From Ted Webber
I agree with Shelly Kagan that fear of being dead is irrational (20 October, p 42). But there is more to the fear of the process of dying than he admits to.
Will I die alone? With dignity? The law will not allow me to make arrangements with my carers (if any) to help me to die when life becomes insupportable, nor may I stockpile drugs to facilitate my own departure or that of my wife.
Suicide was a glaring omission from your recent special issue on death. The World Health Organization ranks it as the 13th most common cause of human death. Although other animals show some understanding of death, we are the only species to self-terminate a healthy body just because we don’t like how our life turned out.
Clearly suicide ends any possibility of reproduction so, if the principles of natural selection still apply to Homo sapiens, then suicide must be conferring some advantage on the species as a whole.
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Dick Teresi’s piece reads as if brain-death testing was devised for the benefit of the transplant community (20 October, p 36). This is not the case. It came about in the early days of life-support technology, which yielded a small population of deeply comatose patients who were unable to breathe on their own. Within a few days of “life support” their hearts would stop beating. The tests now applied to such patients grew out of the need to develop robust evidence to justify withdrawal of clearly defined futile treatment.
The article can only add further confusion to what is already a vexed and complex issue. For instance, the movements Teresi described are due to lingering spinal reflexes and have nothing to do with the brain. This is routinely made clear to relatives visiting the intensive care unit.
I am concerned that this article may prove disquieting to the bereaved who have granted permission for organ donation, sowing needless doubt and discouraging people from signing up to organ donor registers.
Many people in the transplant community recall the effect of a BBC Panorama programme entitled “Are the donors really dead?”. In the four weeks following its transmission in October 1980, kidney transplants fell by a quarter. The programme was subsequently discredited.
Saffron Walden, Essex, UK
Buderim, Queensland, Australia
