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Here's an interesting study: 
Elevation of brain serotonin during dying
http://www.sciencedirect.com/science/article/pii/S0304394011005234

New Scientist discusses its implications for NDEs here:

http://www.newscientist.com/article/mg21128294.900-neardeath-experiences-may-be-triggered-by-serotonin.html

-Christie Aschwanden


On Sep 9, 2011, at 9:37 AM, Mark V. Johnston wrote:

Excellent  ... (my opinion) .... Thanks.

On 9/9/2011 9:03 AM, Ash Paul wrote:
[log in to unmask]" type="cite">
There was a 2009 systematic review in the Canadian Journal of Neurological Sciences:
 
Movements in Brain Death: A Systematic Review
 
 
and
 
A recent 2011 systematic review of 'Brain death and the Courts', in the Journal of the American Academy of Neurology:
 
 
Regards,
 
Ash
 
From: jo kirkpatrick <[log in to unmask]>
To: [log in to unmask]
Sent: Friday, 9 September 2011, 14:28
Subject: Re: DEATH

Hi Rakesh

One way round this uncertainty would be to have death declared in two stages instead of one. The first could be defined by the loss of vital signs and brain stem reflexes eg pupils fixed and dilated etc. Death could be reassessed after a set time with a second declaration defined by something like core temperature. This would be gentler and might even make the process easier for the family. But would this work in hot climates?

jo




From: Rakesh Biswas <[log in to unmask]>
To: [log in to unmask]
Sent: Friday, 9 September 2011, 4:00
Subject: Re: DEATH

Every time i declare a patient dead after examining the brain stem reflexes i remain apprehensive s/he may spring to life after some time ( read about it happening sometimes with others in the local newspapers).

One way is to share the decision of a patient's death with other physicians and get two or more of us involved in the declaration but we need a better objective tool than just our impressions. A straight line on EEG would be expensive in our settings (besides as already discussed it is not foolproof either).

It would be good to have some shared objective evidence based tool to help physicians with declaring death (a check list perhaps?).

:-)

On Fri, Sep 9, 2011 at 5:20 AM, Mark V. Johnston <[log in to unmask]> wrote:
i heard a lecture on definitions of death 15 years ago.   The speaker said that,
under British law, a person is dead when a physician says the person is dead
-- unlike the US, where is there is extensive law and regulations (e.g. state laws)
on the issue.    Is this true -- or not?

On 9/8/2011 6:46 PM, Ahmed Abou-Setta wrote:
Hi Amy,
 
When we were early on in medical school they told us something really important… the definition of death is not completely defined. It is a changing definition based on medico-legal, ethical, religious and regional rules and regulations. At the end of the day the decision makers on the definition of life and death are really politicians and not physicians because courts of law are the final decision makers on these issues.
 
Ahmed
 
 
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Dr. Amy Price
Sent: September 8, 2011 5:33 PM
To: [log in to unmask]
Subject: Re: DEATH
 
Dear All,
 
I am inclined to believe this is a question of increasing importance due to the dynamic evolution of  regenerative medicine. My concern is that older functional decisions maybe outdated in the near future. Even with cell and organ viability it is important to find the lines where functional degradation occurs in signalling structures. I see a number of brain injury, near drownings etc and I am somewhat shocked to see the lack of objective standardised and accurate measures used to grade these conditions bearing in mind that the grading ultimately influences the viability of the treatment plan and choice to prolong or discontinue life support systems. I look forward to hearing more on ways to determine death that would be clearly appropriate and evidenced based.
 
Amy
 
Amy Price
Http://empower2go.org
Building Brain Potential
 
 
 
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of jo kirkpatrick
Sent: 08 September 2011 06:18 PM
To: [log in to unmask]
Subject: Re: DEATH
 
Oh what an interesting question. As a psychologist I would define death as a permanent irreversible loss of consciousness; iow brain death. The nearest thing to research into this that I have seen were qualitative studies using interviews with terminal patients; and there have also been studies of NDEs.
 
Best wishes Jo
 
From: Sandeep Saluja <[log in to unmask]>
To: [log in to unmask]
Sent: Thursday, 8 September 2011, 1:40
Subject: DEATH
I am interested in scientifically studying the phenomenon or the process of death.I have no interest in invoking philosophy but wish to first of all understand whether there are any limitations of the current scientific knowledge on the subject.

We currently possibly understand death as a failure of a vital organ or vital area of a vital organ or a cascade of biochemical events set in motion by it.Are there any limitations or fallacies in our current understanding?

I shall sincerely appreciate esteemed members' inputs.

SANDEEP SALUJA M.D.
 

--
Mark V. Johnston, Ph.D.
Professor, Occupational Science and Technology,
College of Health Sciences
University of Wisconsin – Milwaukee
(414) 229-3616






--

Mark V. Johnston, Ph.D.

Professor, Occupational Science and Technology,

College of Health Sciences

University of Wisconsin – Milwaukee

(414) 229-3616