Defining death take 2

As a physician, one of the actions we have to take is to pronounce someone's death. Now this is not as straight-forward as it seems to be. You could maybe attempt to check the patient's vital signs mainly respiratory movements, pulse. But when these stop, as in a respiratory arrest or cardiac arrest, not only this doesn't mean death in most cases, but on the contrary it means that emergency measures may be indicated to revert the condition and trying to keep the person alive, and with a quality of life. So what I'm saying is that at the moment of the arrest his neurons, myocites are still alive and have potential to stay alive.
These emergency measures are an attempt to get new oxygen into your blood and to get your blood flowing in your body taking that oxygen to your organs.
So that doesn't count as death. Patients can also be kept alive through mechanical ventilation, through drugs that keep their blood pressure at a minimum to oxygenate their organs, in hopes that the condition that led them to need these measures will be reversible and the patient will be able to maintain his blood pressure without drugs and be able to breath well without help from a respirator.
Sometimes this condition is not reversible, such as a damage so severe to the brain that there is no hope. In this kind of patient, for example young people who suffer from car accidents, their hearts have no disease and could be kept alive indefinitely with mechanical aid. But sometimes, this patient may brain dead. So maybe this is the best definition of death. How to define this is not easy as well. Because of organ donation, rigid protocols have been estabilished. They usually involve the observation of the absence of primitive reflexes and more elaborate exams such as an electroencephalogram or as my previous post a functional MRI attested by more than one physician.

How to define death.

As technologies advance further and further something that seems so simple as to say if somebody is dead or not becomes more and more complicated. Enter functional-MRI into the picture.
For people who came into my blog though I wrote a little bit more here.

Negligence

Today at work, I was forced to report negligence towards an elderly patient. I feel very sorry for this situation. This is the third time I have seen the same patient in a very short period of time. He always comes in a very poor state of hygiene. It is sad. His family doesn't seem to give him any of the medications necessary, they do not follow our orientations, and most of all they refuse to put him into a home.
They say they have to work and cannot watch him during the day, which is why now he is filled with pressure sores from his occipitus down to his ankles, they do not give him his medications that was prescribed because besides the fact that it is expensive, that will make him evacuate more often (which in fact is part of his treatment), and diapers are expensive as well. Today he came in with two diapers, which the nurse explained to me, make them last longer for the contents of one diaper will spill onto the other.
The most outrageous fact of all is that the family always is hard demanding on the whole staff to watch out for this patient: he is so sick, this is absurd, how could the let him go out of the hospital in this state. He always goes home a little bit better, but a few days later comes back a total wreck.
Which is why I made the choice of reporting him. Doesn't this run away from the medical-patient relationship? Should I have confronted the family more before doing this?

Self-inflicted diseases

I talked about this a while ago, one in four doctors in the UK are starting to think the same thing: Should we pay for self-inflicted diseases such as lung cancer and cirrhosis... As I mentioned in my post, I think there might be something good out of it if, and only if, you ensure free treatment to whomever is engaged in trying to stop their addiction.
Source: Kevin M.D. weblog