What is Death? Winston Chiong and Sean Aas

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GeriPal - A Geriatrics and Palliative Medicine Podcast 48 min 2 speakers 8 chapters transcribed 9 hours ago

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What is the main focus of the episode and who are the guests?

Eric Widera 0:00

This episode of the JerryPal Podcast is CME eligible.

Alex Smith 0:04

To claim credit, please go to the CME tab on jerrypal.org.

Eric Widera 0:09

Welcome to the Jerry Powell Podcast. This is Eric Quadero. This is Alex Smith. And Alex, who do you have with us today?

Alex Smith 0:14

Today we are delighted to welcome longtime friend Winston Chong, neurologist and bioethicist, professor at UCSF in the Department of Neurology and Director of UCSF Bioethics. Winston, welcome to the Jerry Powell podcast.

Winston Chiong 0:27

Thanks so much for having me.

Alex Smith 0:29

And we're delighted to welcome Sean Oss, who is a philosopher and bioethicist and senior research scholar at the Kennedy Institute of Ethics and Associate Professor in the Department of Philosophy in Georgetown. Sean, welcome to the Jerry Powell podcast. Thanks for having me. And

Eric Widera 0:44

Alex, we've done a podcast on what happens after you die.

Alex Smith 0:47

Mm-hmm. Bob Troug.

Eric Widera 0:49

Uh no no Oh after you die after you die Oh yeah recently we've got Undertaker. Yeah. We've done podcasts on Dying. Mm-hmm. We've only done one other podcast on just death. What is

Alex Smith 1:01

death? That was with Bob Truck.

Eric Widera 1:02

That was with Bob Trock. That was great. We'll have a link to that in our show notes. We're gonna double up on that subject. We haven't figured it out? I'm still trying to figure out what death is and thinking about kind of what does it mean going forward in the future too. But before we jump into that topic, we always have a song request. Sean, I think you have the song request for Alex.

Sean Aas 1:21

I'd love to hear uh the song Cease by the band Bad Religion.

Eric Widera 1:25

And why did you choose a bad religion cease?

Sean Aas 1:29

Uh, Bad Religion is this interesting punk band originally from the 80s that has this very kind of philosophical uh lyrical content in their songs and got me interested in philosophy in the first place, really listening to them as a as a teenager. So so so this song is a song of theirs. It's about something I'm philosophically interested in. It fits.

Eric Widera 1:47

Let's hear it, Alex.

Sean Aas 1:48

All right.

Unknown 1:54

Unknown 2:03

Like a chemical reaction or a steam roller spreading randomly. There's a distant buzz and low frequency, it tickles my ears, rustles under my feet, and it shakes the leaves off of every tree. Vi landly. What pretension, everlasting keys, Everything must cease.

Alex Smith 2:45

Well done. Well done. Thank you. Everything must cease. Great. Okay,

Eric Widera 2:52

I I see the connection between uh the topic and the song. So Sean, is there anything besides bad religion that got you interested in going down this pathway about thinking about kind of how we define death? Uh and just to let our l listeners know is that Sean just published a great paper it what what journal was it in again?

Sean Aas 3:14

Uh the Journal of Medicine and Philosophy.

Eric Widera 3:16

Journal of Medicine and Philosophy. Uh about the topic that we're gonna be talking about. We'll have links to that in our show notes. So Sean, what got you interested in this?

Sean Aas 3:24

Yeah, so you know, I'm a a a philosopher, um, and uh in particular a bioethicist and philosopher of medicine, and I My kind of niche within that, um, I guess I have a couple of overlapping niches, but uh I'm especially interested in in how to define some of the kind of central concepts in medicine or weather and in what way we might think about defining them. So I'm interested in for instance in the boundaries of the human body, what counts as being healthy or unhealthy, what it means for something to be a disease, right? So these are kind of classic questions of of what people sometimes call philosophy of medicine as a kind of overlapping subject matter with bioethics. So that comes together with the longstanding interest in a tradition in political philosophy, you know, the philosophy of how we should justify laws and state and, you know, governments, which really emphasizes the importance in a pluralistic society of having ways of talking about the things that matter to our common life, which are justifiable to people from a wide range of different points of view, different religious and philosophical points of view.

Sean Aas 4:22

So some of your listeners, if they took some philosophy classes, as may have read the work of the uh philosopher John Rawls, this uh way of coping with pluralism is a a tradition that he really extended and pioneered and was deeply influential and and and and a lot of my work is kind of in that vein.

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Chapters

8 chapters

1 What is the main focus of the episode and who are the guests? 0:00–4:57 2 Why did the hosts choose Bad Religion’s song “Cease” and how does it relate to the discussion on death? 4:57–11:37 3 When did the guests first start thinking seriously about what death means? 11:37–20:45 4 How do advancing technologies like ECMO, organ‑printing, and brain‑uploading challenge traditional definitions of death? 20:45–28:26 5 What moral and legal pressures do organ‑donation practices place on the definition of death? 28:26–38:32 6 Will the concept of brain death become obsolete if we can grow or replace organs in the lab? 38:32–44:40 7 How can clinicians, families, and policymakers reach consensus on when a person is legally dead? 44:40–48:07 8 What are the guests’ final thoughts on navigating future debates about death and technology? 48:07–48:13

Speakers

2 identified

Eric Widera 8 min Alex Smith 4 min

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Topics in this episode

Alex Smith 5 UCSF 2 New England Journal of Medicine 1 David Chalmers 1 Carol Heyman 1 James Tulsky 1 Mark Wren 1 Matt Schuster 1 Patrick Lally 1 Lloyd Woolstadt 1 American Bar Association 1 Nina Flanagan 1

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Recorded22 Aug 2024

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Show notes

We've talked about Brain Death before with Robert (Bob) Troug and guest-host Liz Dzeng, and in many ways today's podcast is a follow up to that episode (apologies Bob for mispronouncing your last name on today's podcast!). Why does this issue keep coming up? Why is it unresolved? Today we put these questions to Winston Chiong, a neurologist and bioethicist, and Sean Aas, a philosopher and bioethicist. We talk about many reasons and ways forward on this podcast, including: The ways in which advancing technology continually forces us to re-evaluate what it means to be dead - from the ability of cells/organs to revive, to a future in which organs can be grown, to uploading our consciousness to an AI. (I briefly mention the Bobiverse series by Denise Taylor - a science fiction series about an uploaded consciousness that confronts the reader with a re-evaluation of what it means to be human, or deserving of moral standing). The moral questions at stake vs the biologic questions (and links between them) The pressures the organ donation placers on this issue, and questioning if this is the dominant consideration (as Winston notes, organ donation was not central to the Jahi McMath story) What we argue about when we argue about death - the title of a great recent paper from Sean - which argues that "we must define death in moralized terms, as the loss of a significant sort of moral standing," - noting that those why are "dead" have something to gain - the ability to donate their organs to others. Winston's paper on the "fuzziness" around all definitions of brain death, titled, Brain Death without Definitions. As we joke about at the start - talking with philosophers and bioethicists, you almost always get a response along the lines of, "well that's a good question, but let's examine a deeper more fundamental question." Today is no different. And the process of identifying the right questions to ask is absolutely the best place to start. Eventually, of course, everything must cease. -@AlexSmithMD

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