Elementary Clinic Lecture for 3rd
year medical students at the faculty of Medicine National University of Malaysia Friday 10th April 2003 by Prof Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH & DrPH (Harvard) Deputy Dean Kulliyah
of Medicine, International Islamic University, Kuantan. E-MAIL firstname.lastname@example.org . WEBSITE: http://doctor-omar.net/
1.0 DEFINITION OF DEATH:
Death can be defined as moral, legal, or biological death. Death could be permanent or temporary (in sleep).
2.0 NATURE OF DEATH
There is a continuous cycle involving life and death. Life arises from death and vice versa[i]. All human endeavors cease with death[ii]. Death is followed by burial in the grave[iii]. There may be reward or punishment in the grave. This is followed by a transitional phase between
life on earth and life in the hereafter[iv]. On the last day humans will be resurrected back to life[v]. This life will be physical life with physical
bodies. There will be no more death in the hereafter[vi]. All humans will eventually die[vii]. Humans fear death[viii]. In view of the inevitability of death it is futile to attempt to avoid death or think of its
elimination[ix]. Modern biotechnology discoveries of artificial life support, cloning, and frozen embryos are
not in essence prolongation of life. Death is a transition to life after death[x]. Death could therefore be a welcome event for good people who look forward to a better life
in the future.
3.0 ATTITUDES TO DEATH
Death and its occurrence are in the hands of God[xi]. Good people welcome death as a rite de passage to
a better existence in the hereafter. They look forward to death as a happy event. The approach of death is an opportunity
for repentance[xii]. Death is an occasion for reminding and remembering the hereafter. Humans are apprehensive about
death and often fear it[xiii]. Wishing for death in desperation with severe painful illness is discouraged. The wish for death[xiv] can be negative for the escapist who looks to death as a relief from present psychological or
physical distress. Death is a trial[xv] and is a calamity[xvi].
4.0 PROCESS OF DEATH
The process of death is long. It starts with the humanly understood causes like infection or trauma. The body progressively
fails until a point of no return is reached. There is a point during this process when the angels take away the ruh thus separating the essence from the body[xvii]. The process of terminal death following God’s laws cannot be reversed except in exceptional
cases of divine intervention such as when God gave the prophet Jesus (PBUH) the ability to revive the dead[xviii].
5.0 CRITERIA OF DEATHTechnological
developments in intensive care units have blurred the demarcation between life and death that was taken for granted before.
Many brain-dead people can be kept apparently alive on artificial respirators. The increase in transplantation has given momentum
to the need to develop new criteria for death. This is because organs have to be harvested quite early in the death process
to prevent them from further degeneration. The traditional criteria of death were respiratory failure, cardiac failure, and
loss of consciousness. Use of brain death as a criterion gives rise to ethical and legal problems because in cases of brain
death, many other organs and functions of life are still alive. There are also controversies about the definition of brain
death as a pathological entity. There is controversy whether it is death of the whole brain or specific parts of it. There
is also disagreement whether criteria used for adults can be used for children.