Contemporary intensive care unit (ICU) medicine has complicated the issue of what constitutes death in a life support environment. Not only is the distinction between sapient life and prolongation of vital signs blurred but the concept of death itself has been made more complex. The demand for organs to facilitate transplantation promotes a strong incentive to define clinical death in a manner that most effectively supplies that demand. We consider the problem of defining death in the ICU as a function of viable organ availability for transplantation
Unique among animals, humans survive not by superb physical adaptation to our environment, but rather by intelligent, large-scale adaptation of the environment to our needs. We build houses with climate control systems that mimic the environment of sub-Saharan Africa. We safely live in environments where the temperature never rises above freezing and where the level of the sea is higher than the land we farm and build vast cities upon. We live in tropical rainforests teeming with hostile organisms, and atop arid, life-poor mountains and plains, at elevations in excess of 5000 m. As this editorial is written, a few of us live in space, circling the earth in an environment of hard vacuum, searing heat, and cryogenic cold. The sole endowment for our survival that evolution has bestowed upon us is reason and technologic civilization, which is its product. All human habitations, and all life on earth for that matter, are under continuous threat of some kind. Violent weather, earthquakes, volcanic eruptions, and even meteorite impacts represent threats of varying degrees of risk.There is a tide in the affairs of men, which taken at the flood, leads on to fortune. Omitted, all the voyage of their life is bound in shallows and in miseries. On such a full sea are we now afloat. And we must take the current when it serves, or lose our ventures.
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