死亡的判定

死亡是生命的终结.死亡判定的标准在历史上经历了一个逐步深化的过程.1959年2位法国医学家首先提出了脑死亡的概念.但是什么是脑死亡,以及如何判定脑死亡是一个有争议的问题.1981年美国总统委员会提出了一个脑死亡的判定指标体系,并被一些国家立法接受.回顾了对死亡判定认识的历史过程.     

Epicurean Equanimity Towards Death

This paper assesses two reformulations of Epicurus' argument that "death … is nothing to us, since while we exist, death is not present; and whenever death is present, we do not exist." The first resembles many contemporary reformulations in that it attempts to reach the conclusion that death is not to the disadvantage of its subject. I argue that this rather anachronistic sort of reformulation cannot succeed. The second reformulation stays closer to the spirit of Epicurus' actual position on death by attempting to reach the conclusion that it is inappropriate to fear or dread or have any other negative affective response towards death. I raise a plausible objection to this argument, suggesting that dissatisfaction is sometimes an appropriate response to the approach of death. I then go on to consider the possibility that Epicurus was partly right in that it may always be inappropriate to dread death.
Death is nothing to us. For while we are still alive, death is not present; and when death is present, we are not.
Epicurus ¹     

对我国脑死亡立法问题的反思

在对1999年以来我国脑死亡问题的研究成果进行初步梳理的基础上,针对我国学者主张脑死亡立法的主要论据,提出并分析了脑死亡问题的三个主要问题：（1）脑死亡是真正的死亡吗？（2）能否以经济效率的考量来定义生死？（3）器官移植和脑死亡到底有什么关系？还提出,脑死亡立法需要在我国现实的医疗卫生条件下进行讨论。     

On Abolishing “Death”: An Etymological Note

The distinction is made between two uses of the word “death,” specifically, your death (the death of the other) and my death (the death of the self). It makes (logical, epistemological and phenomenological) sense for me to speak of your death, but not for me to speak of my death—inasmuch as, by reasonable definition, I cannot possibly ever experience my death. Dying is experienceable—although one can never be certain. The word death is a perfectly good word for the demise of the other; the word omega is suggested to allude to that non-event (the cessation of the self) now routinely spoken of as “my death,”     

浅析死刑认同的心理根源

我国民众普遍认同死刑,这种"死刑认同"具有三种心理情绪根源:死亡情结、社会情感以及正义报复感。死刑认同实质上是国民的一种个人情绪和社会情感的表达和要求。取消死刑是必然趋势,但必须具备相应的社会条件。     

恐惧管理理论的争议及其对死亡心理研究的启示

死亡心理是人类面临死亡及相关事件时所产生的认知、情感和行为意向的复杂心理状态。目前, 研究死亡心理较为全面和科学的理论是恐惧管理理论(Terror Management Theory, 简称TMT)。但该理论存在以下争议: (1)在死亡的基本认知方面, 恐惧管理理论呈现出不一致的研究结果, 如死亡是否与不确定性无关, 死亡是否导致恐惧情绪, 寻求个体生存是否为人类的核心议题; (2)在社会文化层面, 恐惧管理理论提出者的文化背景对待死亡的普遍态度是呈否认的, 但是跨文化的研究显示其他文化背景对待死亡的态度却呈现出接纳或蔑视; (3)在恐惧管理理论的研究结果方面, 呈现出较多的矛盾性, 表明研究中有重要的调节因子未被涉及。基于此, 死亡心理可能的研究方向拟从认知、行为和社会三个层面进行梳理。未来死亡心理研究需秉承科学与文化并重的原则, 并结合死亡心理的内容与过程, 关注群体面对死亡时的心理规律, 开展死亡心理影响下的身心健康干预研究。     

Where is the Harm in Dying Prematurely? An Epicurean Answer

Philosophers have said less than is needed about the nature of premature death, and about the badness or otherwise of that death for the one who dies. In this paper, premature death’s nature is clarified in Epicurean terms. And an accompanying argument denies that we need to think of such a death as bad in itself for the one who dies. Premature death’s nature is conceived of as a death that arrives before ataraxia does. (Ataraxia’s nature is also clarified. It is a pervasive inner peace that is a kind of purity and completeness in how one is living.) Whatever harm we might attribute to a premature death is better attributed to a life’s being lived at that time without ataraxia. The paper ends by explaining how its Epicurean account, more so than comparativist or narrativist accounts, could allow a person to know that her death will not be premature.     

死亡的解析

死亡的痛苦来源于对死亡的无知。依据辩证法原理,结合现代科学的最新发现,对死亡的本质进行解析发现:死亡是构成生命的物质和意识在运动形式上的特殊转化,而非生命体的消失。灵魂是生命体的核心成分之一,而灵魂的实质是承载深层意识的超微观物质结构。     

Thanatos and massive psychic trauma: the impact of the death instinct on knowing,remembering, and forgetting

The connection between massive psychic trauma and the concept of the death instinct is explored using the basic assumptions that the death instinct is unleashed through and is in a sense characteristic of traumatic experience, and that the concept of the death instinct is indispensable to the understanding and treatment of trauma. Characteristics of traumatic experience, such as dissolution of the empathic bond, failure to assimilate experience into psychic representation and structure, a tendency to repeat traumatic experience, and a resistance to remembering and knowing, are considered as trauma-induced death instinct derivatives. An initial focus is on the individual, on how death instinct manifestations can be discerned in the survivors of trauma. Next the intergenerational force of trauma is examined; a clinical vignette illustrates how the death instinct acts on and is passed on to the children of survivors. Finally, the cultural or societal aspects of trauma are considered, with an eye to how death instinct derivatives permeate cultural responses (or failures to respond) to trauma. Because trauma causes a profound destructuring and decathexis, it is concluded that the concept of the death instinct is a clinical and theoretical necessity.     

suspicion of sudden infant death syndrome & injuries to infants: the effects of type of death certifier,training, and economics

This paper examines the level of suspicion by death certifiers when ruling infant deaths as accidents. Data were gathered on economic factors, amount of training in death investigation received, and personal characteristics for 1995 from 776 medical examiners or coroners. Findings indicate that personal and social factors such as age, education, and population have negligible or no effects on the level of suspicion held by death certifiers in manner of death rulings for infants. The findings from this study do suggest there is potential for inaccurate rulings of infant death due to lack of training, education, and economic resources depending on the events surrounding an infant's death and whether the death certifier is a coroner or medical examiner.     

诊断脑死亡的伦理思考

随着医学的进步和社会的发展,死亡的定义、诊断标准和医生道德责任有了新的内容,脑死亡就是生命终结已为医学界普遍接受.诊断脑死亡是非常专业的技术性工作,有权进行脑死亡诊断的医疗单位和医生必须达到相应的资质要求.确诊和宣布脑死亡应遵循的伦理准则包含多方面的内容,如家属应有死亡标准选择权、脑死亡的诊断程序、脑死亡诊断结果的宣布和生效等方面的问题.     

Towards a Theological Metaphysics of Death

Death is an inescapable event. It defines our existence as mortal. It is both a marker of our finitude and a portal to a deeper mystery: what awaits us in, through, and beyond this moment of ending? In thinking about death in the context of a theological dialogue, I identify two key questions: the phenomenological ‘What is death?’ and the philosophical ‘What is the meaning of death?’ as the beginning points of reflection. In general, it is the function of religion to provide some sort of answer to these questions, to give death both coherent definition and adequate understanding. The primary religious response is to articulate appropriate beliefs. But in their intellectual formation and construction, beliefs draw on metaphysics—the structures of logic, language, conceptuality and general worldview presuppositions by which we render all things intelligible and communicable. In this article I shall undertake an exploration of Christian viewpoints on death, which will require noting antecedents and corollaries in Judaism, then discuss possible metaphysical readings of death, that is, philosophical understandings of death that lie within and under, as it were, the otherwise stated religious beliefs about death. The aim of this article is not to present a fully developed ‘theological metaphysics of death’ as such; rather, in the context of an inter-religious dialogical engagement, to raise issues and perspectives from a Christian point of view that might contribute to a wider, more encompassing, theistically oriented understanding of death.     

The absence of cruelty is not the presence of humanness: physicians and the death penalty in the United States

The death penalty by lethal injection is a legal punishment in the United States. Sodium Thiopental, once used in the death penalty cocktail, is no longer available for use in the United States as a consequence of this association. Anesthesiologists possess knowledge of Sodium Thiopental and possible chemical alternatives. Further, lethal injection has the look and feel of a medical act thereby encouraging physician participation and comment. Concern has been raised that the death penalty by lethal injection, is cruel. Physicians are ethically directed to prevent cruelty within the doctor-patient relationship and ethically prohibited from participation in any component of the death penalty. The US Supreme Court ruled that the death penalty is not cruel per se and is not in conflict with the 8th amendment of the US constitution. If the death penalty is not cruel, it requires no further refinement. If, on the other hand, the death penalty is in fact cruel, physicians have no mandate outside of the doctor patient relationship to reduce cruelty. Any intervention in the name of cruelty reduction, in the setting of lethal injection, does not lead to a more humane form of punishment. If physicians contend that the death penalty can be botched, they wrongly direct that it can be improved. The death penalty cocktail, as a method to reduce suffering during execution, is an unverifiable claim. At best, anesthetics produce an outward appearance of calmness only and do not address suffering as a consequence of the anticipation of death on the part of the condemned.     

Death

Theoretical Medicine and Bioethics - There is a classic problem which confronts any attempt to assign death a value. On the assumption that death is personal annihilation, death deprives evil of a...     

Personal identity and brain death: a critical response

The authors contend that there are logical inconsistencies in a theory put forth by Michael Green and Daniel Wikler ("Brain death and personal identity," Philosophy and Public Affairs 1980 Winter; 9(2): 105-133) to justify the brain death concept of death. Green and Wikler had asserted that individuals cease to exist and are dead when the criteria for continuity in their personal identity are not met. Having argued that the theory of personal identity is misguided, Agich and Jones suggest that further research into the ontological foundation of brain death concepts should begin, not by rejecting medical or moral considerations, but by carefully defining the main competing concepts of brain death as brain stem death, cerebral death, death of the brain as a whole, and whole brain death, and then by relating these concepts to the ontological conditions for being a live individual or person.     

Healthy Death

The concept of healthy death is introduced and explored. A review of literature on the subject of death and dying reveals efforts that have sought to make death a “good” and “meaningful” experience. The article concludes with a summary definition of healthy death.     

The ethics of donation and transplantation: are definitions of death being distorted for organ transplantation?

A recent commentary defends 1) the concept of 'brain arrest' to explain what brain death is, and 2) the concept that death occurs at 2–5 minutes after absent circulation. I suggest that both these claims are flawed. Brain arrest is said to threaten life, and lead to death by causing a secondary respiratory then cardiac arrest. It is further claimed that ventilation only interrupts this way that brain arrest leads to death. These statements imply that brain arrest is not death itself. Brain death is a devastating state that leads to death when intensive care, which replaces some of the brain's vital functions such as breathing, is withdrawn and circulation stops resulting in irreversible loss of integration of the organism. Circulatory death is said to occur at 2–5 minutes after absent circulation because, in the context of DCD, the intent is to not attempt reversal of the absent circulation. No defense of this weak construal of irreversible loss of circulation is given. This means that paents in identical physiologic states are dead (in the DCD context) or alive (in the resuscitation context); the current state of death (at 2–5 minutes) is contingent on a future event (whether there will be resuscitation) suggesting backward causation; and the commonly used meaning of irreversible as 'not capable of being reversed' is abandoned. The literature supporting the claim that autoresuscitation does not occur in the context of no cardiopulmonary resuscitation is shown to be very limited. Several cases of autoresuscitation are summarized, suggesting that the claim that these cases are not applicable to the current debate may be premature. I suggest that brain dead and DCD donors are not dead; whether organs can be harvested before death from these patients whose prognosis is death should be debated urgently.     

Brain death, religious freedom, and public policy: New Jersey's landmark legislative initiative

"Whole brain death" (neurological death) is well-established as a legal standard of death across the country. Recently, New Jersey became the first state to enact a statute recognizing a personal religious exemption (a conscience clause) protecting the rights of those who object to neurological death. The Act also mandates adoption through the regulatory process of uniform and up-to-date clinical criteria for determining neurological death.     

The titration of death: a new sin

..."Titration of death" is the phrase I have used, in private musings and discussions, to express the undertaking of causing or permitting death to occur within carefully delimited parameters. It is, I think, a new form of sin. I distinguish it from a similar enterprise, in principle benign, that we might call "titration of dying," which attempts to manage the dying process. The focus of attention of titration of dying is the experience of the patient prior to death, with little or no concern given to the condition of the cadaver following death. Titration of death, on the other hand, is primarily concerned with producing, at the close of the process, a cadaver that is usable in some manner; and titration of death, per se, has only incidental concern with the dying process.     

Intrapsychic and family dynamics in perinatal sibling loss

The effects of perinatal death on surviving and subsequent siblings have been virtually unexplored. Perinatal sibling death is considered an event with impact determined by the interaction of the child's emotiond and cognitive responses with the reactions, distortions, and communications of the parents. The potentially maladaptive aftermath of perinatal sibling death is illustrated by clinical case reports that integrate intrapsychic and family perspectives. In each case, the individual's disturbed response to perinatal sibling death complements parental inability to: (1) resolve their loss; (2) communicate accurate information about the death to their child; and (3) assist their child in dealing with his/her feelings about death.