Death and dying is the one thing that all people, from all walks of life, have in common. While the exact manner in which individuals die differs, what happens after death is quite similar for all people. An overview of what happens to a person just after death can provide understanding and perspective on dying and death.
The Moment of Death
When someone is asked how to define the moment of death, the oftentimes reference the cessation of the heartbeat and of breathing. The phrase “moment of death” is commonly utilized.
Research has brought for the realization that the moment of death really isn’t when the heart stops and breathing discontinues. There is no solid evidence to show that the brain continues to function for 10 or minutes, or even a bit longer after the heart and lungs shut down. The one exception would be if the brain suffered a traumatic injury which was the immediate, underlying or primary cause of a person’s death.
Research into what is going on in a person’s brain at this juncture is preliminary. Much more research needs to be done. However, there is some evidence to suggest that because the brain keeps working for a period of time, a person may be aware of death, may be aware of what is going on as the body stops functioning.
Many people are familiar with the term rigor mortis. A good number of people think this state sets in at the time of death. In fact, that occurs at a later time. The initial “phase” following a death is what is known as primary flaccidity. This occurs directly after a person dies and becomes fully present within an hour.
At the time of primary flaccidity, all of the muscles in a person’s body relax. This includes everything from major muscles in arms and legs to a person’s eyelids.
Blood stops flowing when the heart stops beating. When this occurs at the moment of death, gravity starts to take over. Within a couple of hours, blood starts to accumulate at the point in a deceased person’s body closest to the ground. This is called pooling.
When the blood stops flowing at the moment of death, nourishment if not conveyed to the body. Bacteria that are found in different organs of the body are deprived of what they need to live. Bacteria turns to bodily organs for nourishment when blood flow stops. This is the start of the decomposition process.
Declaring Death in a Hospital Setting
If a person is in a hospital at the time of death, doctors have several requirements they utilize to declare the death of a patient. These are:
- Absence of pulse
- Absence of breathing
- Absence of reflexes
- Absence of pupillary constriction in response to bright light
In most cases, medical personnel declares what is known as cardiac death. In other words, death legally is declared when the heart stops beating. There is one set of circumstances in which brain death is the clinical and legal cause of death.
Understanding Brain Death
The most common situation in which brain death, rather than cardiac death, is utilized to declare the end of a person’s life is when a patient is on a ventilator and there is a desire to donate one or more than one of a patient’s organs. Only 1 percent of all deaths are declared brain deaths. The remaining 99 declared deaths are cardiac deaths.
Death is declared in this situation when a demonstration is made that there is no meaningful brain activity. This can be confusing on some level. Because a person is on a ventilator, that individual’s heart and lungs will be functioning. Cardiac death has not occurred.
Doctors consider three factors as a prelude to considering a declaration of brain death:
- Absence of reflexes
- Apnea or the inability to breathe without mechanical assistance
Five Signs of Irreversible Death
Not all deaths occur in the hospital. Rather, many deaths occur in what are classified as emergency situations. In an emergency situation, paramedics utilize five signs of irreversible death to make a decision about whether attempting resuscitation is possible. These signs are:
- Post mortem lividity
- Post mortem rigidity
- Burned beyond recognition
In the state of California, paramedics have the legal authority to declare death in some situations. In many states, this is not permissible. The individual must be taken to a hospital emergency room in order for a doctor to declare death.