Abstract

Influenced by James Bernat’s approach, the US President’s 1981 Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioural Research concluded that human death is an instant that separates the dying process from the cadaveric state. Death, as Bernat and the President’s Commission argue, cannot be a process. Because organisms cannot be both alive and dead, Bernat claims, the transition from one state to the other must be sudden and instantaneous. Since then, few have argued the opposite notion that death is a process, and that the transition between living and perishing is not a discrete event. In this article we argue that human death is a process that comprises three distinct phases: dying (when the physiological responses against the shutdown of vital organs and systems are in an imminence of breaking down), decease (when events such as respiratory and cardiac arrest indicate the critical failure of vital organs or systems), and decay (the irreversible and accelerated systemic biological process of cellular death that eventually takes over the whole body). We also argue that human death differs from the ‘time of death’ indicated by death certificates, which is pointed out only to clinically and legally establish the irreversibility of the entire process.