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1:00

It's

1:03

unexplainable. I'm No. I'm Hassonfeld. And

1:06

on today's Bird Pinkerton and

1:08

Brian Resnick are talking about death.

1:10

So just a quick morning before we get going,

1:13

They're tackling the idea in general, but

1:15

they do talk about the death of young girl.

1:17

There's also discussion about some

1:19

experiments done on dead animals. If

1:22

that's not for you, we understand.

1:28

According

1:28

to Bob Druk, death

1:30

used to be pretty obvious

1:31

Up until about the nineteen fifties,

1:34

there was no confusion about

1:36

what death meant.

1:37

Bob's a bioethicist who thinks a

1:39

lot about what death means. And

1:41

he says that for a long time.

1:43

It meant

1:44

that you were

1:46

to breathing, your heart had stopped,

1:48

you were stiff and you were, you know, blue

1:50

or gray.

1:51

was so clear that one researcher

1:53

I spoke to told me in the early nineteen

1:55

hundreds People weren't

1:58

really writing down textbook

2:00

definitions of death. were more

2:02

interested in telling people how to a

2:04

test for it. Like, you could put a mirror

2:06

in front of someone's mouth to see if it fogged

2:08

up and if it didn't fog up, they

2:10

weren't breathing and were therefore

2:13

probably dead. But

2:15

by the nineteen fifties, technological

2:17

breakthroughs were starting to confuse

2:19

the issue here. So

2:20

inventions like the ventilator

2:23

which could breathe four people if

2:25

their lungs failed. And there was a

2:27

famous article in nineteen fifty nine by

2:29

French neurophysiologists. who

2:31

were the first to write about patients

2:33

in the ICUs in France who had

2:35

such devastating brain injury that

2:38

they could not live without the ventilator. but

2:40

when the ventilator was used

2:43

and you could breathe for them, they

2:45

also didn't die. They went on and lived and

2:47

lived and lived and lived and they They

2:49

referred to this as a state in French called Comme

2:51

de Passe or beyond Comme.

2:53

These scientists

2:53

were being confronted with something that

2:55

eth, this is like Bob grapple with a lot.

2:58

This idea that death is not

3:00

like a light switch where a body just

3:02

switches off, it's

3:03

a process.

3:04

So if an important organ

3:06

like your brain fails completely, then

3:09

your lungs stop breathing as a result, which

3:11

cuts off your body, supply oxygen,

3:13

your other organs, like your liver, your

3:16

your heart, they shut down. Eventually,

3:18

the individual cells in those

3:20

organs die, but it's not

3:22

instantaneous, like it takes a little bit

3:24

of time. And these ventilators they

3:27

were coming in and they were interrupting

3:29

that process part of the way

3:31

through. And

3:32

so suddenly, people had to figure

3:34

out when exactly in

3:36

that process, the death actually

3:38

happened.

3:38

And this began this conversation

3:41

about, are there different ways

3:43

that humans might be dead?

3:45

That conversation eventually evolved into

3:47

a decades long quest to figure

3:49

out whether there are actually

3:51

different ways to determine death and

3:53

to pin down what the definition of death

3:56

is. Like, when in the process of

3:58

dying can we declare someone dead?

4:00

It's a question that people are still grappling

4:02

with day and one that technology

4:05

is only going to further complicate going

4:07

forward.

4:22

In the

4:23

US, one of the first attempts to address this

4:26

definition of death question happened

4:28

in the nineteen sixties. And

4:30

I actually

4:30

started with a a whole new medical

4:32

breakthrough. The world, sixty

4:35

two days ago, a new phrase, hit the

4:37

world headlines, heart

4:38

transplant, In

4:39

December nineteen sixty seven, doctor

4:41

Christian Bernard performed the first heart transplant

4:43

in Cape Town. A young woman suffered

4:45

a brain injury in a car accident. She's put

4:47

on a ventilator. and her

4:49

father decided to let surgeons

4:51

take her heart and put it into a middle

4:53

aged man who had coronary artery

4:55

disease. So

4:56

this was the beginning of serious

4:59

organ transplantation. This came

5:01

on the

5:01

heels of the first kidney transplant in the

5:03

nineteen fifties. And transplants revolutionized

5:06

medicine. But

5:07

After the praise came the criticism.

5:10

This heart transplant raised yet more

5:12

questions for doctors and surgeons

5:14

and ethicists. At first, it was no more than a

5:16

murmur. Today, it can be heard

5:18

around the world. Questions

5:19

like When

5:20

you took the heart out of the donor

5:22

and put it into the recipient, Was

5:24

the donor dead? because that

5:26

heart was beating. In the US and in

5:28

other countries, this question had actually

5:30

been a roadblock to attempting heart transplant

5:33

surgery to begin with. So

5:35

while the operation was allowed to go ahead

5:37

in South Africa,

5:37

there were questions internationally about

5:40

whether or not this woman had been killed.

5:41

Soon it became clear that the medical

5:44

world was divided. And this

5:46

new heart transplant question was tangled

5:48

up in the questions about what

5:50

to do with patients on ventilators that were

5:53

still unresolved. Like in

5:55

some parts of the

5:55

world, If you took somebody off a ventilator,

5:57

you you were killing them. So

5:59

finally, in the US, someone decided to

6:01

try and come up with some answers. Henry

6:03

Beecher was an anesthesiologist at Harvard

6:05

Medical School and he immediately

6:08

recognized an opportunity for career advancement

6:10

here. Beecher

6:10

gathered together a committee brought

6:13

in some experts, and their goal was to

6:15

work out what to do with the ventilated

6:17

patients in the ICUs, and to figure

6:19

out whether it was ethical to take transplant

6:21

organs from patients. In nineteen

6:23

sixty eight, they outlined something they called

6:25

an irreversible coma, which

6:27

was like the first draft of what we

6:29

now call

6:29

brain death. So this idea that if

6:32

your brain has stopped functioning completely and

6:34

you're never gonna wake up,

6:35

that should be considered

6:36

as death. And

6:38

this irreversible coma idea wasn't just

6:40

academic, it wasn't just a

6:41

paper drawn up by some Harvard Committee.

6:44

It had real world consequences. In

6:46

the US, states

6:47

have a lot of power over a public

6:48

health and welfare laws, which includes

6:51

determining when death happens in

6:53

their boundaries. and at least

6:55

some states decided to put this new concept

6:57

on their books. The problem

7:00

was that not all

7:02

the states decided

7:02

to do this. the dilemma was

7:05

that you could be alive

7:07

in one state and dead in another. And

7:09

that didn't seem to make sense.

7:14

So in

7:14

the nineteen eighties, about a decade later,

7:17

there is this push to figure out one

7:19

definition of death, like one definition

7:21

that everyone in the United States

7:23

could work with. And to

7:25

do that, to figure that out, people

7:27

turned once again

7:28

to a commit A group called the uniform

7:30

law commission whose job

7:32

is to sort of suggest standardized

7:35

laws for all the states to adopt.

7:37

This commission pulled together Lot

7:39

of information about death, the best advice

7:41

from doctors and lawyers, and they

7:43

boiled everything down to a single

7:45

page. One very clear

7:47

simple answer. And it said,

7:49

basically, that there are two different

7:51

things that are both equally valid

7:53

definitions of death. One

7:55

is cardio respiratory death

7:57

which is where your heart stops and you stop

7:59

breathing. This

7:59

is the death we're all familiar with, like

8:02

ninety eight percent of us will die. Heart

8:04

and lung stop, your organs fail, you go

8:06

cold, It's the kind of death where

8:08

a paramedic can declare you dead on the

8:10

scene. And then the other is

8:12

death by neurological criteria or

8:14

what we call brain dev. In the

8:16

definition, they call this the, quote,

8:18

irreversible cessation of all

8:20

functions of the entire brain,

8:21

including the brainstem. So your

8:24

whole brain needs to be unresponsive.

8:27

And what the diagnosis of brain

8:29

death establishes, we

8:31

believe, is that

8:33

the person will never regain

8:35

consciousness and will never

8:37

breathe on their own again.

8:41

But

8:41

we actually includes Bob who also

8:43

works in pediatric intensive care.

8:46

And

8:46

when doctors like Bob have

8:48

a patient lying on a ventilator totally

8:51

unresponsive and in a persistent

8:53

coma. They have a few

8:55

things to look for when they are

8:57

diagnosing brain death. the patient

8:58

has to be unable to breathe

9:00

without a machine and they have to have

9:02

no brain stem reflexes. So

9:04

physicians run a series

9:06

of tests. and which tests

9:07

can vary a bit by state, but it's

9:10

stuff like China

9:11

flashlight into a person's eyes and see

9:13

if they're pupils constrict and you

9:15

stick a tube

9:17

down their throat and see if they cough. In some

9:19

states, a nurse can do these tests and others

9:21

only a physician can do them or even

9:24

sometimes only a trained specialist, like

9:26

a neurologist, But overall, they're

9:28

testing for pain responses and looking

9:30

for stuff like eye motion and gag reflexes as

9:32

well, like things that people do if they

9:34

have any

9:34

kind of brain function. are

9:36

further tests that can also be done, so there are

9:38

blood vessel scans, to see if there's any blood flow

9:40

to the brain, ultrasound, to see

9:43

if blood in the brain is pulsing the way

9:45

that it should And all of these

9:47

tests altogether are

9:48

designed to help people like Bob figure

9:50

out whether there's any possibility

9:53

of the brain recovering or the patient

9:55

ever waking up again. And if

9:56

they have new brainstem reflexes and

9:58

their brain isn't

9:59

sending any signals to breathe, then

10:03

according to our best current science,

10:05

their brain is gone. And

10:07

in my state, Massachusetts, and

10:10

arguably every other state, that

10:12

means you are legally dead.

10:14

and we fill out the death certificate at

10:16

that point. So,

10:17

as Bob says, all

10:19

fifty states do recognize some form

10:21

of brain death now with a lot of them

10:23

adopting the language from the definition.

10:24

And

10:26

so at first glance, it seems like the definition

10:28

has achieved its goal. Like, all the states

10:30

are on approximately the same page about what

10:32

death is, and there's one clear

10:34

standard for everyone in the US.

10:37

Except no matter how hard

10:39

people try, brain death

10:42

refuses to be as simple as

10:44

the death where your heart and lungs

10:46

stop. Like, when Bob

10:48

says that brain death means you are legally

10:50

dead in his state and arguably

10:52

every other state. That

10:54

arguably is because the small nuances

10:56

between the states have created

10:58

complications, which became

11:00

very clear on a national stage

11:02

back in twenty thirteen

11:04

with the story of Johannesburg Math.

11:07

More

11:07

details now on the Jahai McMath

11:09

case has started December ninth when the

11:11

thirteen year old Oakland girl went in for tonsil

11:13

surgery. When she was in the

11:15

recovery room after surgery, she

11:18

started to have bleeding into

11:20

her mouth. Her parents

11:22

tried to get the attention of the nurses etcetera.

11:24

And unfortunately, the response

11:27

was delayed. And by the

11:29

time people really recognized what

11:31

was going on, she'd had a

11:33

cardiac arrest She was resuscitated.

11:35

They were able to get a

11:37

a heartbeat back, but she had

11:39

very severe brain damage. Three

11:41

days later, she was declared

11:43

brain dead after complications that she was put

11:45

on life

11:46

support.

11:48

The initial tests were then

11:49

reinforced by further testing done

11:52

by outside physicians. Doctor

11:54

Paul Fisher is with Stanford's loose

11:56

seal packard Children's Hospital He

11:58

says Jai has no response to facial

12:00

pain, no gag

12:02

reflexes, no reflexes in her

12:04

arms or legs, and a complete abs stance

12:06

of brainstem and cerebral function,

12:08

but the family isn't giving

12:10

up. Johannes

12:11

MacMath's family did not accept

12:13

that she was dead. The fundamental conflict

12:15

circles around different notions of

12:17

death. Her parents

12:18

said, you know, wait a minute,

12:20

why is she dead? According to a

12:22

New Yorker article, the family's

12:23

frustrations were made worse by

12:25

their sense that the brain damage was the result

12:27

of negligence in their view that her

12:29

lack of care was connected to her race.

12:32

A follow-up report later found that the

12:34

hospital had complied with medical

12:36

standards, but the family did get

12:38

a lawyer who help them fight the brain

12:40

death diagnosis. And

12:42

it turns out that there

12:44

is one state which allows

12:46

a family to

12:48

conscientiously object to the diagnosis

12:50

of brain death, and that's New Jersey. New

12:52

Jersey adopted a version of the

12:54

definition of death that was laid out in the eighties.

12:56

but the state later added a religious exception.

12:59

So a family's religious beliefs were

13:01

justification enough for

13:03

hospitals to continue to administer care

13:05

to patients even if they'd been declared brain

13:07

dead. And

13:08

so they arranged for her to be flown

13:10

from California to New Jersey,

13:13

and she went into an ICU

13:15

and she had a tracheostomy placed

13:17

in her neck, which was basically a way for

13:19

her to be to remain on a ventilator for

13:22

a long period of time. and

13:24

she had a tube surgically placed in her

13:26

stomach so that she could be fed. And

13:29

she went on to live for almost

13:31

another five years in

13:33

this state. In the

13:34

four and a half year stretch, while she was

13:36

legally brain dead in California, but

13:38

alive in New Jersey, Johannesburg, Johannesburg's

13:41

body

13:41

spun through puberty,

13:43

She grew taller. She

13:45

did

13:45

not regain consciousness though.

13:48

And

13:48

finally On June twenty two

13:50

in twenty eighteen, Johannesburg died

13:53

in the state of New Jersey. This time,

13:55

she died of various complications, including

13:57

problems with her liver. And

13:59

to

13:59

this day, she has two Death

14:03

certificates, both of which are

14:05

apparently valid. The death certificate

14:07

in California showing that she

14:09

died in two thousand thirteen the death

14:11

certificate in New Jersey saying she died in two

14:13

thousand eighteen. Family's attorney,

14:15

Chris Dolan, says this death certificate

14:17

proves that Jaha'i was alive these

14:19

past four and a half years.

14:22

What

14:23

Jaha'i McMath's story shows is

14:26

that Despite all the efforts in

14:28

the eighties, to create a single

14:30

clear set of standards around death that every

14:32

state could adhere to, despite

14:34

the apparent simplicity of a single

14:36

page with a simple definition, these

14:38

questions about death still are not

14:40

fully resolved. Like a person can

14:42

still be alive in one state and dead

14:44

in another. And there are still

14:46

people pushing back on the idea

14:48

that brain death is death at all.

14:50

I DON'T BELIEVE THERE'S ANY LARGE CHILDREN'S

14:52

HOSPITAL IN THE COUNTRY THAT

14:54

HASN'T FACED A FAMILY WHO HAVE

14:56

SAID THE SAME THING THAT JAI McNASS

14:59

family

14:59

did, like explain to us why

15:01

she's dead. And, you know,

15:03

we don't believe your explanation.

15:05

And

15:06

meanwhile, there are other people arguing that the

15:08

definition of brain death should be

15:10

broader, that it shouldn't require the whole

15:12

brain to be dead, but should just be a

15:14

question of whether someone can regain

15:16

consciousness or not. Bob

15:19

has had his own set of questions.

15:21

Like, he coauthored a book a

15:23

few years ago about whether

15:25

or not brain death and the death

15:28

where your heart and lungs stop are

15:30

really equivalent. And

15:32

at the time, he argued

15:34

that brain death wasn't really death

15:36

because with life support,

15:38

people's bodies can keep functioning

15:40

sometimes for years after

15:42

they've been declared brain dead?

15:44

So, I

15:44

have rethought this. And, you know,

15:47

perhaps people might say that

15:49

I'm intellectually the less

15:51

because of it. I kinda think that if

15:53

your ideas can't evolve over time, you

15:55

might as well you know, not have ideas.

15:58

So my ideas have evolved.

16:00

He's

16:00

ultimately decided in his own

16:02

personal bioethics debate. The

16:04

brain death can be considered a legitimate form

16:07

of death if we say that it's socially

16:09

constructed and that it reflects what

16:11

matters to many people

16:12

about being alive. But

16:14

the

16:14

fact that Bob's ideas have had

16:17

to evolve and shift, it

16:19

just shows that this question is not

16:21

easy. And no matter what

16:23

answers, Bioethasists or physicians

16:25

or philosophers or religious leaders

16:27

ultimately come up with, There's

16:29

not a way to return to the place we were

16:31

in before the invention of life support

16:33

technologies and the possibility of organ

16:35

donation. There's no way to go

16:37

back to the time before we interrupted this

16:39

process of death, back

16:41

when death was just very

16:44

obvious self explanatory death.

16:46

with no pressing need for

16:48

definitions.

16:49

We

16:52

cannot go back But

16:54

we're also still moving forward at the

16:56

same time. And technology

16:59

could make death really

17:01

strange again. After the

17:01

break, Ryan Resnick, on the future

17:04

of death.

17:16

Fox

17:16

creative.

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19:03

There are more abortion storylines

19:05

on TV today than say

19:07

twenty five years ago. That

19:09

doesn't

19:09

mean those storylines get it

19:12

right. often the barrier that we see are the protestors

19:14

in front of the clinic,

19:15

but we don't see,

19:17

you know, logistical, financial,

19:20

legal hurdles. really make up

19:22

the experience of getting an abortion in the

19:24

US today. What abortion

19:25

looks like on screen and why that

19:28

matters? This week on Intuit, Vulture's

19:30

culture podcast.

19:35

isolated organs can be blow to

19:38

life even though they've been

19:39

removed from the animal scopes sometime

19:41

after death on unexplainable.

19:44

Alright. Brian

19:44

Resnick. Science.

19:46

Pankerton. Senior science

19:49

reporter. I'm science in health

19:51

editor at fox pet.

19:53

Okay. Hi,

19:54

Brian Rosnick, science and health editor

19:56

at all. Hey, Bird,

19:59

friend,

19:59

and coworker. What

20:02

have you got from me? So you

20:05

were talking about how

20:08

technologies forced us to

20:10

rewrite our definition of

20:12

debt. And, you know, listening to your story,

20:14

I just couldn't stop thinking about

20:16

a series of experiments that

20:18

I started hearing about a few years

20:21

ago. And these are just the

20:23

exact type of experiment that could

20:25

force us to redefine death.

20:27

Whoa. Again, because maybe,

20:31

and this is just just,

20:33

you know, scare quotes maybe.

20:35

But okay. The

20:38

experiments are just an early

20:40

step towards maybe making

20:43

death reversible. reversible

20:46

Like,

20:46

bringing people back to life.

20:48

Okay. So this

20:50

this conversation will be

20:53

mostly sci fi. Okay. But

20:56

A lot of science fiction does start

20:58

with something that is happening in the

21:00

world today. So this is

21:02

a series of experiments that had

21:04

been done on pigs at Yale. The

21:07

researchers do it to learn more about

21:08

organ transplantation and, you know,

21:11

just like the basics of cell death.

21:13

And to learn more about these

21:15

experiments, I I recently talked with one

21:17

of the researchers involved of

21:20

the project. My name is David

21:22

Andreyevich, and I'm an associate

21:24

research scientist at Yale

21:26

University Department of New York Science. So

21:28

David is involved in the most recent

21:30

batch of experiments here on

21:33

pigs. There were others beforehand before he

21:35

joined the lab. But basically,

21:38

they've taken pigs and for these

21:40

experiments, the pigs need

21:42

to be dead. So they

21:44

induced cardiac arrest. basically

21:47

hard to start pumping blood, and we would

21:49

wait for one hour.

21:51

In some experiments, they're dead for an

21:53

hour and others, they're dead for much

21:55

longer. And they've tried to

21:57

see if they can get the cells

21:59

in

21:59

various organs to

22:02

start working again after

22:04

death. Okay. So

22:05

the pigs are dead. Mhmm. And they're

22:08

reviving those dead pigs

22:09

cells. Yeah. And in

22:11

various really important organs throughout

22:14

the body. Okay.

22:15

How do they

22:18

do that?

22:19

So

22:20

they take

22:21

these dead

22:23

pigs and and in certain cases

22:25

just their decapitated heads.

22:28

And they have this special solution,

22:30

this mixture they've created. It's called

22:33

perfusate, which is kinda like this

22:35

cocktail of chemicals that

22:37

have oxygen and nutrients and and

22:39

kind of protective things in it.

22:40

it contains various vitamins, electrolytes

22:44

in order to

22:46

make cells healthy again.

22:48

it's meant to stop the breakdown

22:51

of cells that happen after

22:54

death and basically push

22:56

like the slow down button on the dying

22:58

process and even maybe reverse some parts

23:00

of it. How do they are they

23:02

just, like, injecting it?

23:03

Yeah. So they have a machine that is

23:05

kinda like an artificial heart that

23:09

pumps this through the pig's

23:11

body, pumps it through like

23:13

the the the circulatory system of

23:15

the pig. And then we

23:17

would eventually evaluate the

23:19

organs. And

23:19

what did they find when

23:22

they evaluated the organs. So

23:24

they

23:25

found that under a

23:28

microscope, a lot of the cells in

23:30

them looked alive. We

23:31

have observed electrical

23:34

activity of the heart, which was

23:37

interesting. It looked like some of the cells

23:39

in the heart had come back to life.

23:41

They did things cells are

23:43

supposed to do. They, like, eat

23:45

glucose. They made

23:47

proteins. They they looked

23:49

like they were turned on. This

23:51

is this is just it's

23:53

a

23:53

lot. So they

23:55

revive these cells, That's

23:57

not the same thing

23:59

as

23:59

reviving in Oregon. Right? Or

24:01

is it just the is it the beginning?

24:04

Is it the first step towards something like that?

24:06

Yeah. This is just a first step, but what's

24:08

really impressive about it is just how

24:10

broad of a first step is it's

24:12

been. So it it wasn't just the heart.

24:15

the muscles when they injected

24:17

the pig with a certain

24:19

contrast dye, like, animals

24:22

would

24:22

would sort

24:24

of

24:24

feature, or move parts

24:26

of their bodies. Twitch,

24:28

like, the pay moved. Yeah.

24:31

Yeah. They even played this off cool, but I

24:33

was like, Were you terrified? I was, like,

24:35

no. But it was inter they said it was, like,

24:37

intriguing. They didn't know what to make of it other than

24:39

that. Like, the muscle still

24:41

had some musclely

24:42

powers. We did not

24:44

want to hypothesize

24:47

what these might indicate.

24:50

But most astoundingly,

24:52

a few years ago, they did

24:54

some of these experiments on specifically

24:57

a pig's brain. or pig's brain. Uh-oh. Yeah.

25:00

And these were the first experiments they

25:02

did, like actually before David joined

25:04

the lab. They were able to

25:06

make brain cells. come back alive

25:08

in a very similar way. Oh my god.

25:11

This was so profound because

25:13

brain cells are thought to, like, be really a

25:15

sensitive to death. Like, they need a ton

25:17

of ox and after you

25:19

don't get oxygen, brain cells are supposed to,

25:21

like, die irretrievably very

25:23

quickly. What this research

25:25

group said or showed? Was

25:27

that maybe not so

25:29

much? This

25:29

is

25:30

maybe a dumb question. Mhmm.

25:33

But did, like, did the brain

25:35

do the equivalent of, like, a muscle twitch?

25:37

Like, did the pig wake up.

25:40

Oh, funny. But, no. Actually,

25:42

this research group really took a lot of pains to ensure that

25:44

could not happen. So We

25:46

just wanted to make hundred percent

25:49

sure that animals would

25:51

not feel any even potential discomfort.

25:53

In some versions of the experiment, they

25:55

use anesthesia, but in the

25:57

brain experiments, they use like a

26:00

neuronal blocker. which prevents, like, the

26:02

cells, the brain cells from communicating

26:04

from me with each other. You know, no

26:05

one

26:06

knows what would happen if they didn't use

26:08

that neuronal blocker, but that's

26:10

that's came out. Is that,

26:13

like, event eventually the goal? Like,

26:15

to to wake the animal up? Or

26:17

Not for this research group. Okay.

26:20

You know, they're focused on preserving

26:22

organs for research and and

26:24

transplantation, but this

26:26

question you're wondering about, like, what could

26:28

happen here in the future? You're

26:30

not the only one thinking

26:33

about it. I

26:33

think my jaw almost, like, fell on the ground. I

26:35

was just like, what? What did you do to pigs? And

26:37

how did it work? And they were dead for four

26:39

hours? And you did what?

26:42

And so I had many, many, many questions. So

26:44

this is

26:44

Nita Farhanie. She's a professor of law

26:46

and philosophy at Duke. And

26:49

she just thinks about death

26:51

a lot.

26:51

gosh. I mean, doesn't everybody at some

26:54

point start to think about death? But,

26:55

Fineda, thinking about death

26:57

is actually a part of her job,

27:00

thinking about what it is, how to

27:02

define it. And she says these

27:04

experiments on pigs could

27:06

affect our

27:06

definition, you know, even though

27:09

this group They

27:09

have not pulled a full Frankenstein. You know,

27:11

they haven't reversed that. It could

27:13

be the beginnings of something. She's

27:16

starting to think about where could lead.

27:19

Like, what would it mean if

27:21

you could revive a heart

27:23

sometime after it's dead? or

27:25

more provocatively. What if

27:28

you could revive a brain to

27:30

some degree? if

27:32

it turns

27:32

out that such technology could

27:35

enable, you know, the the

27:37

pigs to wake up again or, you

27:39

know, have some sentience

27:41

of some form, you know, perception of

27:43

any form, then we

27:46

would think, oh, look, here's

27:49

another technology just like some

27:51

medicine can expand our lives. Here's another technology that

27:54

could expand and extend our

27:56

lifespan and could then change

27:59

we define

27:59

death. Suddenly death gets

28:02

really legally complicated again.

28:05

So all of our definitions right

28:07

now, they're based on this idea that

28:09

death moves in one

28:11

direction. You

28:11

know, death is not reversible and

28:14

there is nothing we can do about

28:16

it.

28:16

But if these technologies

28:19

do make it possible to one day,

28:21

you know, revive someone even

28:23

just momentarily. What does that

28:25

mean? Is is the corpse actually

28:27

a corpse? Can you declare it

28:29

dead if it could possibly be

28:31

revived? There

28:31

are rights that attach to people

28:33

when they're alive. and there are

28:36

regulations that apply when

28:38

a person is dead about how you

28:40

handle a dead body and what

28:43

obligations exist on physicians for

28:45

continuing care requirements? It

28:48

matters. Basically,

28:49

the you know, the jaw drop

28:51

for for Nita was realizing that we've made this

28:53

big assumption about death, this irreversibility

28:57

part. And this

28:59

technology is challenging that

29:01

assumption. And so

29:03

she wants to think through that and think

29:05

about what could

29:08

be a new language that

29:10

could take this into account? So

29:11

take the existing

29:14

definition, which says the irreversible

29:16

cessation done. Well,

29:17

what if it's reversible? Do

29:19

we need to modify irreversible

29:21

which is,

29:22

like, naturally occurring irreversible?

29:26

Or you know, irreversible by the person's body

29:28

spontaneously on their own. Like, what what is it?

29:30

Like, is it just that we haven't described

29:32

it well? or is

29:34

it that

29:34

the line has changed?

29:40

So is

29:41

this these questions that,

29:43

like, Nina is actively working

29:45

on? Like, what does it look like

29:48

to

29:48

to to work on these questions,

29:51

I guess?

29:51

Yeah. So Nida is

29:54

actually actively engaged on

29:57

a process that might change

29:59

laws, might change

29:59

the definition of death in America.

30:02

So she's involved with the

30:04

uniform laws commission, which is

30:06

what? you know, it's proposed the the the first,

30:08

like, round of death

30:10

laws in the eighties. So we're

30:12

doing

30:13

just to be clear, another committee

30:16

in the US. Oh, yeah. determine this.

30:18

She explained it to me. It's, like,

30:20

really bureaucratic sounding. It's, like, a year's

30:22

long process, a lot of committees, a lot

30:25

of deliberating, And but the goal

30:27

is that this

30:28

uniform laws commission can bring to

30:30

the states a uniform definition

30:32

of death that could work for

30:35

the future. and, you

30:37

know, be adopted in every state.

30:39

They're just suggesting that and the states don't

30:41

have to adopt it. So So, like, states

30:43

don't have to adopt them. And I

30:45

feel like in this particular

30:47

political climate, like,

30:49

it's probably that much

30:50

more difficult to get people to all

30:52

agree on what death means

30:54

or life means or Yeah. I

30:56

have no idea. But fresh whole fly.

30:59

I I think we can talk about it. It's,

31:01

you know, funny for, like,

31:03

in academic world, this

31:06

stuff is all easy to talk through. But then,

31:08

you know, could this actually come

31:10

to pass in the real world? I don't

31:12

know. But that'll be interesting to see if

31:14

there really is a kind of public, you

31:16

know, debate around this. But even

31:18

if it's just in, like,

31:21

academic world.

31:22

Mhmm. Is there a universe

31:24

where you can get

31:25

a full definition that

31:27

sort of like takes into account?

31:29

everything This is

31:31

the thing. Like, there's I don't think there will

31:33

ever be such thing as a perfect definition of

31:36

death. I asked

31:40

Nina this, like, is it is it possible

31:42

to write a definition for all time?

31:45

And she said, No. And

31:47

she doesn't necessarily want

31:49

to. I

31:49

think we have not reached

31:51

the limits of human knowledge.

31:54

and nor have we reached the limits of

31:56

medicine and what we might be

31:58

able to do with the human body.

31:59

And I hope we continue

32:02

to overcome many of the

32:04

afflictions and diseases that affect

32:06

humanity. And, you know,

32:08

we're just at the beginning of

32:10

the stages of being able to address so many afflictions of the

32:12

human brain. And the more we understand about the

32:14

human brain, the more I hope we'll be

32:17

able to reverse some

32:19

of the damage that's caused

32:21

by neurological disease and disorders, in

32:24

which case you know, maybe not.

32:26

Maybe it's possible to write the perfect

32:28

definition within the limits of existing human

32:30

imagination. But I hope

32:32

that humans continue to

32:35

defy our current limits of

32:37

human imagination.

32:44

This

32:48

episode was reported and produced by Bird

32:51

Pinkerton and Brian Resnick, It was

32:53

edited by Katherine Wells and Meredith

32:55

Hoddenatt with help from Brian. Music

32:57

from me, Noam Hasenfeld, mixing and

32:59

sound design from Christian Ayala, fact

33:01

checking from Zoe Mollik, and we had help

33:03

keeping our heads on straight from mending

33:06

win. Special thanks to Rainy

33:08

Ramani and Ben Sar who

33:10

took a lot of time to talk through the nuances

33:12

of death. Ben's got a really

33:14

thorough chapter on the subject in an upcoming

33:16

book about death called death determination

33:18

by neurologic criteria areas of

33:21

controversy and consensus. But

33:23

if you wanna read more about the definition of death

33:25

in the meantime, got a good breakdown

33:27

in the Journal of Law and the Biosciences. Brian's

33:31

also got a great article about the pig research that

33:33

he wrote in twenty nineteen,

33:35

You can find that at vox dot com

33:37

slash unexplainable. If you have

33:40

thoughts about this episode or ideas for the

33:42

show, please email us. at

33:44

unexplainable at vox dot

33:46

com. We'd also love it if you left

33:48

us a review or a rating. Unexplainable

33:50

is part of the vox media podcast

33:53

network. we'll be back next

33:55

week.