Ethical & Social Implications of Studying Cardiac Arrest
Recent advances in technology and techniques to improve resuscitation, along with groundbreaking research discoveries about the processes of cell death in the brain and body over the past several decades, have blurred the line between life and death. The study of cardiac arrest has opened research avenues in other fields including neuroscience and the study of consciousness. The ensuing findings have challenged deeply-held beliefs about the definition of death and the process of dying, and triggered debate and discussion about how this research may affect clinical practice, patients, and families.
Organ donation, palliative care, and end-of-life decision-making are all areas that stand to be deeply affected as resuscitation science continues to evolve. Technologies such as ECMO and post-cardiac arrest and hypothermia protocols, which can stall process of cell damage and death and prolong the timeframe during which death may be reversed, stand to change the paradigm for treating some cardiac arrest patients. People who would have long been considered beyond the point of saving can more often be saved.
These advances may have downstream impacts on organ donation programs, which rely on strict protocols to preserve and harvest organs shortly after the declaration of death. Even the notion of “declaration of death” may continue to have to be reviewed as the permanence of death is increasingly elasticized in some cases. Studies that reveal the mechanisms of consciousness, especially during cardiac arrest and in critically ill or vegetative patients, could be both helpful and challenging for families attempting to make palliative care and end-of-life decisions for loved ones, and also have widespread ramifications for ancient philosophical notions such as the mind body problem and the question of what happens when we die.