New research suggests that, fortunately, doctors are skilled at correctly identifying the time of death – a critical aspect of ensuring healthy organs for donation. At the same time, the body can sometimes show flitters of heart activity, even after death has become truly irreversible, according to de study published in the New England of Medicine.
There is no lack of morbid curiosity about 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 a lot we don’t know for sure about someone’s last minutes of life.
Since 2014, they have been collecting vital signs data from dying patients in Canada, the UK and the Czech Republic as part of their work. Their main goal was to document as much as possible about the dying process, especially in seriously ill people who have been taken off livelihoods. They also studied how and why families decide to donate the organs of their loved ones shortly before death and how the donation affects them. People in the study – about 600 in all – were only included after explicit consent from their families. The project received funding from the Canadian government and the Canadian Donation and Transplant Research Program.
While some organs, such as the kidneys, can be kept viable for more than a day before being transplanted, others, such as the heart, must be transplanted within hours. Any delay can 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 can hope for a miraculous recovery even after someone is taken off the livelihood.
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“We recognize that there are stories of people coming back to life, even from members of the medical community. So we wanted to provide real scientific evidence about the dying process to dispel possible myths for humans, ”project lead researcher Sonny Dhanani, a pediatrician at the CHEO Research Institute in Ontario, told Gizmodo over the phone.
Today they are in Canada told Wait at least five minutes after blood circulation has stopped after the end of life support before officially determining the time of death (two to five minutes is recommended in the US). In the patients this team studied, there were no instances where doctors were wrong about their death determination. That said, the movie-friendly sign of death – an instant flatline on an EKG monitor – wasn’t quite accurate either.
Occasionally there were occasional moments of cardiac activity in about 14% of patients. Importantly, however, these moments usually lasted a few seconds and did not cause the heart to reboot completely or suddenly wake people up. The longest time it took a heart to come to a complete stop was about four minutes, indicating that the five-minute rule is indeed a good amount of time to wait for the determination of death (should the heart restart, then doctors wait another five minutes before indicating the time of death).
“Doctors and families need to be aware of this 14% of the time. But they also need to be reassured that this does not mean the person will come back to life, ”said Dhanani.
That reassurance is all too important for families, especially when it comes to organ donation decisions. People can of course also offer this permission themselves by registering preventively as donor organs.
Dhanani and his team were surprised by how many families, when asked, chose to participate in the project (93%). And he hopes the work of his team will help people better recognize the benefits of organ donation, while at the same time being reassured about the process.
“Ultimately, we want our research to help open up the protections around death, dying, and donation, which are topics that can be uncomfortable,” he said. “And we hope that this study can reassure people who are concerned about the idea of becoming a donor, perhaps because they fear their organs will be taken before they die. Donating has a clear process and our research has shown that people will not be abused. “