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  1. Science & Tech
2 October 2013

What makes us alive? Moreover, what makes us dead?

When it comes to death, science is part of the problem as well as part of the solution. Deepening our understanding of the body’s processes and learning how to keep them going longer has complicated and obfuscated the end of life.

By Michael Brooks

There’s a claustrophobic moment in the new film of Stephen Hawking’s life when he describes his wife being given the option to let him die. It was 1985 and A Brief History of Time was a still-unpublished manuscript. Hawking had been hospitalised with pneumonia. He was placed on a life-support machine and put into a drug-induced coma. The doctors asked Jane Hawking if she wanted them to turn off the machine.
 
We can all be glad she said no, otherwise the planet would have been much the poorer for the past 28 years. Nonetheless, the shadow of death hangs over the whole film. One day – and it may not be many years away – Hawking will be no more. His declaration in September that assisted suicide should be possible without fear of prosecution suggests he might be squaring up to the idea.
 
Death seems to be the one thing that sets human beings apart: we are aware, unlike most (if not all) other animals, of our impending demise. Worse – as Jane Hawking knows too well – in this technological age, we have to make fine decisions about death. And here the advance of science seems to offer more hindrance than help.
 
Death is not what it was. Until half a century ago if you couldn’t breathe, you would soon be officially dead. Then someone invented the ventilator. Is a body that needs a machine to operate its lungs still alive? For sure, we now say.
 
It’s no longer the case that the heart has any jurisdiction over whether you’re dead. Remember the Bolton Wanderers footballer Fabrice Muamba? His heart stopped for 78 minutes but then defibrillation got it started again. It’s a testimony to our scientific resourcefulness that we have learned how to choreograph the pulses of electrical current that will kick-start a long-immobile heart. Nonetheless, this, too, has complicated the notion of being “alive”.
 
Even what has been termed “brain death” is not enough. A lack of electrical activity inside your skull is not a sign that your brain cells are all dead. It takes up to eight hours to start dying and you can lose a lot of them before significant damage ensues. What’s more, damage to some cells makes permanent loss of consciousness inevitable. But damage to some others isn’t much of a problem.
 
Perhaps the most extreme technological management of death is among those who have paid to have their bodies frozen. Their hope is that future technologies will be able to defrost them and repair the damage that freezing cells full of water inevitably causes. This is not the last refuge of the frightened fool: plenty of our finest minds, including the MIT professor of artificial intelligence Marvin Minsky, have signed up to be cryo-preserved.
 
So, when it comes to death, science is part of the problem as well as part of the solution. Deepening our understanding of the body’s processes and learning how to keep them going longer has complicated and obfuscated the end of life. That’s why a few researchers have suggested that doctors are no longer qualified to make life-and-death decisions. Robert Veatch, a medical ethicist at Georgetown University, goes further: he thinks you should be allowed to come up with your own definition of death and inscribe it in a living will for others to respect.
 
It would certainly be nice to have a say – especially when you can see it coming. Long live Stephen Hawking. As long as he wants, that is.
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