death and dying

Question 1

Classic criteria of death

Answer 1

• no heart beats
• no spontaneous breathing efforts
• fixed, dilated pupils

Question 2

Signs of death

Answer 2

algor mortis (cold body)
rigor mortis (rigidity of the body)
livor mortis (death spots)

in addition:
- dehydration

Question 3

Golden rules

Answer 3

• death should be established by more than one independent, specially trained physicians
• the physicians establishing death should not be interested in removing or implanting organs
• donation procedures should not start before the official legal death certificate had been issued

Question 4

Death types

Answer 4

immediate death: during of a violent event/injury/accident

Sudden death: instant break down of the function of an internal organ

Gradual dying: consequence of a disease or pathological condition with a shorter/longer period of agony

Physiological “senile decay”: dying at a very old age, to sleep over to death.

Question 5

Special cases

Answer 5

• suspended animation: temporary, but reversible decrease or cessation of life function
• clinical death: a dying process due to a disease or accident turned back by natural or artificial way
• vegetative life: termination of all or most of the brain activity together with the sustained visceral functions.

Question 6

Dying in progress

Answer 6

fastes: oxygen-sensitive tissues (neurons/hearts)
- slower: less sensitive organs (kidneys, liver)
- the slowest: resistant organs
- continuing activity: striated muscles (cramps), certain smooth muscles etc.

Question 7

The three period of dying

Answer 7

PREMORTAL: operation of the organs gradually decreases, sensory processes weaken (reversible)

PERIMORTAL: organ function gradually decline etc. (reversible)

MORTAL: consciousness is lost, start agony, and finally all living functions irreversibly decease (irreversible)

Question 8

Physiological changes

Answer 8

• brain EEG pattern changes
• electric activity of heart first increase, then the the waves become distorted following some sporadic contractions, then the heart stops.
• intensity of breathing increases in te premarital period, later become superficial, gasping, and arrhythmic.
• in mortal phase spastic contraction the smooth muscles is common.

Question 9

Changes in blood flow

Answer 9

Oxygen pressure gradually falls (hypoxia then anoxia)

Question 10

Near death experiences (NDE)

Answer 10

is a complex memory which is attributed by a person revitalized from clinical death to his/her experienced during this period.

A short period immediately preceding death, from which life-functions still can be restores.

Question 11

Elements of NDE

Answer 11

• difficulties to describe;
• hearing that declared to dead;
• feeling of peace, quietness, sometimes happiness or harmony;
• no pain, no suffering;
• out of body experience (spiritual body, OBE);
• „extrasensorial” feelings;
• tunnel-experience, noises;
• light sensation, light-creature;
• experience of „knowing everything”;
• meeting others;
• panorama-memory; life movie
• fence/barrier – called back

Question 12

NDE paradox

Answer 12

enhanced consciousness, thinking, arousal, in a state in which these functions are expected to decrease

Question 13

Following NDE

Answer 13

• later signs of PTSD appear
• relatively more die shortly after than those not experiencing NDE
• more believe in life after death
• less fear of dying
• changing the way of life
• positive attitude
• increased empathy