Thursday, April 25, 2013

Doctors are bringing people back from the dead

BBC   Carol had had a cardiac arrest - her heart had stopped beating. Luckily, an elderly neighbour knew the rudiments of cardiopulmonary resuscitation (CPR) and quickly began to work on her chest. 

Paramedics soon took over, and at a point between 30 and 45 minutes after her collapse - no-one noted the exact time - Carol's heart started beating again.

"While 45 minutes is absolutely remarkable and a lot of people would have written her off, we now know there are people who have been brought back, three, four, five hours after they've died and have led remarkably good quality lives," says Dr Sam Parnia, the director of resuscitation research at Stony Brook University in New York. 

Most people regard cardiac arrest as synonymous with death, he says. But it is not a final threshold. 

Doctors have long believed that if someone is without a heartbeat for longer than about 20 minutes, the brain usually suffers irreparable damage. But this can be avoided, Parnia says, with good quality CPR and careful post-resuscitation care. 

He says it is vital that chest compressions occur at the right rate and force and that patients are not over-ventilated. CPR would be considerably prolonged, with machines doing the work.
Doctors also have new ways to care for patients after their hearts have been restarted. ==============================

Sam Parnia practices resuscitation medine. In other words, he helps bring people back from the dead — and some return with stories. Their tales could help save lives, and even challenge traditional scientific ideas about the nature of consciousness.[...]

It sounds supernatural, and if their memories are accurate and their brains really have stopped, it’s neurologically inexplicable, at least with what’s now known. Parnia, leader of the Human Consciousness Pro [...]
 Wired: In the book you say that death is not a moment in time, but a process. What do you mean by that?

Sam Parnia: There’s a point used to define death: Your heart stops beating, your brain shuts down. The moment of cardiac arrest. Until fifty years ago, when CPR was developed, when you reached this point, you couldn’t come back. That led to the perception that death is completely irreversible. [...]


  1. The big question is how does the halacha look at such a situation? Did the person die (and therefore his wife is no longer his wife, etc.) and come back to life?

    1. I have thought about this also. If one holds the position that loss of spontaneous respiration and pulse are the simanim of halachic death, it seems to me inescapable that if an individual experiences cardiac arrest and is revived, undergoes cardiac surgery requiring heart stoppage, that person is, indeed, halachically dead with all of the ramifications. His wife is a widow and collects her cesubah, his children inherit, etc. For planned surgery, it would probably be a good idea arrange something with Beis Din (i'm not sure exactly what) to allow return of the estate but I don't see a could avoid having to remarry his wife.

  2. Around 20 years ago MD"A offered a course in resuscitation to men learning in Kollel. The Rabbonim insisted that anyone who felt he could perform CPR was mechuyav to take the course. The Kollelim paid as if the person was in the Beis Medrash. And although I have not yet needed the skills I learned, I have not forgotten them.
    I would like to raise the issue of Halachic death. The Rabbonim have fought to maintain that cessation of heart activity and respiration define death. So, if someone's heart and breathing stop, is there a chiyuv to resuscitate? Is there a chiyuv to be mechayei meisim? Is a Cohen allowed to perform CPR?
    I remember a Tosafos regarding Eliyahu HaNavi that seems to imply that there is a chiyuv to be mechayei meisim, and as such it is muter for a Cohen, but it is would make for an interesting topic.


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