New research suggests that doctors are fortunate enough to correctly identify the person’s death time – an important aspect of ensuring healthy organs for donation. At the same time, the body can sometimes show flashes of heart activity, even after death has become truly irreversible, according to the study published in the New England of Medicine.
There is no shortage of morbid curiosity surrounding death. But according to the researchers behind this project, known as the Death Prediction and Physiology after Removal of Therapy Study, or DePPaRT, there is much we do not know for sure about the last minutes of someone’s life.
Since 2014, they have been collecting important sign data from dying patients in Canada, the United Kingdom and the Czech Republic as part of their work. Their main goal was to document as much as possible about the dying process, especially among critically ill people who receive life support. They also studied how and why families decide to donate their loved ones’ organs shortly before death and how the donation affects them. People in the study – about 600 in total – were admitted only with the express consent of their families. The project has received funding from the Canadian government as well as the Canadian research program for donations and transplants.
Although some organs, such as the kidneys, can be viable for more than a day before being transplanted, others, such as the heart, need to be transplanted within hours. Any delay could literally be the difference between life and death for the organ recipients. But people are understandably sensitive about death, and many families and some doctors may be hoping for a miraculous recovery, even after a person has been taken off maintenance.
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‘We realize that there are stories about people coming back to life, even from members of the medical community. So we really wanted to provide scientific evidence on the process of dying, to dispel potential myths for humans, ”project researcher Sonny Dhanani, a pediatrician at the CHEO Research Institute in Ontario, told Gizmodo by phone.
Nowadays, doctors are in Canada tell to wait at least five minutes after the cessation of blood circulation to the end of life before officially calling the person’s death period (in the US, two to five minutes is recommended). In the patients who studied this team, there were no cases where doctors were wrong about their death determination. That said, the film-friendly sign of death – an immediate flat line on an ECG monitor – was also not entirely correct.
Sometimes there were about 14% of the patients on-and-off moments of cardiac activity. However, it is important that these moments usually lasted for a few seconds and did not lead to the heart starting all over again, or to people suddenly waking up again. The longest time it took for a heart to stop completely was about four minutes, which suggests that the five-minute rule is indeed a good time to wait for the determination of death (would the heart during that period starts again, doctors will then wait another five minutes before declaring the time of death).
‘Doctors and families need to be aware of this 14% of the time. But they must also be reassured that this does not mean that the person will come back to life, ‘Dhanani said.
Insurance is too important for family members, especially when it comes to organ donation decisions. Of course, people can also offer that permission themselves by tentatively registering as a Organ donor.
When asked, Dhanani and his team were surprised at how many families chose to participate in the project (93%). And he hopes the work of his team will help people better realize the benefits of organ donation while reassuring them about the process.
“Ultimately, we want our research to help open up the custody around death, death and donation, which can be topics that can be uncomfortable,” he said. ‘And we hope this research can reassure people who are concerned about the idea of being a donor, perhaps because they’re afraid their organs will be taken away before they die. There is a clear process to donate, and our research has shown that people will not be abused. ‘