Clinical Death

"Death" is a word which leaves cold shivers in all of us. The word is feared and one does not like it to be talked about. Ignorance breeds fear and hence fear manifests because of ignorance about the death phenomenon. Though we all know that it is universal yet we tend to think that it is for others and not for us. We attend funerals and become philosophical and then only we get a thought that one day we also will meet this eventuality. Soon after attending a funeral, the thought gets brushed away and we continue life as if we are immortal.

A total of 12 patients underwent surgical repair for thoracic aortic dissections with a technique which included cardiopulmonary bypass, profound hypothermia, high-dose thiopentone and circulatory arrest. Seven of nine early postoperative survivors made a complete recovery on clinical criteria. There were three perioperative deaths and there was one late postoperative death from chronic renal disease. There were no deaths among those operated on electively. Neuropsychological testing may help to define the consequences of circulatory arrest on higher function.

The possibility of AI consciousness depends much on the correct answer to the mind-body problem: how our materialistic brain generates subjective consciousness? If a materialistic answer is valid, machine consciousness must be possible, at least in principle, though the actual instantiation of consciousness may still take a very long time. If a non-materialistic one (either mentalist or dualist) is valid, machine consciousness is much less likely, perhaps impossible, as some mental element may also be required. Some recent advances in neurology (despite the separation of the two hemispheres, our brain as a whole is still able to produce only one conscious agent; the negation of the absence of a free will, previously thought to be established by the Libet experiments) and many results of parapsychology (on medium communications, memories of past lives, near-death experiences) suggestive of survival after our biological death, strongly support the non-materialistic position and hence the much lower likelihood of AI consciousness. Instead of being concern about AI turning conscious and machine ethics, and trying to instantiate AI consciousness soon, we should perhaps focus more on making AI less costly and more useful to society.

Introduction. The single most important clinically relevant cause of global cerebral ischemia is cardiac arrest. The estimated rate of sudden cardiac arrest is between 40 and 130 cases per 100.000 people per year. Almost 80% of patients initially resuscitated from cardiac arrest remain comatose for more than one hour. One year after cardiac arrest only 10-30% of these patients survive with good neurological outcome. The ability to survive anoxic no-flow states is dramatically increased with protective and preservative hypothermia. The results of clinical studies show a marked neuroprotective effect of mild hypothermia in resuscitation. Material and Methods. In our clinic, 12 patients were treated with therapeutic hypothermia. A combination of intravascular and external method of cooling was used according to the ILCOR (International Liaison Committee on Resuscitation) guidelines. The target temperature was 33oC, while the duration of cooling was 24 hours. After that, passive rewarmi...

The possibility of AI consciousness depends much on the correct answer to the mind-body problem: how our materialistic brain generates subjective consciousness? If a materialistic answer is valid, machine consciousness must be possible, at least in principle, though the actual instantiation of consciousness may still take a very long time. If a non-materialistic one (either mentalist or dualist) is valid, machine consciousness is much less likely, perhaps impossible, as some mental element may also be required. Some recent advances in neurology (despite the separation of the two hemispheres, our brain as a whole is still able to produce only one conscious agent; the negation of the absence of a free will, previously thought to be established by the Libet experiments) and many results of parapsychology (on medium communications, memories of past lives, near-death experiences) suggestive of survival after our biological death, strongly support the non-materialistic position and hence the much lower likelihood of AI consciousness. Instead of being concern about AI turning conscious and machine ethics, and trying to instantiate AI consciousness soon, we should perhaps focus more on making AI less costly and more useful to society.

Extracorporeal cardiopulmonary resuscitation is increasingly recognised as a rescue therapy for refractory cardiac arrest, nevertheless data are scanty about its effects on neurologic and cardiac outcome. The aim of this study is to compare clinical outcome in patients with cardiac arrest of ischaemic origin (i.e. critical coronary plaque during angiography) and return of spontaneous circulation during conventional cardiopulmonary resuscitation vs refractory cardiac arrest patients needing extracorporeal cardiopulmonary resuscitation. Moreover, we tried to identify predictors of survival after successful cardiopulmonary resuscitation. We enrolled 148 patients with ischaemic cardiac arrest admitted to our hospital from 2011-2015. We compared clinical characteristics, cardiac arrest features, neurological and echocardiographic data obtained after return of spontaneous circulation (within 24 h, 15 days and six months). Patients in the extracorporeal cardiopulmonary resuscitation group ...

Technological advances, particularly in the capacity to support, replace or transplant failing organs, continue to challenge and refine our understanding of human death. Given the ability to reanimate organs before and after death, both inside and outside of the body, through reinstitution of oxygenated circulation, concepts related to death of organs (e.g. cardiac death) are no longer valid. This paper advances the rationale for a single conceptual determination of death related to permanent brain arrest, resulting from primary brain injury or secondary to circulatory arrest. The clinical characteristics of brain arrest are the permanent loss of capacity for consciousness and loss of all brainstem functions. In the setting of circulatory arrest, death occurs after the arrest of circulation to the brain rather than death of the heart. Correspondingly, any intervention that resumes oxygenated circulation to the brain after circulatory arrest would invalidate the determination of death.