualbirth,whenafully formedfetusexitsthemotherandbeginstofunctionindependentlyofher.Inallcasesand culturesofwhichImaware,whenachildisbornitisconsideredaliveandthushasallthe rightstolifeasanyother.Isupposequestionscouldarisewhenababyisstillborn,butIbelieve mostwouldbelievethatthebabyhadnotevenreachedalivenessyet.Oriftheyhad,the alivenesswasachievedinthewombafterwhichthebabydiedwithnohopeofresuscitation, thusmakingquestionsaboutalivenessordeadnessmoot.

Whenisapersondead?

Thequestionofwhetherapersonisdeadornot,andwhendidtheirstatuschange,causes moredilemmasthandeterminingwhenlifebegins.Thisdilemmahasbeenbroughtaboutby advancesinmedicalknowledgeandtechnology,specificallytheabilitytosupplementorsupplant thefunctioningofcertaincriticalorgans,particularlytheheartandlungs. Beforetheadventofmodernmedicine,thecriteriontodeterminedeathwastheabsenceof breathing.Later,asmedicineadvanced,theabsenceofpulsecouldbeaddedtodeathcriteria. Asmedicalknowledgegrewandthetechnologyadvanced,however,certainfatalpathologies couldbepostponed.Itbecamepossibletoartificiallyrecreatethefunctionofcriticalorgans. Questionsbegantoarisewhenthetechnologywassuchthatapersoncouldbekeptbreathing andtheirheartpumpingwhiletheywereunconsciousorinacoma.Technologyalsomadeit possibletofeedthembybypassingthemouthandesophagusthusfurtherlengtheningthe amountoftimethiscouldbemaintained.Andallthiswhilethepersonwasunableto communicateoranyvoluntarymovementcouldbeobserved.Sothenthequestion:isthe personaliveordead? In1968,anadhoccommitteeatHarvardMedicalSchoolcitedbraindeathasthecritical determinantinanalyzingtheoccurrenceofdeath.Theysetforthcriteriatodeterminebrain death,criteriawhichcouldbeeasilymeasuredbythencurrentmedicaltrainingandtechnology. ThisdefinitionandcriteriawereeventuallyadoptedacrosstheUnitedStates,uponwhichcurrent lawaboutdeathisbased. (http://www.hods.org/english/hissues/documents/ADefinitionofIrreversibleComaJAMA1968.pdf) Advancesinmedicaltechnologysincethistime,however,haveagainbroughtquestiontothe definitionofdeath.Theseadvancescenteraroundtheabilitytomeasurebrainactivity.Those whoareinacoma,apparentlyirreversibleastheHarvardcommitteecalledit,stillshowedsigns ofbrainactivity,includingwhenphysiciansorothersspoketoortouchedthem.Further advanceshaveallowedphysicianstomeasureactivityinspecificpartsofthebrain.Individuals whowouldbedeterminedbraindeadbytheHarvardCommitteescriteriaweremeasuredto havebrainactivitytovaryingdegrees.Thequestionofalivenessordeadness,thencontinuesto beadilemma. Anewdefinition? Perhapsthequestionneedstobechanged.Perhapsthequestionshouldbewhenisaperson nolongeralive?Thisbringsanewsetofdeterminantstoconsider.Isitwhentheyareno longerresponsivetostimuli?Isitwhentheycannolongertakecareofthemselves?Isitwhen theycannotperformanymateriallysignificantfunctionintheirlives?Isthereameasurementof brainactivitybelowwhichwecandeterminethattheyarenolongeralive?Would/shouldthere beamaterialdifferenceinregardstothelaw? DickTeresi,aresearcheroflifeanddeathquestions,said:

Today,morethanever,ithasbecomeaphilosophicalquestion.Whenwewitnessedthe braindeathexamofawomaninSpringfield,Massachusetts,aftertheperfunctorytests,anurse proclaimed,Whateveritwasthatmadeherherisn'tthereanymore.Sothatisthenew standard:personhood.Doctorssaybraindeathisimperfectasaruleforcallingthebody biologicallydead,butsowhat?Thepersonisgone. Here'swhatI'dliketoknow:duringwhatyearofmedicalschooldodoctorslearnwhataperson is,andwhenthepersonismissing? (http://io9.com/5915339/themeaningofdeathhowdoweknowsomeoneisnolongeralive) Withallofmodernmedicinesbenefits,ithasmadethequestionoflifeanddeathmoredifficultto answer.Mattersofreligionandspiritualitycomplicatethematterfromasocialandlegalpointof view.ShouldthedeterminationoflifeordeathbemadebytheStateorthefamily?Arethere minimumrequirementssetbythestate,afterwhichthefamilycandecidetokeepthepersonon lifesupportortopulltheplug?Whoshouldpayforcontinuedlifesupport? Conclusion Personally,readingandwritingaboutthistopichasbroughtmorequestionsthananswerstome. AtthemomentIhavenogreatconsternationaboutit,butImsurethatwouldchangeiffacedwith lifeanddeathdecisions.Neartheendofhislife,mygrandfathermadealivingwilltopreclude medicalprofessionalsfrommakingheroiceffortstoresuscitatehim.Afewdaysbeforehis death,andwithhisconsent,doctorsturnedoffhispacemaker.Iwaswithhimwhenhepassed. Itwasasweetexperienceforme.Myspiritualbeliefsgivemecomfortattimesofdeath, believingthatoursoulcontinuesonandthatwewillseeourlovedonesagainafterthislife. CertainlythatwouldfactorintoanydecisionsIwouldneedtomakeinthefaceoflifeanddeath determinations.