LEARNING OBJECTIVES

• How is death defined?

• What legal and medical criteria are used to determine when death occurs?

• What are the ethical dilemmas surrounding euthanasia?

• What issues surround the costs of life-sustaining interventions?

E

rnesto and Paulina had been married 48 years when Ernesto developed terminal pancreatic cancer. Ernesto was suffering terrible pain and begged Paulina to make it stop. Paulina had heard about “mercy killing” that involved administering high dosages of barbiturates, but she believed this was the same as murder. Yet she could hardly bear to watch her beloved husband suffer. Paulina wondered what she should do.

When one first thinks about it, death seems a very simple concept to define: It is the point at which a person is no longer alive. Similarly, dying is simply the process of making the transition from being alive to being dead. It all seems clear enough, doesn’t it? But death and dying are actually far more complicated concepts.

Cultural and religious differences in the defini­tion of death and the customs surrounding it make for rich experiences. The meaning of death depends on the observer’s perspective, as well as on the specific medical and biological criteria one uses.