How does a human being truly die?

Do you want to destroy mankind?

Types of death: According to the starting point of irreversible cessation of the functions of three important life organs: the whole brain, heart and lungs, people can divide death into brain death, cardiac death and pulmonary (respiratory) death.

(1) Brain death refers to death caused by the irreversible cessation of functions of the whole brain (including cerebellum and brainstem).

Although brain death is a new concept of death proposed in the 1960s, in fact, in a broad sense, this kind of death has always existed objectively.

Any severe brain trauma, brain diseases (such as encephalitis, meningitis, brain tumors) and poisons that disrupt the central nervous system (such as barbiturates and non-barbiturates hypnotic sedatives, stimulants, narcotics), or even

Electric shock, radiation and radioactive rays can all cause irreversible cessation of whole brain function and lead to brain death.

When brain death occurs, cardiopulmonary function will soon and irreversibly cease in most cases, and respiratory cessation generally precedes cardiac cessation.

But sometimes the function of the heart and/or lungs can still be maintained in some form. It goes without saying that the diagnosis of brain death should be very strict at this time.

The diagnostic criteria for brain death first proposed by the Harvard Medical School Special Committee in 1968 are as follows: 1.

Anesthesia and unresponsiveness, including complete lack of response to the strongest painful stimuli; 2.

No movement or spontaneous breathing.

It means that the artificial ventilator maintained the patient's normal blood C02 tension and breathing for 10 minutes before the test, but there was no respiratory function within 3 minutes after the ventilator was removed; 3.

Pupils are fixed without reflection, and cranial nerve reflexes disappear (such as turning the head or stimulating the ears with ice water but still no corneal, swallowing and eye movement responses, etc.); 4.

Isopotential (zero potential) EEG.

The committee also pointed out that all the above examinations should be repeated after 24 hours, and emphasized that the final examination can only be carried out after excluding conditions such as hypothermia (below 32.2°C) and central nervous system depressant poisoning such as barbiturates that may restore the function of the whole brain.

Irreversible suspension of confirmed brain injury.

Later, it was added that metabolic neuromuscular blocker poisoning, shock, and children under 5 years old should also be excluded.

At the same time, cerebral angiography and radionuclide examination were added to the detection methods to prove the cessation of cerebral blood flow.

Apparently the Harvard standards are too complex and stringent.

In 1977, the National Institute of Neurological Disorders and Stroke in the United States proposed a more refined diagnostic standard after collaborative research: 1.

Coma and cerebral unresponsiveness; 2.

Breathing stops; 3.

Mydriasis; 4.

Brain (including brainstem) reflexes disappear; 5.

Resting brain waves.

They note that brain death can only be diagnosed after coma and respiratory arrest have occurred for at least 6 hours, these criteria have persisted for 30 minutes, and all appropriate treatment measures have been ineffective.

Moreover, if one of the above criteria is doubtful or has not been checked, a confirmatory examination of cerebral blood flow must be done.

It can be seen that the above diagnostic criteria for brain death are obviously developed to meet the needs of organ transplantation.

In fact, many brain deaths caused by irreversible cessation of whole brain functions caused by severe brain injuries or brain diseases are almost immediately followed by the cessation of heartbeat and breathing, and there is no time to take life-sustaining measures such as artificial ventilators.

This is most common in daily life and forensic practice.

Although the patient is still brain dead at this time, judging whether the person is dead will still or has to rely on traditional heartbeat and respiratory function tests.

After proposing the concept of brain death, it must also be emphasized that brain death after severe brain injury cannot be confused with persistent vegetative state (so-called "vegetative").

Although patients in both cases clinically show persistent coma and severe brain damage, the brainstem functions of brain-dead people have been completely lost, while those in persistent vegetative state are only due to the cerebral cortex, mainly the frontal lobe function.

The result of complete destruction of the continuity.

There are cases reported in which the vegetative state lasted for more than 1 year or even longer, and eventually not only consciousness but also health was restored.

Therefore, it should be particularly emphasized that it is illegal to arbitrarily treat patients with severe brain damage and in a persistent vegetative state as brain-dead and abandon rescue and treatment, which may lead to civil or criminal charges.

(2) Heart death refers to death caused by irreversible cessation of cardiac function.

This is when the heart stops beating before the complete cessation of breathing and brain function.

The main cause of cardiac death is severe damage or disease to the heart itself.

Other reasons, such as various causes of shock, electric shock through the heart, and poisoning with cardiotoxic poisons, can also cause irreversible cessation of cardiac function and death.

Neuroreflexive cardiac rhythm disturbances (such as ventricular fibrillation) and cardiac arrest are also examples of cardiac death.

The examination of cardiac arrest is relatively easy. Feeling the pulse and the precordial area of ??the left chest with your hands, and listening to the heart sounds with a stethoscope are commonly used simple methods.

However, the former is unreliable, and the auscultation examination should last more than 5 minutes.

When conditions permit, electrocardiogram examination is the most reliable method.