Dr Rajiv Desai

An Educational Blog

THE DEATH

THE DEATH

 

Prologue:

As a student of medicine, since I joined medical college in the year 1978, I have been a witness to death either in the form of dissecting a dead body or declaring someone dead. The dissecting cadaver (corpse) is a critical component of every medical education. Without the anatomical understanding of the human body that is afforded by dissection, much of modern medicine would simply not exist. I also remember a very difficult task of informing a crying mother that her only son died of poisoning. Hundreds of patients have died before me in my experience as a doctor. Many times my junior doctors have expressed apprehension of declaring someone dead because they were afraid that patient may still be alive and I used to teach them signs of death like unconsciousness, no response to any stimulus, no breathing, no pulse and no heart beat on auscultation with a stethoscope. To make doubly sure, I used to teach them to take a 12 lead ECG which will show flat line in all leads. It is easy to witness a death in humans but difficult to define death. 

 

Introduction:

In my article on ‘Duality of Existence’, I have shown that the distinction between living and non-living matter is arbitrary because every electron/photon has a consciousness. In my article on ‘Genetically Modified’, I have shown that every DNA in every living organism has consciousness. So somehow consciousness is the key word of deciding that something is alive. Consciousness means awareness of one’s own existence. When it comes to consciousness of humans, ‘I’ comes into picture.  I’d like to know where the “I” goes under you are under general anesthesia. Where does it go during sleep (for those of us who don’t recall dreams)? Where does the “I” go in someone who is in a coma? And is the “I” still the same, the fundamental spirit, for lack of a better term. If a stroke transforms the personality into something totally different from what it was like before that stroke, what happens to ‘I’?  Is it the same ‘I’? Can we separate the “I” from the brain? If you ablate area 17 of the occipital lobe of your brain, you lose vision. Ablate Broca’s area, and you take out speech. If you ablate the temporal lobes, you take out morality. Ablate the frontal lobe, and you radically transform personality, volition, and so on. So we know that the “I” is a function of the physiology and neurochemistry of the brain and therefore when the brain dies, ‘I’ also dies. So brain death means irreversible & permanent destruction of human consciousness, irreversible & permanent loss of ‘I’. However, it will be apparent later on in this article that even if brain is dead, other organs like heart, kidneys, liver etc may be still be alive because cells in these organs survive as long as they get blood circulation no matter whether brain is dead (‘I’ death) and these organs can be used to save lives of other humans by organ transplantation. So ‘I’ death in one human can make another ‘I’ in another human survive. On the other hand, a human may be alive & healthy with good functioning brain with full consciousness but cells of his other organs may be dying on daily basis by the process known as Programmed Cell Death (PCD).  PCD is death of a cell in any form, mediated by an intracellular program. In contrast to necrosis, which is a form of cell-death that results from acute tissue injury and provokes an inflammatory response, PCD is carried out in a regulated process which generally confers advantage during an organism’s life-cycle. PCD serves fundamental functions during both plant & animal tissue developments. PCD are of 2 types, Apoptosis or Type I cell-death and Autophagic or Type II cell-death (Cytoplasmic: characterized by the formation of large vacuoles which eat away organelles in a specific sequence prior to the nucleus being destroyed).  So what is apoptosis?  The term apoptosis had been coined in order to describe the morphological processes leading to controlled cellular self-destruction. Apoptosis is of Greek origin, having the meaning “falling off or dropping off”, in analogy to leaves falling off trees or petals dropping off flowers. This analogy emphasizes that the death of living matter is an integral and necessary part of the life cycle of organisms. The apoptotic mode of cell death is an active and defined process which plays an important role in the development of multicellular organisms and in the regulation and maintenance of the cell populations in tissues upon physiological and pathological conditions. For example, the differentiation of fingers and toes in a developing human embryo occurs because cells between the fingers apoptose; the result is that the digits are separate. Between 50 and 70 billion cells die each day due to apoptosis in the average human adult. For an average child between the ages of 8 and 14, approximately 20 billion to 30 billion cells die a day. Too little or too much apoptosis plays a role in a great many diseases. When programmed cell death does not work right, cells that should be eliminated may hang around and become immortal, for example in cancer. When apoptosis works overly well, it kills too many cells and inflicts grave tissue damage. This is the case in strokes and neurodegenerative disorders such as Alzheimer, Huntington and Parkinson diseases.  So what is death anyway? You are alive & healthy but your billions of cells are dying daily. You may be declared dead by a doctor but your organs are alive and can be transplanted in another human to save his life. Think over it.

 

If the “I” does in fact survive bodily death, we would like to know where the “I” goes. There comes a concept of the soul & the body. A soul in certain religious, spiritual, philosophical, and psychological traditions, is the incorporeal essence of a human being which is regarded as immortal, separable from the body at death, and susceptible to happiness or misery in a future state. The afterlife (also referred to as life after death) is an idea that soul in the form of consciousness continues to live after death of the body occurs, by natural or supernatural means. Major views on the afterlife derive from religion, esotericism and metaphysics. The concept of afterlife includes various experiences or phenomena right from reincarnation to near death experiences to out-of-body experiences to astral projection to EVP to mediumship etc. The concept of afterlife is also based on faith which is depicted in religious books like the Bible, the Quran, the Talmud, the Vedas, and the Tripitaka etc. One way that humans have devised for dealing with the tragedy of death and the knowledge of our own mortality is to develop complex visions of what might follow death. Major religions teach the immortality of the soul and put forward an afterlife of reward or punishment, depending on your performance when you were alive; and some teach that human souls cycle eternally, life after life. If a person does believe in the traditional dualistic & religious notion that the soul is separate and distinct from the physical body, then out-of-body experiences can be explained by a non-physical reality that does not lend itself to scientific experimentation of explanation. Such a phenomenon could not be investigated scientifically because science measures physical phenomena. Of course, it is possible that there is some kind of physical manifestation of the out-of-body soul that has not been measured yet because the appropriate scientific measures have not been applied to measuring it. (Has any scientist actually used existing scientific instruments to measure physical signs of the soul departing the body?) Alternately, from a scientist’s perspective perhaps we don’t yet even know of some physical forms of energy that correspond to the soul. It is quite possible that soul never existed and we are only imagining things depending on our religious teaching and in fact we are victims of confirmatory bias of our religious beliefs.

 

A near-death experience (NDE) refers to a broad range of personal experiences associated with impending death. These phenomena are usually reported after an individual has been pronounced clinically dead or otherwise very close to death, hence the term near-death experience. According to a Gallup poll, approximately eight million Americans claim to have had a near-death experience. Many view the NDE as the precursor to an afterlife experience, claiming that the NDE cannot be adequately explained by physiological or psychological causes, and that the phenomenon conclusively demonstrates that human consciousness can function independently of brain activity. NDEs are also associated with changes in personality and outlook on life. Among these changes one finds a greater appreciation for life, higher self-esteem, greater compassion for others, a heightened sense of purpose & self-understanding, desire to learn, elevated spirituality, greater ecological sensitivity & planetary concern, and a feeling of being more intuitive. Changes may also include increased physical sensitivity; diminished tolerance to light, alcohol, and drugs; a feeling that the brain has been “altered” to encompass more; and a feeling that one is now using the “whole brain” rather than just a small part. NDE researchers are trying to prove that consciousness can survive death.

 

Your life is created by mating of your father’s sperm with your mother’s ovum at the time of fertilization. Both the sperm and the ovum were living cells. These living sperm and ovum were created from the living cells of the bodies of father and mother which in turn were created from their respective embryos which in turn were created from the mating of the sperm of grand father and ovum of the grand mother and so on and on and on… So life is created from life of parental germ cells which in turn were created from grand-parental germ cells which in turn were created from great-grand-parental germ cells. In other words, life means ability of DNA to replicate in suitable environment to reproduce itself. When this ability is taken away, it becomes dead DNA. So death means permanent cessation of DNA’s ability to replicate itself. Since DNA functions like a biological internet in any living cell, this DNA’s ability to replicate itself is correlated with the functioning of the biological internet. In other words, death means irreversible cessation of the functioning of the biological internet of DNA.  I will give example. The undifferentiated amebas need never die, only divide. One amoeba divides into two amoebas and two amoebas divide into four amoebas and so on. That means the DNA in the nucleus of amoeba keeps on replicating into similar DNA and the biological internet of DNA continuously functions indefinitely. However, we can kill amoeba by boiling water as extreme heat kills amoeba. So extreme heat destroys the biological internet of amoeba permanently. In the same way we can view the potential immortality of human germ cells. You see, germ cells go on making more germ cells as well as our bodies. The line of germ cells goes on without a break from grandparents to parents to you. And now we see what death is. Death is the casting aside of the body after it has done its work. That work is to carry the germ cells, to feed it, to protect it, to warm it in a warm-blooded organism, and finally to mingle it with the germ cell of the opposite sex. With that, it has completed its function and can be discarded. The thought that life is through with the body once sexual reproduction has been accomplished is repugnant to us as humans because we consider ourselves civilized as opposed to animals. Yet now I should like to say that, repugnant or not, this would be no surprise to a salmon. For in salmon, and eels, and many such creatures, it is all too clear that reproduction is the last act of life, and that the preparation to reproduce is simultaneously the preparation to die. We humans declare someone dead but in fact his DNA is alive in his children and when his children die, his DNA continues to live in his grand children and so the life continues despite deaths of bodies. This invalidates the concept of soul & afterlife as discussed earlier. So this is the asymmetry between life and death. While cells and organisms may die, they have never been observed to arise from non-living material (spontaneous generation). In human affairs, we are normally concerned with the life and death of a person, not the death of his or her components.

 

If there is one thing we can be certain of in life, it’s that eventually we will die – that is, we will no longer be alive. Sadly we are not completely certain what “being dead” mean because defining death is much more complicated than it appears. Also, it seems it is not death per se that scares most people, once you’re dead (really dead, that is), you won’t know anything about it. What does seem to frighten people is the process of dying, and whether it will be painful. Another potentially frightening event is the death of a loved one. It can certainly be a very sad and painful time. There are thought to be five main stages of grief: disbelief, yearning, anger, depression and finally, acceptance. The most common emotional difficulty experienced is, unsurprisingly, emotional loneliness.

 

Death is the termination of the biological functions that sustain a living organism. The word refers both to the particular processes of life’s cessation as well as to the condition or state of a formerly-living body. Death is the irreversible ending of the vital processes by which an organism sustains itself including chemosynthesis, photosynthesis, cellular respiration, cell generation, and maintenance of homeostasis. Almost all animals fortunate enough to survive hazards to their existence eventually die from senescence. Rare and remarkable exceptions include the jellyfish Turritopsis nutricula, thought to be, in effect immortal. The medusa of Turritopsis nutricula is the only form known to have developed the ability to return to a polyp state, by a specific transformation process that requires the presence of certain cell types (tissue from both the jellyfish bell surface and the circulatory canal system). Careful laboratory experiments have revealed that all stages of the medusae, from newly released to fully mature individuals, can transform back into polyps. Polyps further multiply by growing additional stolons, branches and then polyps, to form colonial hydroids. This ability to reverse the life cycle (in response to adverse conditions) is probably unique in the animal kingdom, and allows the jellyfish to bypass death, rendering Turritopsis nutricula potentially biologically immortal. However, in spite of this remarkable ability, most Turritopsis medusae are likely to fall victim to the general hazards of life as plankton, including being eaten by other animals, or succumbing to disease.

 

Death means irreversible & permanent cessation of life functions. This can involve the whole organism (somatic death), individual organs (organ death), individual cells (cellular death), and individual parts of cells (organelle death). In traditional Western medical practice, death was defined as the cessation of the body’s circulatory and respiratory (blood pumping and breathing) functions. Death meant cessation of heartbeat (cardiac arrest) and of breathing, but the developments of CPR (cardiopulmonary resuscitation) and prompt defibrillation have rendered that definition inadequate because breathing and heartbeat can sometimes be restarted. Events which were causally linked to death in the past no longer kill in all circumstances; and without a functioning heart or lungs, life can sometimes be sustained with a combination of life support devices, organ transplants and artificial pacemakers. With the invention of machines that provide artificial circulation and respiration; that definition has ceased to be practical and has been modified to include another category of death called brain death.

 

In the United States, the states have adopted criteria for death modeled on the Uniform Determination of Death Act (developed by the President’s Commission, 1981), which says that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.” In the United Kingdom, the accepted criterion is brain stem death, or the “permanent functional death of the brain stem”. A dictionary defines a death in a better way: ‘Death is defined as the cessation of all vital functions of the body including the heartbeat, brain activity (including the brain stem), and breathing’.

 

Deaths in humans are classified into deaths due to natural causes (senescence, diseases) and unnatural causes (accidents, suicides and homicides including war). From all causes, roughly 150,000 people die around the world each day; out of which about two thirds die of age-related causes but in industrialized nations, the proportion is much higher reaching 90%. In developing nations, inferior sanitary conditions and lack of access to modern medical technology makes death from infectious diseases more common than in developed nations. One such disease is tuberculosis, a bacterial disease which killed 1.7 million people in 2004, Malaria causes about 1–3 million deaths annually and AIDS death toll in Africa may reach 90–100 million by 2025. Hunger or malnutrition cause death of 36 million people worldwide every year. Tobacco smoking killed 100 million people worldwide in the 20th century and could kill 1 billion people around the world in the 21st century.

 

Thanatology is academic and often scientific study of death among human beings. It investigates the circumstances surrounding a person’s death, the grief experienced by the deceased’s loved ones, and larger social attitudes towards death such as ritual and memorialization. It also describes bodily changes that accompany death and the after-death period. In most cases, thanatology is studied as a means towards the end of providing palliative care for dying individuals and their families. Thanatology recognizes that ultimately death is inevitable. It works to develop guidelines to ease the process of dying. Thanatology also studies the similarities and differences of various cultures around the world and their manner of dealing with death of themselves or a loved one. It is primarily an interdisciplinary study frequently undertaken by professionals in nursing, psychology, sociology, psychiatry, social work, and is offered as a course of study at many art schools.

 

Death can also be classified as biological death, legal death, religious death, clinical death and brain death.

 

Biological death:

Biological death means death at a cellular level when all metabolic & homeostatic processes of a living cell irreversibly close down and the cell dies along with enzymatic autolysis of cell organelles. I have already discussed how a human can be alive with death of billions of his cells by apoptosis and a human can be dead yet his organs with living cells can be transplanted. It is note-worthy that many types of human cells like blood & skin cells live for a short time and are replaced by new ones.

 

Legal death:

Legally, a person can be pronounced dead in three different ways. By far the most common is pronouncement by a medical doctor. The second most common is pronouncement by a coroner or a medical examiner. The third way a person can be pronounced legally dead is by the courts; after a person has disappeared for some time, the courts will pronounce them dead so that their property can be distributed appropriately. A death certificate is a legal document which states how and when a person died, and who pronounced them dead.

 

Religious death:

For the Roman Catholic Church, death is the “complete and final separation of the soul from the body”. However the Vatican has conceded that diagnosing death is a subject for medicine, not the Church. Followers of religions like Buddhism believe that the mind & body are integrated and have trouble accepting the brain death criteria to determine death. Some Orthodox Jews, Native Americans, Muslims and fundamentalist Christians believe that as long as a heart is beating even artificially, you are still alive. 

 

Clinical death:

Clinical death is the medical term for cessation of blood circulation and breathing, the two necessary criteria to sustain life. Since breathing rarely continues when the heart is stopped, clinical death would also mean cardiac arrest or cardiac death. The reversal of clinical death is sometimes possible through cardiopulmonary resuscitation (CPR), Defibrillation, Epinephrine injection, and other treatments. Resuscitation after more than 4 to 6 minutes of clinical death at normal body temperature is difficult, and can result in brain damage. Longer intervals of clinical death can be survived under conditions of hypothermia.  Most tissues and organs of the body can survive clinical death for considerable periods. Detached limbs may be successfully reattached after 6 hours of no blood circulation at warm temperatures. Bone, tendon, and skin can survive as long as 8 to 12 hours. However, the brain appears to accumulate ischemic injury faster than any other organ and full recovery of the brain after more than 3 minutes of clinical death at normal body temperature is rare without CPR. The purpose of CPR during cardiac arrest is ideally reversal of the clinically dead state by restoration of blood circulation and breathing so that oxygen can reach vital organs of body. If clinical death occurs unexpectedly, it will be treated as a medical emergency and CPR will be initiated. This effort will continue until either the heart is restarted, or a physician determines that continued efforts are useless and recovery is impossible. If this determination is made, the physician will pronounce legal death and resuscitation efforts will stop. If clinical death is expected due to terminal illness or withdrawal of supportive care, often a Do Not Resuscitate (DNR) order will be in place. This means that no resuscitation efforts will be made, and a physician may pronounce legal death at the onset of clinical death. Reduced body temperature, or therapeutic hypothermia, during clinical death slows the rate of injury accumulation, and extends the time period during which clinical death can be survived. The decrease in the rate of injury can be approximated by the Q10 rule, which states that the rate of biochemical reactions decreases by a factor of two for every 10°C reduction in temperature. As a result, humans can sometimes survive periods of clinical death exceeding one hour at temperatures below -20°C.

 

Brain death:

Until the late twentieth century, death was defined in terms of loss of heart and lung functions, both of which are easily observable criteria. However, with modern technology these functions can be maintained even when the brain is dead, although the patient’s recovery is hopeless. Therefore, a more advanced understanding of death was accepted by the medical community: when the brain dies before the heart and respiration ceases, this is known as neurological death or brain-death. Accordingly, it is misleading to call a patient “brain-dead”, since that sounds as if the patient is alive and merely suffering from a condition. The brain dead patient is dead and the medical community knows this by the fact that the brain is dead.

 

The term brain death is defined as irreversible unconsciousness with complete loss of brain functions including the brain stem, although the heartbeat may continue. Neuroscience experts define brain death as irreversible cessation of all functions of the entire brain, including the brain stem.  Physicians, health care workers, members of the clergy, and laypeople throughout the world have accepted fully that a person is dead when his or her brain is dead. There is a clear difference between severe brain damage and brain death. The physician must understand this difference, because brain death means that life support is useless, and brain death is the principal requisite for the donation of organs for transplantation. In adults, the chief causes of brain death are traumatic brain injury and stroke. In children, abuse is a more common cause than motor vehicle accidents or asphyxia. However, brain death also occurs following clinical death with failure to revive despite CPR but it is classified as clinical death and not brain death. It must be emphasized that when heart & lungs stop working irreversibly, consequently, the brain also dies due to lack of oxygen but it is not classified as brain death. Only 1 % of deaths in the U.S. result in brain death and rest all are clinical deaths. Brain death is the irreversible end of all brain activity (including involuntary activity necessary to sustain life) due to total necrosis of the cerebral neurons following loss of brain oxygenation. There is a controversy whether brain death means death of whole brain along with brainstem or death of only brainstem since all the vital centers to maintain circulation & respiration reside in brain stem. The brain mainly consists of the larger part of the brain (the cortex) and the smaller part of the brain (the brain-stem). Whole brain death is when the entire brain (both cortex and brain-stem) is not functioning, and medical tests show this to be irreversible. Brain stem death means irreversible cessation of functions of brain stem. In both cases, there is a total absence of any response whatsoever to stimulation, and a total lack of breathing and total unconsciousness and no chance of recovery.  The difference lies in the results of testing. In brain stem death, there are instances where blood succeeds in reaching other areas of the cortex and there can be measurable electrical tracings as indicated by an EEG. This is not necessarily indicative of brain function but rather that some cells have electrical activity. Even with this activity, if the patient is brain-stem dead, there is no chance of recovering consciousness or breathing.  Brain death, either of the whole brain or the brain stem, is used as a legal indicator of death in many jurisdictions.  Brain stem death has been the criterion in use in the United Kingdom for declaring death on neurological grounds since 1979. The UK ‘brain stem death’ standard for the diagnosis of death on neurological grounds ignores evidence of persisting life and function in other parts of the brain and has never been accepted in the USA – where the irreversible cessation of function of the entire brain, specifically including the brain stem (‘whole brain death’), is required. The US President’s Council on Bioethics has recently described the UK standard as “conceptually suspect” and ‘clinically dangerous’. Medical science contends that a permanent cessation of electrical activity of brain indicates irreversible loss of consciousness. The definition of brain death can be challenged in future only if technological advancement makes artificial brain possible.

 

Cardinal findings in brain death include coma or unresponsiveness, absence of cerebral motor responses to pain in all extremities, absence of brain stem reflexes, and apnea.  Medical criteria for the diagnosis of brain death when the patient is identified as a beating-heart organ donor are as follows:

Preconditions:

1) There should be no doubt that the patient’s condition – deeply comatose, unresponsive and requiring artificial ventilation – is due to irreversible brain damage of known aetiology.

2) There should be no evidence that this state is due to depressant drugs.

3) Primary hypothermia as the cause of unconsciousness must have been excluded.

4) Potentially reversible circulatory, metabolic and endocrine disturbances likewise excluded.

5) Potentially reversible causes of apnoea (dependence on the ventilator), such as muscle relaxants and cervical cord injury, must be excluded.

 

With these pre-conditions satisfied, the definitive criteria are:

1) Fixed pupils which do not respond to sharp changes in the intensity of incident light.

2) No corneal reflex.

3) Absent oculo-vestibular reflexes means no eye movements following the slow injection of at least 50ml of ice-cold water into each ear in turn (the caloric test). Absent oculo-cephalic reflex means eye balls remained fixed in position on movement of head laterally.

4) No response to supraorbital pressure.

5) No cough reflex to bronchial stimulation or gagging response to pharyngeal stimulation.

6) No observed respiratory effort in response to disconnection of the ventilator for long enough (typically 5 minutes) to ensure elevation of the arterial partial pressure of carbon dioxide to at least 6.0 kPa (6.5 kPa in patients with chronic carbon dioxide retention). Adequate oxygenation is ensured by pre-oxygenation and diffusion oxygenation during the disconnection (so the brain stem respiratory centre is not challenged by the ultimate, anoxic, drive stimulus). It should be noted this is a dangerous and potentially lethal test.

7) Two doctors, of specified status and experience, are required to act together to diagnose death on these criteria and the tests must be repeated after “a short period of time … to allow return of the patient’s arterial blood gases and baseline parameters to the pre-test state”.

8) Brain death is a clinical diagnosis. Confirmatory test may include two isoelectric (flat-line) EEGs 24 hours apart. The patient should have a normal temperature and be free of drugs that can suppress brain activity if the diagnosis is to be made on EEG criteria. Alternatively, a radionuclide cerebral blood flow scan that shows complete absence of intracranial blood flow can be used to confirm the diagnosis without performing EEGs. Other confirmatory tests for brain death include conventional cerebral angiography, extracranial doppler sonography (ECD), somatosensory & brain stem auditory evoked potentials (use of multimodality evoked potentials) and MRI. However, both EEG & ECD have false positives & false negatives and therefore cerebral angiography and cerebral blood flow studies are the most reliable investigations in confirming diagnosis of brain death.    

9) These criteria for the diagnosis of brain-death are not applicable to infants below the age of two months.

 

A study on fifty consecutive patients (aged 19-77 years, median 56 years) with primary cerebral diseases and the clinical signs of absent cortical and brainstem function were subjected to electroencephalography (EEG), brainstem acoustic evoked potentials (BAEP), extracranial Doppler ultrasonography (ECD) and arterial digital subtraction angiography (DSA). In the majority of cases the results of the technical tests agreed with the clinical signs and were suggestive of brain death. However, in one patient EEG revealed clear bioelectrical activity. In 6 cases, doubts existed about whether the EEG was isoelectric; in 3 of the 6 cases biological activity might have been present. In 31 of 42 patients ECD showed a typical pattern of intracranial circulatory arrest, in 9 of 42 ECD revealed a pattern suggestive of the cessation of cerebral blood flow. In four patients BAEP recordings compatible with brain death were recorded 2-3 days before intracranial circulatory arrest. In 2 patients with isoelectric EEG and absent BAEP arterial DSA demonstrated residual perfusion. The findings are discussed in view of the conceptional differences concerning brain death. It is concluded that the strict application of the concept of death of the whole brain requires angiographic demonstration of absent intracerebral blood flow.

 

Clinical observations compatible with the diagnosis of brain death:

These manifestations are occasionally seen and should not be misinterpreted as evidence for brainstem function.

1) Spontaneous movements of limbs other than pathologic flexion or extension response.

2) Respiratory-like movements (shoulder elevation and adduction, back arching, intercostal expansion without significant tidal volumes).

3) Sweating, blushing, tachycardia.

4) Normal blood pressure without pharmacologic support or sudden increases in blood pressure.

5) Absence of diabetes insipidus.

6) Deep tendon reflexes; superficial abdominal reflexes; triple flexion response.

7) Babinski reflex.

  

 

Brain death may result in legal death, but still with the heart beating, and with mechanical ventilation, all other vital organs may be kept completely alive and functional, providing optimal opportunities for organ transplantation. The non-living donor is kept on ventilator support until the organs have been surgically removed. If a brain-dead individual is not an organ donor, ventilator and drug support is discontinued and cardiac death is allowed to occur.

 

Organ transplantation has been one of the greatest advances of modern science that has resulted in many patients getting a renewed lease of life. It was included in the top five medical miracles of the last century. Transplantation would not be possible but for organ donation. Organs can be donated by a living person, after natural death and after brain death. Experts say that the organs from one donor can save or help as many as 50 people. The organs that can be donated include kidneys, heart, liver, pancreas, intestines, lungs, bone and bone marrow, skin, cornea etc After natural death only a few tissues can be donated (like cornea, bone, skin and blood vessels) whereas after brain death almost 37 different organs and tissues can be donated including critical organs such as kidneys, heart, liver and lungs. Various countries have passed laws on human organ transplant to streamline the activities of organ transplants.

 

Family members of patients with brain death need reassurance and accurate information. They may think that their loved one has a heartbeat and is therefore being “kept alive” by mechanical ventilation. They may also think that their loved one will get better through treatment or intensive rehabilitation. They must be explained that brain death is irreversible. Patients who are brain dead have permanently lost the capacity to think, be aware of self or surroundings, experience, or communicate with others. It is difficult for some families to understand that a person who has a heartbeat can be brain dead, because historically the presence of a heartbeat indicated life. Family members of a patient of brain death must be told in unequivocal language that brain death means death and not coma and therefore ventilator support ought to be discontinued.  Also, a living will can solve many problems surrounding brain death. A living will is made after intimate discussion with decision makers covering the many possible scenarios surrounding the end of life. This discussion is difficult, for few people like to contemplate their own demise. However, the benefits of a living will are substantial, both to physicians and to loved ones who are faced with making final decisions. Most states have passed living will laws, honoring instructions on artificial life support that were made while a person was still mentally competent.

 

The opponents of ‘brain death’ concept believe that it seems to be going too far to equate the life of a human being with the functioning of a single organ like brain. In fact for one period of our lives—namely during the very early stages of embryo development—we exist without a brain at all. An early embryo has no functioning brain, and is therefore not conscious, but is undeniably alive. However, at the age of about 3 weeks of embryo, brain tissue starts getting differentiated from a ball of cells albeit with no recognizable evidence of consciousness. Another problematic example concerns the case of brain dead mothers who have subsequently gone on to give birth, in one case 107 days after brain death was diagnosed. It seems strange to describe a woman’s body functioning as an organic whole in this way—even to the extent of producing breast milk for her unborn child – as “dead,” and if medical opinion is saying that dead patients can give birth it would seem to have lost touch with the ordinary common-sense understanding of what the words “life” and “death” mean. The opponents of ‘brain death’ concept believe that there is a real shortage of organs for transplant and therefore doctors have created concept of brain death so that more organs can be donated for transplant.

 

Signs of imminent death:

Physical death is a progressive process, during which there are some signs that usually indicate that death is imminent. Not all of the following changes occur, nor do they necessarily occur in any particular order, as the body shuts down during the dying process.

1) The dying individual may become increasingly tired and sleepy, and may be difficult to arouse. The dying individual may become confused much of the time and may no longer recognize familiar persons, places, or objects.

2) Hearing and vision may become impaired, and speech may be slurred, difficult to understand, or nonsensical.

3) A few dying individuals become restless or very anxious and move about frequently in the bed, pull at the bed clothes or bedding (linen clutch), and reach out.

4) The person may experience hallucinations.

5) Less nourishment will be required, and the person’s intake of food and water will diminish. Difficulty in swallowing (dysphagia) may also occur.

6) The person may sweat profusely.

7) The dying person may lose control of his/her urine or bowels (incontinence), necessitating that the individual be kept especially clean and dry in order to prevent bed sores (decubitus ulcers).

8) Urination may become darker and diminish or stop.

9) The mouth of the dying individual may become dry, and then secretions may accumulate in the back of the throat. Breathing may become noisy because of the gurgling or rattling of the secretions in the mouth or chest (“death rattle”).

10) The pattern of breathing may change; become slower or faster, deeper or shallower, or irregular. Often the dying individual will have periods of rapid breathing followed by periods in which breathing is very slow or is even absent for as long as 15 seconds.

11) The legs, and then arms, may become cold and non-reflexive as the circulation slows down.

12)  The skin may be pale or mottled, and some parts, particularly the underside of the body, may become a dark color as the blood pools, usually a deep blue or purple.

 

Vegetative state:

Patients in a vegetative state may have awoken from a coma after severe brain injury, but still have not regained awareness. Recovery of consciousness may occur without functional recovery, but functional recovery cannot occur without recovery of consciousness.  In the vegetative state patients can open their eyelids occasionally and demonstrate sleep-wake cycles, but completely lack cognitive function. The vegetative state is also called a “coma vigil”. The chances of regaining awareness diminish considerably as the time spent in the vegetative state increases. The persistent vegetative state (PVS) is the standard usage for a medical diagnosis, made after numerous neurological and other tests, that due to extensive and irrevocable brain damage, a patient is highly unlikely ever to achieve higher functions above a vegetative state. Individuals in PVS are seldom on any life-sustaining equipment other than a feeding tube because the brainstem, the center of vegetative functions (such as heart rate and rhythm, respiration, and gastrointestinal activity) is relatively intact. Recovery after long periods of time in a PVS has been reported on several occasions and is often treated as spectacular events. In a severe vegetative state the cerebral cortex, the center of cognitive functions including consciousness and intelligence, may be dead while the brain stem, which controls basic life support functions such as respiration, is still functioning. Relatives will often remark, when facing severe vegetative state, “Well, any chance is better than none”. But this is not true; the chance of survival might only be bought at the cost of a very high risk of an unacceptably bad survival. This is a serious wager because we have a responsibility to do what the patient would want if he were able to choose. As opposed to brain death, severe vegetative state is not recognized by statute as death in any legal system.            

 

Shattering the dogma:

Suppose somebody has just died of heart attack. The patient couldn’t be revived because the tissues of his brain and heart had suffered irreversible damage from lack of oxygen. This process was understood to begin after just four or five minutes. If the patient doesn’t receive cardiopulmonary resuscitation (CPR) within that time, and if his heart can’t be restarted soon thereafter, he is unlikely to recover. That dogma went unquestioned until researchers actually looked at oxygen-starved heart cells under a microscope. To their astonishment, the researchers found that heart cells were alive for few hours even after the blood supply was cut off. But if the cells are still alive, why can’t doctors revive someone who has been dead for an hour? Because once the cells have been without oxygen for more than five minutes, they die when their oxygen supply is resumed. It was that “astounding” discovery. Biologists are still grappling with the implications of this new view of cell death—not passive extinguishment, like a candle flickering out when you cover it with a glass, but an active biochemical event triggered by “reperfusion,” the resumption of oxygen supply. The research takes them deep into the machinery of the cell, to the tiny membrane-enclosed structures known as mitochondria where cellular fuel is oxidized to provide energy. Mitochondria control the process known as apoptosis, the programmed cell death; and it is the apoptosis of abnormal cells that is the body’s primary defense against cancer. It appears that the cellular surveillance mechanism cannot tell the difference between a cancer cell and a cell being reperfused with oxygen. Something throws the switch that makes the cell die. Researchers say that while resuscitating we should aim to reduce oxygen uptake, slow metabolism and adjust the blood chemistry for gradual and safe reperfusion. A study found remarkable rate of success in treating sudden cardiac arrest with an approach that involved among other things, a “cardioplegic” blood infusion to keep the heart in a state of suspended animation. Patients were put on a heart-lung bypass machine to maintain circulation to the brain until the heart could be safely restarted. The study involved just 34 patients, but 80 percent of them were discharged from the hospital alive as compared to 15 % success rate of traditional method. So the body in the emergency room is clinically dead, but its trillions of cells are all still alive and we want to resolve that paradox in favor of life.

 

Scientific research on clinically dead dogs:

The scientists at a leading university have killed dozens of dogs and then brought them back to life. Several dogs have their veins drained of blood and filled with an ice-cold salt solution which drops their body temperature from a normal 101 degrees to near freezing. That puts them in a state of extreme hypothermia, making them scientifically dead with no breathing, no heartbeat and no brain activity. But their tissues and vital organs are preserved. These corpses are then brought back to life by returning the blood to their bodies, giving them pure oxygen and applying electric shocks to restart their hearts. The test subjects could be brought back to life from the state of being dead for the period of maximum three hours. Anything more than three hours and they could not be revived. The lucky ones turn out to be perfectly normal with no brain damage — although other dogs are stricken with serious physical or behavioral problems. The animal-rights activists slammed the research as “indefensible,” cruel and inhumane. However, the researchers say that they are developing technique for suspended animation to help humans who are injured in combat or crime. The issue before me is that a highly evolved mammal was clinically dead with no brain activity & no heart activity for three hours and revived back to life.

 

Cryopreservation:

Cryopreservation is a process where cells or whole tissues are preserved by cooling to low sub-zero temperatures at – 196 °C (the boiling point of liquid nitrogen). At these low temperatures, any biological activity, including the biochemical reactions that would lead to cell death, is effectively stopped. Cryogenic storage at very low temperatures is presumed to provide an indefinite, if not near infinite, longevity to cells although the actual “shelf life” is rather difficult to prove. A new technique named vitrification is the process of converting something into a glass-like solid that is free of any crystal formation. For example, by adding a cryoprotectant, water can be cooled until it hardens like glass without any ice crystals forming. This is important in the embryology world because ice crystal formation can be very damaging to frozen embryos (or other frozen cells). So it is now also possible to freeze human embryos and store them in liquid nitrogen. These frozen embryos can be stored for as long as is needed – even for many years. When they are in liquid nitrogen, at a temperature of -196 C, they are in a state of suspended animation, and all metabolic activity at this low temperature stops. Pregnancy rates with good-quality frozen-thawed embryos are as good as with fresh embryos. It is reassuring to know that the risk of birth-defects is not increased as a result of freezing. So these frozen embryos are almost dead at minus 196 degree centigrade with no metabolic activities for many years but can develop into a normal human being.

 

After death:

Immediately after death, blood circulation stops and various changes occur in a dead body.

 

Algor Mortis (body temperature): After death, body temperature declines progressively until it reaches the temperature of its surroundings. This process generally takes about 8 to 12 hours on the skin, but the centre of the body takes about three times as long to cool. This fact can be used to estimate time of death.

 

Rigor mortis: The breakdown of glycogen in the muscles of a dead body leads irreversibly to high levels of lactic acid in the muscles. This leads to a complex reaction where actin and myosin fuses to form a gel. This gel is responsible for the stiffness felt in the body. This stiffness will not be over before decomposition begins. Rigor mortis should never be the only basis for estimating time of death. After the onset of putrefaction (about two days after death) the body temperature will increase again, due to the metabolic activity of the bacteria and other decomposing organisms. 

 

Autopsy:

An autopsy (postmortem examination) is a medical procedure that consists of a thorough examination of a human corpse (dead body) to determine the cause and manner of a person’s death and to evaluate any disease or injury that may be present. It is usually performed by a specialized medical doctor called a pathologist. The time of death is sometimes extremely important. It is a question almost invariably asked by police officers, sometimes with a touching faith in the accuracy of the estimate. Determining the time of death is extremely difficult, and accuracy is impossible. The time of death can be ascertained by the study of the amount and distribution of rigor mortis, the change in body temperature, and the degree of putrefaction of the body.

 

Temperature of body Stiffness of body Time since death
Warm  Not stiff  Dead for less than three hours
Warm  Stiff Dead between 3 to 8 hours
Cold  Stiff Dead between 8 to 36 hours
Cold Not stiff Dead in more than 36 hours

 

Time of death can also be ascertained by comparing the occurrence of events which took place at known times with the time of occurrence of the death. For example, a wrist watch stopped by a blow during an assault, the extent of digestion of the last known meal etc. Other benefits of autopsy include allaying a family’s fears about what they could have done to prevent the death, providing family members information about potential genetic diseases that may have implications for them, medical education, training and research leading to improved health care and providing information about preventable causes of disease and accident and other public health hazards.

 

Dying declaration:

In the law of evidence, the dying declaration is testimony that would normally be barred as hearsay but may nonetheless be admitted as evidence in certain kinds of cases because it constituted the last words of a dying person. However, it must be emphasized that it is wrong to assume that the dying person always speak truth. Also, the defendant has a right to cross-examine a witness who has given testimony against him but since the person who gave ‘dying declaration’ is already dead, he can not be cross-examined. Under such circumstances, many courts have ruled out dying declaration as a mere ‘hearsay’.

 

Misdiagnosed death:

There are many anecdotal references to people being declared dead by physicians and then “coming back to life”, sometimes days later in their own coffin, or when embalming procedures are about to begin. This is especially true in neonatal death immediately after birth or alleged stillbirth. In cases of electric shock, CPR for an hour or longer can allow stunned nerves to recover, allowing an apparently dead person to survive. People found unconscious under icy water may survive if their faces are kept continuously cold until they arrive at an emergency room. The comatose patient from drug overdose or hypothermia may mimic being dead but can be revived.

 

A faked death occurs when an individual leaves evidence to suggest that he or she is dead in order to mislead others to fraudulently collect insurance money or avoid capture by law enforcement for some other crime. People who fake their own deaths sometimes do so by ostensibly drowning, because it provides a plausible reason for the absence of a body.

 

Practice of disposal of corpses:

I will not discuss religious beliefs or family traditions or costs for the disposal of a corpse. Every year more than 50 million people die worldwide. The two main forms of funeral rites adopted by most are either cremation or burial.

 

Cremation is the practice of disposing of a corpse by burning. Most archaeologists believe that cremation was invented during the Stone Age, about 3000 BC. The word cremation comes from the Latin word cremo which means “to burn” – particularly the burning of the dead. Cremation generally involves the application of high temperature, typically between 1400 and 2100 Degrees Fahrenheit (760 to 1150 Deg. C), to a wooden package or casket which contains a dead body. The body and the wooden-package are almost completely consumed; the cremated remains consist of bone fragments and particles, which usually weigh from 4 to 8 pounds (1.8 to 3.6 kg). They are then finely ground into granule form. The entire process takes 3 to 5 hours. Although the attendants attempt to remove all of the remains, a small portion will be left inside the cremation chamber, and subsequently mingled with the next body to be cremated. Cremations release both mercury and poisonous chemicals into the environment – carcinogenic dioxin, hydrochloric acid, hydrofluoric acid, sulphur dioxide, carbon dioxide, nitrogen oxides, carbon monoxide, particulate matter, hydrogen fluoride (HF), NMVOCs, and other heavy metals, in addition to Persistent Organic Pollutants (POP). Cremation of one adult body releases 50 kg of carbon dioxide and 200 micrograms of toxic mercury in the environment harming the ecology. In addition, cremation can be an aid to murderers. A cremated body cannot be exhumed and analyzed for evidence. There are many instances where in a suspicious death occurs, and a certain member of the family insists upon cremation. It usually turns out that this one family member is a suspect in the death. However, during the Black Plague epidemic, when having too many bodies during the burial process would spread disease to an already dangerously depopulated Europe, cremation was preferred over burial. Some times some persons who died with severe contagious diseases like tuberculosis, are likely to spread that disease as the bacteria spread after death but cremation that is consuming the body to fire eliminates this possibility and so it is welcome from health point of view. Also, it is a quicker and easier way to dispose off dead body. Once cremated and flushed, the place can be used for any number of times. Required wood is readily available from dead/dried trees.

 

When Christianity became the official religion of the Roman Empire, and the followers of other religions were exiled or exterminated, burial became the only method of disposing of bodies throughout Europe. “Cemetery” has its roots in the ancient Greek for “sleeping place,” a reflection on the belief that death is a type of sleep. The deceased is buried in a coffin and left to decompose over time. Decomposition takes more than six months in usual and it takes years together for decaying of bones, especially skull & pelvis. Unless everything is clear, we can not bury another person on the same place. For want of sufficient space, it is not practicable in every village and don’t think of cities. Also for burial, lot of trees are cut for making coffins. Natural decomposition after burial seems less harmful to the environment, especially when a shroud rather than a coffin is used. However, burial is also a known source of certain environmental contaminants. Embalming fluids, for example, are known to contaminate groundwater with mercury, arsenic and formaldehyde. Each year, traditional burials in the U.S. deposit 827,060 gallons of embalming fluids – formaldehyde, methanol, and ethanol – into the soil which are then washed by rainfall into the seas and lakes, endangering the ecosystem with pharmaceutical wastes. The coffins themselves are another known source of contamination. Another concern is contamination from radioisotopes that entered the body before death or burial.

 

Newer greener method for disposing of your mortal remains includes Aquamation where the corpse is placed into a steel container and potassium is added, followed by water heated to 93 degree Centigrade. The flesh and organs are completely decomposed in 4 hours, leaving bones as the only solid remains. Aquamation uses only 10 per cent of the energy of a conventional cremation and releases no toxic emissions.  Another method involves freeze-drying of the corpse in liquid nitrogen, pulverizing it with high frequency vibrations into powder that can be used as much for trees or shrubs planted in the cemetery or in the family’s back yard.

 

So various methods are available for disposal of a corpse but as a general rule, whenever foul play is suspected in death, bury the body and whenever infectious disease has caused death, cremate the body.          

 

DNA test for identity of a person after death:

Under normal circumstances, a buccal (oral) or blood sample will be taken from a living human for the study of DNA but there may be plenty of DNA recoverable from a human body 10, 50 or even 150 years after death. Also, DNA has been extracted from Egyptian mummies 2,400 years after their deaths and DNA has been extracted from Mammoths preserved in permafrost over 27,000 years after they died and Human DNA has been recovered from a Neanderthal fossil 70,000 years old. Generally, DNA testing is quite reliable on a deceased person prior to cremation but it is once the DNA is exposed to the heat of cremation, it does not survive intact. If the person is recently deceased, within a week of death, samples such as fingernail clippings or hair (with roots attached) may be collected. DNA is present in these tissues and may still be viable after death. It is important to note that if the decedent’s body has been exposed to preservatives such as formalin, the DNA in these and other tissues may be damaged and, therefore not useful in DNA testing. If the decedent’s body has already been buried, one may consider trying to obtain personal effects of the decedent. Many items such as toothbrushes, cigarette butts and worn & unwashed clothing may contain the owner’s DNA and can prove useful in DNA testing. When all else fails, and there is justification for exhumation of a decedent’s body, DNA may still be found in the exhumed remains. Generally, there will be no soft tissue remaining, and if so, it is likely not to be viable. In this case, the recommendation is to obtain a two-gram bone sample from the humerus or femoral shaft or alternatively two teeth. DNA is vulnerable. It breaks down in sunlight and water, and there are enzymes that naturally destroy it. But long after death, DNA would survive in teeth and bones.  

 

Euthanasia:

Euthanasia is the act of killing an incurably ill person out of concern and compassion for that person’s suffering. It is sometimes called mercy killing. Euthanasia is usually separated into two categories: passive euthanasia and active euthanasia. Withholding or withdrawing life-sustaining medical care is often classified as a form of passive euthanasia. Active euthanasia, sometimes called aid in dying, on the other hand, can consist, for example, of a physician’s giving a patient a lethal injection of medication. Opponents of active euthanasia argue that it undermines the value of and respect for all human life; erodes trust in physicians; desensitizes society to killing; and contradicts many people’s religious beliefs. In the United States, active euthanasia is generally recognized as murder or manslaughter, whereas passive euthanasia is accepted by professional medical societies and the law in certain circumstances. The American medical association (AMA) considers euthanasia – which it defines as ‘the administration of a lethal agent by another person to a patient’ – to be a breach of professional ethics. In a way, euthanasia may be classified as medically assisted suicide involving people who are terminally ill, in extreme pain, or have (perceived or construed) minimal quality of life through injury or illness.

 

Suicide:

Suicide is the act of a human being intentionally causing his or her own death. Over one million people commit suicide every year. There are an estimated 10 to 20 million non-fatal attempted suicides every year worldwide. Mental disorders are frequently present at the time of suicide with estimates from 87% to 98%. Besides mental disorders, other causes are substance abuse, socio-economical factors and genetic factors. The leading methods of suicide in different regions include hanging, insecticide poisoning, and firearms. According to stricter definitions of suicide, to be considered suicide, the death of the person who commits suicide must be the central component and only intention of the act, not just a certain consequence; and hence, suicide bombing is considered a kind of bombing rather than a kind of suicide, and martyrdom usually escapes religious or legal proscription.

 

DEATH PENALTY (CAPITAL PUNISHMENT):

 

The Death Penalty has existed long before 2500 BC, when Hammurabi was the first to create written law. Before that time, it’s likely that if a person committed a capital crime, such as murder or theft, they were executed to maintain harmony in the community. Even though the world’s most major religions take an ambiguous position on the morality of capital punishment, the doctrines of the world’s majority religions, which is to say the Bible, the Torah, and the Quran, have occurrences where the death penalty is not only supported, but staunchly endorsed. As a result, the religious doctrine is and will continue to be one of the strongest arguments for death penalty, especially in countries where religious doctrine has a strong influence on legal doctrine, such as countries within the Middle East, Israel, and even the United States. In Islam, death penalty is allowed but the family of a murder victim can pardon the murderer. However, in the 2010 world, killing a criminal is more and more being considered a barbaric practice with revenge instead of retribution being the sole motivating factor.

 

The death penalty (capital punishment) is the killing (execution) of a person by judicial process as a punishment for an offense. The term capital originates from Latin capitalis, literally “regarding the head” (Latin caput). Hence, a capital crime was originally one punished by the severing of the head. Crimes that can result in a death penalty are known as capital crimes or capital offences but  what is capital crime is debatable & variable and therefore various countries have implemented death penalty on various offences depending on religion, culture, type of offences, type of state, people’s inclination etc. Although laws vary between different countries as to capital punishment, the crimes for which it is most commonly used are murder and drug-related offenses. In some countries sexual crimes such as rape, adultery, incest and sodomy carry the death penalty, as do religious crimes such as apostasy in Islamic nations (the formal renunciation of the state religion). In China, human trafficking and serious cases of corruption are punished by the death penalty. In militaries around the world courts-martial have imposed death sentences for offenses such as cowardice, desertion, insubordination, and mutiny. The death penalty was overwhelmingly practiced in poor and authoritarian states, which often employed death penalty as a tool of political oppression.

 

 

In the year 2007, UN passed a non-binding resolution (by 104 to 54, with 29 abstentions) by asking its member states for “a moratorium on executions with a view to abolishing the death penalty”. Among non-governmental organizations (NGOs), Amnesty International and Human Rights Watch are noted for their opposition to capital punishment. According to them, the death penalty is the ultimate denial of human rights. It is the premeditated and cold-blooded killing of a human being by a state. This cruel, inhuman and degrading punishment is done in the name of justice. It violates the right to life as proclaimed in the Universal Declaration of Human Rights. Amnesty International opposes the death penalty in all cases, without exceptions, regardless of the nature of the crime, the characteristic of the offender, or the method used by the state to kill the prisoner. The death penalty specifically and explicitly violates the right to life clause stated in most modern constitutions and human right treaties. The Supreme Court of India ruled in 1983 that the death penalty should be imposed only in ‘the rarest of rare cases.’ In India, capital punishment is awarded in the “rarest of rare” cases and there are adequate safeguards provided in the law in this regard.  

 

In Canada, Australia, New Zealand, Latin America, and Western Europe, the death penalty has become relatively unpopular, with the majority of the population opposing it. However certain cases of mass murder, terrorism, and child murder occasionally cause waves of support for reinstitution. Abolition was often adopted due to political change, as when countries shifted from authoritarianism to democracy, or when it became an entry condition for the European Union. In United States some 15 states have had bans on capital punishment for decades while others actively use it today. The death penalty there remains a contentious issue which is hotly debated. In the U.S., surveys have long shown a majority in favor of capital punishment. 74% of Americans support the death penalty; nearly half of those do not think the death penalty is used enough. A Gallup International poll from 2000 said that “Worldwide support was expressed in favor of the death penalty, with just more than half (52%) indicating that they were in favour of this form of punishment.” Capital punishment has in the past been practiced in virtually every society, although currently only 58 nations actively practice it, with 95 countries abolishing it (the remainder having not used it for 10 years or allowing it only in exceptional circumstances such as wartime). In the European Union member states, Article 2 of the Charter of Fundamental Rights of the European Union prohibits the use of capital punishment. The four most populous countries in the world (China, India, United States and Indonesia) where 44 % of world’s population live, apply death penalty and all of them voted against the Resolution on a Moratorium on the use of the Death Penalty at the UN General Assembly in 2008.  Since World War II there has been a trend toward abolishing the death penalty. According to Amnesty International, at least 714 executions were known to have been carried out in 18 countries in 2009. In addition, there are countries which do not publish information on the use of capital punishment, most significantly China, which is estimated to execute hundreds of people each year. At least 17,000 people worldwide were under sentence of death at the beginning of 2010. Countries which retained death penalty are called ‘retentionist’ and countries which abolished death penalty are called ‘abolitionist’ countries. For example, India is retentionist country while England is abolitionist country. Singapore, Japan, Taiwan, South Korea and the U.S. are the only developed countries that have retained the death penalty.

 

Terrorism, drug trafficking and death penalty:

Those who really think that death penalty can stop terrorist attacks or make them decrease, are naïve people or dreamers. Usual punishments, death penalty included, don’t provoke any fear within terrorists or political criminals, who are ideologically motivated and devoted to die for passion of their cause. Their religious masters have already brain-washed their minds in thinking that they will straight go to heaven after death. Besides, terrorist activities are dangerous and the terrorist faces lethal risks every day, so he isn’t frightened by immediate death. How could he be discouraged by the risk of being sentenced to death?  Also, there is no convincing evidence that a decrease of drug traffic in interested countries could be attributed to the threat or application of capital punishment. In Iran, executions for drug crimes started before the revolution in 1979. It turns out that later, over a thousand people have been sentenced to death; and yet drug abuse and trade are still a serious problem, not solved at all. In Malaysia, where death penalty for drug crimes is compulsory since 1983, authorities have more than once publicly acknowledged its ineffectiveness. On the grounds of many experts’ experience, the fact that as utmost punishment there is death penalty doesn’t imply necessarily that it has particular effects against drug traffic; as a matter of fact in some cases it could complicate Public Prosecution’s activity since law courts need much higher standards of evidence if death penalty is provided (particularly if it’s compulsory). The most effective deterrent is surely the certainty to be discovered and arrested. There is some merit in suggestion that terrorists should be given life imprisonment without parole so that their wish of going to heaven after death is converted into living in solitary confinement in this world till death.

 

Methods of execution include electrocution, firing squad or other sorts of shooting, stoning in Islamic countries, beheading, gas chamber, hanging, and lethal injection. Opponents of death penalty find methods of execution as barbaric & inherently cruel and will always mock the attempt to cloak them in justice. Our society has nonetheless steadily moved to more humane methods of carrying out capital punishment.

 

Arguments put forward by supporters of death penalty:

1) It is justified by the principle of retribution.

2) It deters crime and future murders.

3) Life imprisonment is not an equally effective deterrent.

4) The death penalty affirms the right to life by punishing those who violate it in the strictest form.

5) It is a good tool for police and prosecutors.

6) It improves the community by making sure that convicted criminals do not offend again.

7) It provides closure to surviving victims or loved ones.

8) It is a just penalty for a heinous crime.

9) The threat of death leads defendants to enter plea deals for life without parole or life with a minimum of 30 years—-the two other penalties, besides death, that the law allows for aggravated murder.

 

Arguments put forward by opponents of death penalty:

1) It has led to the execution of wrongfully convicted.

2) It is arbitrary and discriminates against minorities and the poor.

3) It does not deter criminals more than life imprisonment; life without parole is just as effective a way to prevent someone re-offending as executing them.

4) It encourages a “culture of violence” and its main motive is not justice but revenge.

5) Killing someone is always wrong and two wrongs can never make a right.

6) It violates basic human right, the right to live in this world.

7) It is more expensive than life imprisonment.

 

Discussion:

What is justice anyway?

 

 

“May the punishment fit the crime.”  This is definitely the best definition of justice that has ever existed or ever will exist. A desire for justice is one of the inherent qualities of most humans, and it prevents society from falling into a despotic chaos where the average, peaceful person would be subject to the anger, violence, and madness of criminals. A society’s law, and the justice that is dispensed by its hands, is ultimately what keeps the citizenry of that society safe at night if anything does. For the sake of society’s stability, fair and swift justice must always exist, and the complete removal of people who would destroy that society through crime is absolutely necessary. The death penalty serves this purpose better than any other form of punishment, as it ultimately ensures that a criminal can never harm another person again.

 

Morality of death penalty:

Abolitionists may contend that the death penalty is inherently immoral because governments should never take human life, no matter what the provocation. Death sentences are imposed in a criminal justice system that treats you better if you are rich and guilty than if you are poor and innocent. This is an immoral condition that makes rejecting the death penalty on moral grounds not only defensible but necessary for those who refuse to accept unequal or unjust administration of punishment. The legacy of racial apartheid, racial bias, and ethnic discrimination is unavoidably evident in the administration of capital punishment in America. Abolitionists contend that capital punishment is cruel and unusual. It is a relic of the earliest days of penology, when slavery, branding, and other corporal punishments were commonplace. Like those other barbaric practices, executions have no place in a civilized society. Opposition to the death penalty does not arise from misplaced sympathy for convicted murderers. On the contrary, murder demonstrates a lack of respect for human life. For this very reason, murder is abhorrent, and any policy of state-authorized killings is immoral. Executions give society the unmistakable message that human life no longer deserves respect when it is useful to take it and that homicide is legitimate when deemed justified by pragmatic concerns. A decent and humane society does not deliberately kill human beings. An execution is a dramatic, public spectacle of official violent homicide that teaches the permissibility of killing people to solve social problems — the worst possible example to set for society. We cannot teach that killing is wrong by killing. Abolitionists oppose capital punishment not just for what it does to those guilty of horrible crimes, but for what it does to all of us as a society. Increasing reliance on the death penalty diminishes all of us and is a sign of growing disrespect for human life. We cannot overcome crime by simply executing criminals, nor can we restore the lives of the innocent by ending the lives of those convicted of their murders. The death penalty offers the tragic illusion that we can defend life by taking life. In the brutalization hypothesis, capital punishment may send a certain message that it is acceptable to kill in some circumstances, or that society has a disregard for the sanctity of life.

 

Let me discuss what retentionist may contend. The communities would plunge into anarchy if they could not act on moral assumptions less certain than death penalty for crimes such as mass murder, terrorism, rape with murder etc. The death penalty gives the guilty the befitting punishment for whatever wrong he has done and not treat him as an animal with no moral sense. Most abolitionists acknowledge that they would continue to favor abolition even if the death penalty were shown to deter more murders than alternatives could deter. Abolitionists appear to value the life of a convicted murderer or, at least, his non-execution, more highly than they value the lives of the innocent victims who might be spared by deterring prospective murderers. Also by abolishing death penalty, a murderer’s life has got more value than the value of the life of his innocent victim. Have you ever thought about how many criminals escape punishment and yet, the victims never have a chance to do that?  Are crime victims in the world today the forgotten people of our time?  Do they receive full measure of justice?  It can not be overemphasized that the human rights of victims and future victims are consistently ignored because many criminals are never caught and even when caught escape death penalty. A criminal on death row has a chance to prepare his death, make a will, and make his last statements etc; while most victims can never do it. There are many other crimes where people are injured by stabbing, rape, theft, etc. To some degree at least, the victim’s right to freedom and pursuit of happiness is violated. Opponents of death penalty show virtually no compassion for the victims of violent crime or concern for future victims, yet, they exhibit overwhelming support for those who violate our human rights and murder our loved ones. Opponents equate legal execution with murder, believing that if two acts have the same ending or result, then those two acts are morally equivalent. This is a morally untenable position. Is the legal taking of property to satisfy a debt the same as a car theft? Both result in loss of property. Are kidnapping and legal incarcerations the same? Both involve imprisonment against one’s will. Is killing in self defense the same as capital murder? Both end in taking human life. Are rape and making love the same? Both may result in sexual intercourse. How absurd. Opponents’ flawed logic and moral confusion mirror their “factual” arguments – there is often an absence of reality. The moral confusion of some opponents is astounding. Some equate the American death penalty with the Nazi holocaust. Opponents see no moral distinction between the slaughter of 6 million totally innocent men, women & children and the just execution of society’s worst human rights violators. There is a very common anti death penalty slogan: “Why do we kill people to show that killing people is wrong?” We don’t. Even with no sanction, most folks know that committing murder is wrong. We execute guilty murderers who have murdered innocent people. The difference between crime and punishment, guilty murderers and their innocent victims is very clear to most. The moral confusion exists when people blindly accept the amoral or immoral position that all killing is equal. The anti death penalty folks are looking at an act — “killing” — and saying all killings are the same. Only an amoral person would equate acts, without considering the purpose behind them.  Irresponsible editors & anchors, politicians & authors debate ‘live’ on television about abolition of death penalty of a criminal who raped & murdered an innocent woman. My blood starts boiling. I wonder how people watch such debate on television. I want to ask a question to various editors & anchors, what would you do if your wife or sister or daughter is brutally raped and then murdered?  Would you come on a television program and support abolition of death penalty?  People who talk of abolition of death penalty in such cases are misguided people and countries which have abolished death penalty ought to consider reinstating it. Let me put it differently. Had a murder not committed, the victim would still be alive and help his family/ nation/ society in many ways. Had a doctor not murdered, he would have saved many lives. Had a scientist not murdered, he would have made many discoveries & inventions. Had a leader not murdered, he would have made many good policies. So when a criminal murders someone, it is not only personal loss to victim’s family but it could be loss to society and the world.

 

It is assumed that an individual who commits a heinous crime must have been “damaged” by his environment. Hence, there are always mitigating factors that can be used to “explain” any crime. For example, child abuse is oftentimes used as a mitigating factor for heinous crime like rape & murder. Needless to say, millions of children are abused every year, and yet few end up becoming sadistic rapists and killers. As a matter of fact, several infamous serial killers have testified to the fact that their childhoods were bereft of any abuse. So a criminal can not manipulate his abuse in childhood as an excuse to escape death penalty. Everybody knows that poverty is a leading cause of crime. Does that mean that a poor person can say that I raped & murdered a woman because I did not have money to buy sex as rich people do?  Poverty can not be used as an excuse for crime nor to escape death penalty. Both environmental & genetic factors do influence criminality. Studies show that adopted children with a biological parent who is a criminal have an increased risk of engaging in criminal behavior. Also, other studies have found that certain genetic physical traits, such as gender, muscularity, and an extra Y chromosome, also increase the risk of criminality. Does that mean that a serial killer can escape death penalty on the ground that he committed crime due to genetic factors?

 

Arbitrariness of death penalty:

In my view, the biggest drawback of death penalty is the arbitrariness with which it is imposed. Arbitrariness starts from which country/ state you belong. It is arbitrary when someone in one county or state receives the death penalty, but someone who commits a comparable crime in another county or state is given a life sentence. Even if the death penalty punishes some while sparing others, it does not follow that everyone should be spared. The guilty should still be punished appropriately, even if some do escape proper punishment unfairly. Obviously, there remains a lack of uniformity in the capital punishment system. Some of the most heinous murders do not result in death sentences, while less heinous crimes are punished by death. Also, all murderers are never caught and out of those caught; only few will receive death penalty. Many factors other than the gravity of the crime or the culpability of the offender appear to affect death sentences including geography, race, gender, poverty, media hype, electoral politics, and access to adequate counsel. Of the 10.3 million violent crimes in 1993 in the U.S., only 100,000 of those victimizations or 1% resulted in an actual jail sentence. Only 6.2% of all violent crimes result in arrest. Statistically speaking, only about one out of every 300 murders actually results in an execution. Of all those convicted on a charge of criminal homicide, only 2 percent — about 1 in 50 — are eventually sentenced to death. Also, more than 98 percent of murder victims’ family will never see the murderer of their loved one sentenced to death, and more than 99 percent will not experience the murderer’s execution.  In a death penalty system in which approximately 2% of known murderers are sentenced to death, fairness mandates that the gravity of crime of a criminal who is sentenced to death should be comparable to the gravity of crime of another criminal who is also sentenced to death; and their gravity of crime should be worse than those who are not sentenced to death despite committing murders. Indian Supreme Court stated that death penalty should be imposed in rarest of rare cases but who is going to define rarest of rare case? I do not agree that a crime that shocks the conscience of a nation is a rarest of rare crime. When innocent people are dying due to hunger & tobacco smoking, and politicians & media watching hopelessly, such a nation has already lost its conscience. In fact, the human rights of victims are consistently ignored when one analyses the ratio of number of crimes committed to number of offenders brought to justice.

 

Now let me discuss race factor in death penalty. African Americans (blacks) have made up 41 percent of death row inmates in the US while they are only 12 percent of the general population. According to a 2003 Amnesty International report, blacks and whites were the victims of murder in almost equal numbers, yet 80 percent of the people executed since 1977 were convicted of murdering white victims. In 1990, the U.S. General Accounting Office reviewed the research on this issue and found that in 82% of the studies, race of victim was found to influence the likelihood of being charged with capital murder or receiving a death sentence, i.e., those who murdered whites were found to be more likely to be sentenced to death than those who murdered blacks. Does that mean that if the victim is white & murderer is black, then, there is more chance of imposing death penalty than if the victim was black & the murderer white? The fact that blacks and hispanics are charged with capital crimes out of proportion to their numbers in the general population may simply mean that blacks and hispanics commit capital crimes out of proportion to their number. In fact, more white people are executed in the U.S. than black people. And even if blacks are disproportionately represented on death row, proportionately blacks commit more murders than whites. Moreover, the U.S. Supreme Court has rejected the use of statistical studies which claim racial bias as the sole reason for overturning a death sentence. After examining 42,500 criminal files in the nations 75 largest counties in the U.S., Patrick Langan concluded that there was no evidence…that, in the places where blacks in the U. S. have most of their contacts with the judicial system, that (the) system treats them more harshly than whites. From 1929-66, white murderers were more likely to be executed than black murderers (10.4 versus 9.7 per1000). This trend continues today. A study on the death penalty found that the death penalty was imposed on white and black murderers in proportion to the capital offenses committed by those race classifications.

 

Do poor offenders get death penalty more than rich offenders? There is some truth in it. Why do poor people get the death penalty? It has everything to do with the kind of defense they get. Money gets you good defense. That’s why you’ll never see an O.J. Simpson on death row. As the saying goes: ‘ Capital punishment means those without the capital get the punishment.’ A shocking two out of three capital convictions have been overturned on appeal because of police and prosecutorial misconduct, as well as serious errors by incompetent court-appointed defense attorneys with little experience in trying capital cases. How can we contend that we provide equal justice under the law when we do not provide adequate representation to the poor in cases where a life hangs in the balance?  “Approximately ninety percent of those on death row could not afford to hire a lawyer when they were tried.” A defendant’s poverty, lack of firm social roots in the community, inadequate legal representation at trial or on appeal–all these have been common factors among death-row populations. The death penalty isn’t reserved for the worst crimes, but for defendants with the worst lawyers. It doesn’t apply to people with money because money can buy best defence lawyers irrespective of the gravity of crime. When is the last time a wealthy person was on death row, let alone executed?  The quality of legal representation is related to the arbitrary application of the death penalty in a way that inadequate representation contributes to mistakes in capital sentencing. The National Law Journal, after a study of death penalty representation in the South of the U.S., concluded that capital trials are “more like a random flip of the coin than a delicate balancing of scales,” because the defense attorney is “too often . . . ill-trained, unprepared [and] grossly underpaid.” People who are well represented at trial do not get death penalty. For example, In Washington state, one-fifth of the 84 people who have faced execution in the past 20 years were represented by lawyers who had been, or were later, disbarred, suspended or arrested. The American Bar Association said the cost of the quality legal representation is substantial.  Ninety-nine percent of criminal defendants end up penniless by the time their case is up for appeal.

 

There is also overwhelming evidence that the death penalty is employed against men and not women. … It is difficult to understand why women have received such favored treatment since the purposes allegedly served by capital punishment seemingly are equally applicable to both sexes. Women account for about 1 in 10 (10%) murder arrests but the same women account for only 1 in 50 (2.0%) death sentences imposed at the trial level.

 

Can an innocent person get death penalty?

Abolitionist’s biggest argument is that death penalty once implemented is irreversible and if by mistake, a wrong person is executed, he can not be brought back to life once the mistake is discovered.  How do innocents end up on death row in the first place? Bad legal representation due to lawyers who have never tried a capital case. Others are wrongfully convicted for lack of DNA evidence or corrupt witnesses. Wrongful execution is a miscarriage of justice occurring when an innocent person is put to death by capital punishment. Newly available DNA evidence has allowed the exoneration of more than 15 death row inmates since 1992 in the U.S, but DNA evidence is only available in a fraction of capital cases. No system of justice can produce results which are 100% certain all the time. Mistakes will be made in any system which relies upon human testimony for proof. We should be vigilant to uncover and avoid such mistakes. Our system of justice rightfully demands a higher standard for death penalty cases. The risk of making a mistake with the extraordinary due process applied in death penalty cases is very small indeed. There is no proof that any innocent person has actually been executed since increased safeguards and appeals were added to our death penalty system in the 1970s. Even if such executions have occurred, they are very rare. Imprisoning innocent people is also wrong, but we cannot empty the prisons because of that minimal risk. If improvements are needed in the system of representation, or in the use of scientific evidence such as DNA testing, then those reforms should be instituted. However, the need for reform is not a reason to abolish the death penalty. Besides, many of the claims of innocence by those who have been released from death row are actually based on legal technicalities. Just because someone’s conviction is overturned years later and the prosecutor decides not to retry him, does not mean he is actually innocent. Most human activities like medicine, manufacturing, automobile,  air traffic, sports, not to mention wars & revolutions, can cause death of  innocent bystanders but that does not mean that we must stop all such activities  Nevertheless, advantages outweigh the disadvantages; human activities including the penal system with all its punishments are morally justified. In my view, it is next to impossible to convict an absolutely innocent person to death penalty in a democratic country with functioning democratic institutions with the due process of law right from the trial stage to the appeal stage.

 

Death penalty and deterrence:

Deterrence means death penalty to a murderer would deter/ discourage others to commit similar crime for the fear of death. Abolitionist would argue that death penalty does not deter crimes and show statistics in its support while retentionist would argue that death penalty does indeed deter crimes and show statistics in its support. Let us discuss both sides. The existence of a deterrence effect of death penalty to prevent future murder is disputed. States that have death penalty laws do not have lower crime rates or murder rates than states without such laws. And states that have abolished capital punishment show no significant changes in either crime or murder rates. The question of whether or not the death penalty deters murder usually revolves around the statistical analysis. Studies have produced disputed results with disputed significance. Some studies have shown a positive correlation between the death penalty and murder rates – in other words, they show that where the death penalty applies, murder rates are also high. This correlation can be interpreted in either that the death penalty increases murder rates by brutalizing society or that higher murder rates cause the state to retain or reintroduce the death penalty. However, supporters and opponents of the various statistical studies, on both sides of the issue, argue that correlation does not equal causation. There is 8 percent average murder rate per 100,000 people in the U.S (retentionist) but 5 percent: average murder rate per 100,000 people in countries that do not have a death penalty. Even in America, during the 1980s, death-penalty states averaged an annual rate of 7.5 criminal homicides per 100,000 of population while abolition states averaged a rate of 7.4. A recent study published in the Journal of Criminal Law and Criminology reported that 88% of the country’s top criminologists surveyed do not believe the death penalty acts as a deterrent to homicide. Eighty-seven percent of them think that the abolition of the death penalty would not have a significant effect on murder rates and 77% believe that debates about the death penalty distract legislatures from focusing on real solutions to crime problems. Most of the criminologists assert that the best way to discourage murderers isn’t increasing the severity of punishment, but increasing the possibility of discovering the crime and condemning the culprit. If the crime is premeditated, the criminal ordinarily concentrates on escaping detection, arrest, and conviction. The threat of even the severest punishment will not deter those who expect to escape detection and arrest. If the crime is not premeditated, then it is impossible to imagine how the threat of any punishment could deter it. Most capital crimes are committed during moments of great emotional stress or under the influence of drugs or alcohol, when logical thinking has been suspended. Impulsive or expressive violence is inflicted by persons heedless of the consequences to themselves as well as to others. Most homicides are spur-of-the-moment, spontaneous, emotionally impulsive acts. Murderers do not weigh their options very carefully in this type of setting. It is very doubtful that killers give much thought to punishment before they kill.

 

However, according to roughly a dozen recent studies in the US, executions save lives. For each inmate put to death, the studies say, 3 to 18 murders are prevented. The studies, performed by economists in the past decade, compare the number of executions in different jurisdictions with homicide rates over time and say that murder rates tend to fall as executions rise. The studies concluded that those who object to capital punishment, and who do so in the name of protecting life, must come to terms with the possibility that the failure to impose capital punishment will fail to protect life. Critics of the studies say they are based on faulty premises, insufficient data and flawed methodologies. There are more than 30 years of respected academic studies which reveal a general or systemic deterrent effect, meaning that there is statistical proof that executions produce fewer murders. However, such studies are inconclusive because there are also studies that find no such effect. Because such studies are inconclusive, we must choose the option that may save innocent lives. For, if there is a general deterrent effect, and we do execute, then we are saving innocent lives. But, if there is a general deterrent effect and we don’t execute murderers, we are sacrificing innocent lives. If we have made an error of judgement regarding general deterrence, then such error must be made on the side of saving innocent lives and not on the side of sacrificing innocent lives. This is a moral imperative. Even if there is an error of judgement regarding deterrence effect of death penalty, we have to choose between saving a life of a convicted murderer on one hand, and on the other hand, saving a life of an innocent person who may get murdered in future had death penalty indeed had deterrence effect.  Should we err on the side of caution and protect the innocent and honor the memories of those murdered or should we give murderers the opportunity to harm again?  The test for deterrence is not whether executions produce lower murder rates, but that executions produce fewer murders than if the death penalty did not exist. For example, the fact that the state of Delaware executes more people per capita (1/87,500) than any other state and has a murder rate 16 times lower than Washington, D.C. (5/100,000 versus 78.5/100,000) is not proof per se, that the death penalty deters murder in Delaware or that the lack of the death penalty escalates murders and violent crime in Washington, D.C., which has the highest violent crime and murder rates in the U.S.

 

There are four rational conclusions one can make regarding general or systemic deterrence.

(1) If the death penalty is not a deterrent and we execute, then we are executing our worst human rights violators.

(2) If the death penalty is a deterrent and we execute, then we are executing those criminals and saving innocent lives.

(3) If the death penalty is not a deterrent and we don’t execute, then we are not sacrificing innocent lives.

(4) If the death penalty is a deterrent and we don’t execute, then we are sacrificing innocent lives.

 

Regarding deterrence, it is necessary to err on the side of saving innocent life and not to err on the side of sacrificing innocent life. These are moral imperatives.

 

Crime rates in various nations showing lesser crimes in retentionist as compared to abolitionist nations: 

 

Since 1967, there has been one execution for every 1600 murders, or 0.06%. The average time on death row for those 56 executed – 11 years, 2 months in America. So there is an inordinate delay from the time of murder to the time of execution which range on average between 10 to 12 years in most democratic countries. Any punishment can be an effective deterrent only if it is consistently and swiftly employed. Capital punishment cannot be administered to meet these conditions. Considerable delay in carrying out the death sentence is unavoidable, given the procedural safeguards required by the courts in capital cases. It squanders the time and energy of courts, prosecuting attorneys, defense counsel, juries, courtroom & correctional personnel and also burdens the system of criminal justice. The sobering lesson is that we can reduce such delay and costs only by abandoning the procedural safeguards and constitutional rights of suspects, defendants, and convicts, with the attendant high risk of convicting the wrong person and executing the innocent. In order to prevent conviction of an innocent to death penalty, several safeguards & appeals exist which cause considerable delay in convicting guilty which causes deterrence effect to wane off. So the issue is inordinate delay which dilutes deterrence effect. Assume that all murderers would instantly die upon murdering, then murderers would kill only if they wished to die themselves. Murder plus suicide by an offender is an extremely small component of all murders. Therefore, if a swift and sure death penalty was universally applied to our worst criminals, it is logically conclusive that the death penalty would be a significant deterrent and that many innocent lives would be saved. In fact, swift and sure executions do result in deterrence.  The classical example is of some countries (e.g. Singapore, Saudi Arabia) which almost always carry out death sentences swiftly and therefore there is far less serious crime in these countries, which proves conclusively that death penalty is a deterrent, but only when execution is a virtual certainty and swiftly.

 

Many people believe that there should be a death penalty for the manufacturers of spurious medicines and food adulteration because both these malpractices are taking lives of innocent people and an exemplary punishment will deter future attempts.

      

It must of course be conceded that inflicting the death penalty guarantees that the condemned person will commit no further crimes. This is an incapacitative, not a deterrent effect of executions. The incapacitation effect saves lives – that is, that by executing murderers you prevent them from murdering again and do thereby save innocent life. The evidence of this is conclusive and incontrovertible.  6% of young adults paroled in 1978 in the U.S. after having been convicted of murder were arrested for murder again within 6 years of release. Murderers have so violated the human rights of their victims and of society that it should be a moral imperative that they never again have that opportunity. Obviously, those executed can’t murder again. A recent study examined the prison and post-release records of 533 prisoners on death row in 1972 whose sentences were reduced to life by the U.S. Supreme Court’s ruling in Furman. The research showed that 6 had committed another murder. There is no way to predict which convicted murderers will kill again. Repeat murders could be prevented only by executing all those convicted of criminal homicide. Abolitionists consider such a policy as too inhumane and brutal to be taken seriously and propose life imprisonment without parole instead.

 

Death penalty and retribution:

Abolitionists say that if someone deserves to die for committing a murder, families of victims whose murderers did not receive the death penalty may be hurt by the idea that their loved one was not worth the same level of retribution. Also, to kill the person who has killed someone close to you is simply to continue the cycle of violence by taking revenge. An eye for an eye will make the whole world blind. Criminals no doubt deserve to be punished, and punished with severity appropriate to their culpability and the harm they have caused to the innocent. But severity of punishment has its limits — imposed both by justice and our common human dignity. Governments that respect these limits do not use premeditated, violent homicide as an instrument of social policy.

 

However, all punishment by its nature is retributive, not only the death penalty. The basis of punishment is not how successful it will be in rehabilitating the offender but rather whether it is fair with respect to the crime committed. In other words, the basis of punishment is justice. So, whether the punishment meted out will reform the criminal or deter other would-be offenders is not the issue before family members of the victim. The one question they always ask is: “Does this punishment fit the crime that has been committed? The issue is not rehabilitation but whether the punishment fits the crime. This is retribution. It is also often argued that death is what murderers deserve, and that those who oppose the death penalty violate the fundamental principle that criminals should be punished according to their deserts–“making the punishment fit the crime.”  Humans have evolved a repertoire of emotions that served as adaptive solutions to problems of evolutionary import. One of these emotions is the universal need for retribution.  In other words, our human nature is so predisposed to seek retribution that moral philosophers and theologians alike have tried in vain to restrain our drive to punish those who harm us. As a civilized society, we have agreed to “subcontract” our vigilante desires to the state. However, our need for the retributive justice does not suddenly disappear  just because we are a “civilized” people. In fact, in my view, abolition of death penalty is not a sign of civility but a sign of feebleness. Society is justly ordered when each person receives what is due to him. Crime disturbs this just order, for the criminal takes from innocent people their lives, peace, liberties, and worldly goods in order to give him undeserved benefits. Deserved punishment protects society morally by restoring this just order, making the wrongdoer pay a price equivalent to the harm he has done.  Retributivists are said to believe in three ideas: the guilty deserve punishment, only the guilty deserve punishment, and the punishment should be proportional to the offense. The ideas of retribution and proportionality have been around for much longer time. Victims of murder cannot avenge themselves, only the law and those closest to the victim can do this. A victim’s family feels, rightfully so, that they are obligated to attain justice for the victim. This isn’t justice in the traditional sense, but retribution. A just society requires the death penalty for the taking of a life. Justice, it is often insisted, requires the death penalty as the only suitable retribution for heinous crimes.

 

Death penalty versus life imprisonment:

It was assumed that life imprisonment was obviously more expensive than executions but contrary is the truth.  All experts agree that the cost of the death penalty amounts to a net expense to the state and the taxpayers. Or to put it differently, the death penalty is clearly more expensive than a system handling similar cases with life imprisonment.  Death Penalty is much more expensive than life imprisonment because the constitution requires a long and complex judicial process for capital cases. This process is needed in order to ensure that innocent men and woman are not executed for crimes they did not commit.  A murder trial normally takes much longer when the death penalty is at issue than when it is not. Litigation costs – including the time of judges, prosecutors, public defenders, and court reporters, and the high costs of briefs — are all borne by the taxpayer. Florida, with one of the U.S.’ largest death rows, has estimated that the true cost of each execution is approximately $3.2 million, or approximately six times the cost of a life-imprisonment sentence. Anti-capital punishment campaigners in the U.S. cite the higher cost of executing someone over life in prison, but this, whilst true for America, has to do with the endless appeals and delays in carrying out death sentences that are allowed under the U.S. legal system where the average time spent on death row is over 12 years. Many opponents present, as fact, that the cost of the death penalty is so expensive (at least $2 million per case? on average), that we must choose life without parole (“LWOP”) at a cost of $1 million for 50 years.  Predictably, these pronouncements may be entirely false. On the other hand, JFA estimates that LWOP cases will cost $1.2 million – $3.6 million more than equivalent death penalty cases. Also, in developing nations like India & china, death penalty is cheaper than life imprisonment where criminal will stay whole life in prison on tax payers’ money. Anyway, life is cheaper in developing country than developed country not only with respect to cost of death penalty but also deaths due to starvation, accident, disasters or terrorism. The American company Union Carbide Corporation paid about 2000 dollars for each death claim as compensation in Bhopal industrial disaster in India. How much they would have paid if the same disaster occurred in America?  Interesting to note that it is probably a higher standard of living to be in prison in the U.S. than to be a free man in a developing nation like India. So cost should have no bearing in deciding life sentence instead of death penalty. Anyway, cost is born by people of a country and therefore people should have a say in deciding whether the offender should get death penalty or life sentence. Nonetheless, many opponents of capital punishment put forward life in prison without parole as a viable alternative to execution for the worst offenders, and surveys in America have shown that life without parole (LWOP) enjoys considerable support amongst those who would otherwise favour the death penalty. It is argued by some that LWOP is in fact a far more cruel punishment that death. They cited LWOP as a living death where they died a little every day.  One might be forgiven for asking what is the point of locking a person up to the day they die and one might wonder if it is indeed a far worse punishment than death.

 

However, LWOP cannot prevent or deter offenders from killing prison staff or other inmates or taking hostages to further an escape bid – they have nothing further to lose by doing so and there are instances of it happening in the U.S. According to one survey in the U.S., 7 prison-guards are murdered each year in prison-many presumably by lifers who, in a state where there is absolutely no capital punishment, have nothing to lose. What are we to say to prison guard’s families–“Well! If a murderer murders your loved one we will pile on another life sentence??”  Also, however good the security of a prison, someone will always try to escape and occasionally will be successful. If you have endless time to plan an escape and everything to gain from doing so, it is a very strong incentive. Also, we have no guarantee that future governments will not release offenders, who were imprisoned years previously, on the recommendations of various professional “do-gooders” who are against any punishment in the first place. Twenty or thirty years on it is very difficult to remember the awfulness of an individual’s crime and easy to claim that they have reformed. The most conclusive evidence that criminals fear the death penalty more than life without parole is provided by convicted capital murderers and their attorneys. 99.9% of all convicted capital murderers and their attorneys argue for life, not death, in the punishment phase of their trial. When the death penalty becomes real, murderers fear it the most. Criminals fear nothing more than death. Therefore, nothing will deter a criminal more than the fear of death… life in prison is less feared. Murderers clearly prefer it to execution — otherwise, they would not try to be sentenced to life in prison instead of death… Therefore, a life sentence must be less deterrent than a death sentence. Nonetheless, murderers do commit capital crimes because fear of death penalty is diminished as executions are neither swift nor sure in the U.S as well as in other democratic nations.

 

Few death row prisoners try to commit suicide and fewer succeed. Few death row prisoners insist that all appeals on their behalf be dropped. Few convicted murderers sentenced to life in prison declare years later that they wish they had been sentenced instead to death and executed. Few if any death row prisoners refuse clemency if it is offered to them. No doubt prison life can be made unbearable and hideous; no doubt death row can be managed by the authorities in an inhumane fashion. But none of this is necessary. No doubt not all life-term prisoners find ways to make their imprisonment something more than an inhumane endurance test. So it should hardly come as a surprise that the vast majority of friends of the death penalty as well as its opponents believe that death is worse than imprisonment. This is why its opponents want to abolish it—and why its supporters want to keep it. A great deal of crime is committed on a cost-benefit schema, wherein the criminal engages in some form of risk assessment as to his or her chances of getting caught and punished in some manner. If he or she estimates the punishment mild, the crime becomes inversely attractive, and vice versa. The fact that those who are condemned to death do everything in their power to get their sentences postponed or reduced to long-term prison sentences; in the way lifers do not, shows that they fear death more than life in prison. Most murderers commit murders not because they are not afraid of death penalty but because they believe that they will never be caught. This belief need to be shattered.

 

Abortion versus death penalty:

Common sense suggests that those who support abortion would also support death penalty and vice versa. But the truth is paradoxical. Those who oppose death penalty usually support abortion (liberals) and those who support death penalty usually oppose abortions (conservatives). Is this morally inconsistent? Let me give one example. If a woman forgot to take contraceptive pill and became pregnant, it is her choice to abort but whose mistake was it anyway. The unborn child is aborted because woman made a mistake. So why should innocent unborn child pay the penalty of woman’s mistake. Yes, it is woman’s right to choose; here’s a thought; choose not to have sex. We’ve known where babies come from for over 5,000 years. Taking a human life for the sake of convenience should not be anyone’s right anyway. Also, if the man wants the baby and the woman does not, the man has no say because it is assumed that women have been oppressed throughout history…therefore they cannot be held responsible for their actions and if they choose to abort the baby, so be it, it is their choice. Men on the other hand, being the alleged oppressors, have no choice notwithstanding the fact that both man & woman contribute almost equally to the genetic makeup of an embryo. People must also understand difference between abortion and miscarriage. Abortion is deliberately causing the death of a baby; miscarriage is the accidental death of the baby on its own.

 

The person who is on death row awaiting execution is there as a result of his/her own criminal actions. The unborn child who is aborted dies from the action of another. The child has not done anything warranting such a harsh penalty. The distinction is an innocent life versus a convicted life. Assuming the legal system is working properly, the death sentence is justified as retribution for the criminal’s act. An unborn baby is aborted because her mother sees her as a burden, not because of any act of the baby.  The death penalty is essentially a state decision. Abortion, on the other hand, puts the individual in the position of imposing the death penalty on the unborn child. The death penalty is a system’s response to volitional acts, abortion an individual’s response to mere existence. When civilization reserves the death penalty for mass murderers and serial killers, that punishment becomes a moral act. Society must protect its citizens from irredeemable evil. Pro-life means advocating the legal protection to human embryos and fetuses, especially by favoring the outlawing of abortion on the ground that it is the taking of a human life, but can we extend the same rationale to save a life of a serial killer on death penalty row? Abortion supporters cannot lump serial killers with innocent unborn. It is outrageous and preposterous to compare an innocent unborn child with a serial murderer or terrorist. There is absolutely no equivalency between capital punishment for crimes, and abortion. As for abortion versus death penalty, every citizen has signed a social contract that they forfeit their lives if convicted of certain crimes. If you commit an uncivil act, the law necessitates a penalty to keep social order. The innocent baby committed no such act.  People who support abortion says that it is woman’s right to choose whether to continue a pregnancy or not but many people insist that abortion is wrong because it terminates a human life. This life is valuable and deserves a chance to live. Therefore, a pregnant woman should not have the option of killing the embryo unless there is a medical indication for termination of pregnancy or pregnancy caused by rape.

 

Do we believe in the basic premise that either all life is sacred (as in the case of the death row inmate & unborn child) or none of it is?  The answer to this question will solve the puzzle of abortion versus death penalty. Those who believe that all lives are sacred will oppose death penalty and oppose abortion. Those who believe that no life is sacred will support abortion and support death penalty. Those who believe that all lives are not equally sacred would either be a conservative or a liberal. Conservative believes that a mass murderer is an evil human and deserves death penalty while an unborn child is innocent and must not be aborted.  Liberal believes that we have no right to take life of a criminal no matter whether he has taken life of another innocent human and a woman has a right to abort her unborn child.

 

So where do you stand? Think over it.

 

THE MORAL OF THE STORY:

1) Life and death are the words used by humans to describe certain processes or conditions but human intelligence is not evolved enough to define or understand it.

2) For all practical purposes, brain death means death of a human being no matter whether it occurs either due to primary brain injury or secondary to cessation of circulation & breathing.

3) The death of a human embryo is equivalent to death of a human being because even 3 weeks old embryo does have a developing living brain-tissue no matter whether it possesses consciousness of the degree of a newborn.

4) With due respect to all religions, I humbly state that the soul does not exist and there is no afterlife.

5) It is immoral to abolish death penalty for heinous crimes in a democratic country with functioning democratic institutions.

6) Swift, certain, consistent and non-arbitrary death penalty is the best way to deter future would-be-offenders from committing heinous crimes.

 

Dr.Rajiv Desai. MD.

November 11, 2010.

 

Postscript:

I will also die one day. I am only a human.

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