Jahi McMaths in bed, with closed eyes, and carefully made up. In the picture, the 17-year-old American seems to sleep American from Oakland. However, at the time of the recording had not left her bed for years. It was held by a machine – and therefore was in the USA recently the focus of a debate about when life ends and death begins.

In the age of modern medicine, it is doctors, ethicists, lawyers, and to answer the last for the relatives of people who are in the grey zone between life and death, a real challenge, this is the question. Because modern imaging techniques and new treatment options are blurring the boundary increasingly.

until the 20th century. Century were no longer considered people as dead when their heart beat, the breathing was suspended. Today, the cardiac death is death as a sole criterion is no longer valid. Instead, the diagnosis of brain death is valid as a safe determination of death of a human being.

Two Doctors have to the brain death

brain death notice indicates that you have failed overall function of the cerebrum, cerebellum and Brain stem irretrievable and irreversible. The brain-stem death will need to find two experienced specialist physicians independently of each other according to set criteria.

However, this Definition, so clear it first sounds, is met in the practical implementation limitations, such as the case of McMaths. After a dramatic botched tonsil surgery in 2013, her EEG showed no brain waves. It was declared in California for dead.

A doctor said, MacMaths’ body’ll decompose soon. But her parents wanted to wait and brought their daughter in the U.S. state of New Jersey. There it is possible to refuse, on religious grounds Off of the Ventilator.

and Then breathed McMaths with machine assistance, seemed to be stabilizing. You grew up, got their rule. In the summer of 2014, a modern MRI Scan showed that her brain was largely lifeless, in a small, for the consciousness of the major part but still the blood flowed. A physician certified the patient in addition, minimal responses: Here and there they moved, therefore, to address point fingers and feet, so that a state of time, have minimal consciousness seemed possible.

Without a brain, no life?

if the Definition of brain death, irreversible coma with no measurable brain waves, and dependence on breathing machines, are where people like McMaths?

Robert Truog, Director of the center for bioethics, Harvard Medical School, describes in the journal “Jama” the difficulty of this to explore the grey zone: “While legal definitions are usually marked by clear lines, with a tendency in biology to be a continuum.” As a comparison, he mentions the legal age of majority at 18. Birthday, with the help of a border will be drawn, although to this date, biologically hardly anything changed.

in other words: the occurrence of The death is not necessarily a single Moment, but rather a process. Long advances in modern medicine, even the death can stop it, sometimes even to a kind of reversible condition.

An example: it Meant a ten-minute cardiac arrest, the death to stand judgement for a long time, patients today are revived in extreme cases, even after hours.

this is made Possible by significant advances in the hypothermia, the cooling of an injured body. The constant cooling to 32 to 34 degrees for up to 24 hours prevents runaway inserting the end of all processes of Decay, especially in the brain. During or after resuscitation are used for this purpose, special cooling pads, infusions or ice packs. The procedure is in most Rescue Standard.

“in the Meantime, more than 80 percent of those who survive have a good neurological outcome,” says Bernd Böttiger, Director of the clinic for anesthesiology and operative intensive care medicine, University hospital of Cologne. That is, you survive the cardiac arrest without or at least without serious brain damage.

new portable heart-lung machines to help emergency doctors, the death of a person at the scene to postpone, if a recovery fails. At least for a while, heart beat, breathing and oxygen supply drives the machine.

heart massage can do much to align

“This can buy time to explore about a specific heart problem alone,” says Böttiger. He remembers a case where a young Pregnant woman who had been initially more than resuscitated for one hour, unsuccessful, after three days in the life came back.

Much more effective to avoid a death after cardiac arrest, however, was something else: early on in the revival. Therefore, does Böttiger in a large campaign that already in school children heart learn massage. “What you learn before puberty, you never forget.”

a step further Kryoniker, the cool complete people after death in liquid nitrogen, and optimistic patients call go, in the hope to bring them with the forefront of medicine in the future, a new life.

“For Kryoniker is only an irreversible death to a death,” says the sociologist Thomas Lemke, the research at the Goethe University in Frankfurt am Main on the border of life and death.

He is engaged in a EU-project for Cryobiology, especially with the past few years, the existing possibility of the body tissue freeze, such as eggs, sperm or embryos. He starts from the Thesis that kryobiologische practices a specific Form of life, and calls this “suspended life” – deferred life. “This is a life in limbo, the afterlife or between life and death. It plays a role of hope and anticipation.“

The biological substances are neither completely alive nor completely dead. It is a matter of the offer, certain decisions “on ice”. “As a result, life appears as something Controllable.”

but it is not necessarily the case. So not all women would be after a “social freezing” be pregnant.

death is not to define today

The traditional Definition of death will change step by step, says Lemke. “What was once familiar and known, is now no longer a matter of course. It comes to end-of-life processes. And it is a task to synchronize these processes with the legal binary breakdown of death and life.“

this task will remember cases like that of Jahi McMaths in the future. The 17-Year-old is now dead. She died at the end of June to the consequences of liver failure. To a will change, despite all the medical progress for the time being: Eventually, death always wins.

Sam Yoon has many years of experiences in journalism. He has covered such areas as information technology, science, sports and politics. Yoon can be reached at 82-2-6956-6698.