Carlos Roberto de Souza, M.D.*
Science currently considers brain death that encompassing the complete and irreversible arrest of the functions of the whole encephalon, including not only the brain cortex but also the diencephalon, cerebellum and especially the brainstem. Standard tests and clinical criteria have been established by the world scientific community for the diagnosis of encephalic death.
We, as spiritists also need to differentiate between death and discarnation. Death is a biological phenomenon where the many organs and systems that maintain life collapse, progressively and irreversibly. Discarnation, in turn, is the process of disconnection between the spirit and the physical body, where the spirit gradually frees itself from the magnetic links that tied it to the matter, unleashing the fluidic bonds that united them. Therefore, usually the process of discarnation begins after the biological phenomenon of death. In turn, death is only definitive after the brainstem becomes inactive. The brainstem contains the rhomboid fossa (floor of the 4th ventricle), which is the site of union between the spirit and the physical body, according to Andre Luiz in the book “Evolução em Dois Mundos” (“Evolution in Two Worlds”)**.In the book “Entrevistas” (“Interviews”)* by Francisco Xavier, Dr. Bezerra de Menezes states that discarnation leads to total brain silence, as detected by the electroencephalogram. While the brain activity is detected, even if minimal, the spirit remains connected to the body.
The suspension of ordinary measures of life support such as hydration and feeding, and the interruption of drugs that result in death due to cardiopulmonary arrest, is considered passive euthanasia. Spiritism does not endorse this practice because euthanasia abbreviates death and severs the natural course of the Divine laws, which may result in unpleasant consequences for the spirit. We encourage patients and proxies to take this into consideration when discussing a living will or a DNR (do not resuscitate) order. Conversely, when a patient undergoes a cardiopulmonary arrest followed by death despite all life support resources and appropriate treatment used, then death occurs as a natural course of the disease. In such a case, we believe that resuscitating the patient would be considered dysthanasia, as the spirit would not be allowed to “go” in peace.
In summary, we believe that when discussing a living will or a DNR order, one has to bear in mind these concepts of passive euthanasia and dysthanasia, as well as the presence or absence of encephalic death.
*Carlos Roberto de Souza, M.D., Spiritist Medical Association – Brazil (AME-BRASIL)
**Books not yet available in English
Translated to English by the U.S. Spiritist Medical Association (February 2011)