One of the challenges in defining death is in distinguishing it from life. Death would seem to refer to the moment at which life ends, or when the state that follows life begins. Determining when death has occurred requires drawing precise conceptual boundaries between life and death.
This is problematic because there is little consensus over how to define life. Some have suggested defining life in terms of consciousness. When consciousness ceases, a living organism can be said to have died. One of the notable flaws in this approach is that there are many organisms which are alive but probably not conscious.
Another problem with this approach is in defining consciousness, which remains a mystery to modern scientists, psychologists and philosophers. This general problem of defining death applies to the particular challenge of defining death in the context of medicine.
Attempts to define the exact moment of a human death have been problematic. Death was once defined as the cessation of heartbeat and of breathing, but the development of CPR 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 without a functioning heart or lungs, life can sometimes be sustained with a combination of life support devices, organ transplants and artificial pacemakers.
Today, where a definition of the moment of death is required, doctors and coroners usually turn to brain death or biological death to define a person as being clinically dead, people are considered dead when the electrical activity in their brain ceases. It is presumed that an end of electrical activity indicates the end of consciousness.
Suspension of consciousness must be permanent, and not transient, as occurs during certain sleep stages, and especially a coma. In the case of sleep, EEGs can easily tell the difference. The category of brain death is seen by some scholars to be problematic.
Dr Franklin Miller, senior faculty member at the Department of Bioethics, National Institutes of Health, notes By the late 1990s, the equation of brain death with death of the human being was increasingly challenged by scholars, based on evidence regarding the array of biological functioning displayed by patients correctly diagnosed as having this condition who were maintained on mechanical ventilation for substantial periods of time.
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