All humans understand the continuous cycle between life and death-the cycle from the beginning to the end. I have reflected and thought extensively about the philosophical meaning of death and life through Dr. Paul Kalanithi’s powerful memoir When Breath Becomes Air, whose words have captivated many as his memoir circulated throughout our cohort. For him, death -“the fate of all living, breathing, metabolizing organisms”-was represented by the cessation of the organ defining the essence of our self: the brain. His role as a physician demanded him to fight the impending fate of death to preserve the conscious, to sustain life until its very last breath.
However, Dr. Kalanithi’s view on death was challenged from the beginning of our discussion with Dr. Nita Farahany. Dr. Farahany introduced us to a Yale study in which cellular activity of pig brains was sustained for four hours after oxygen deprivation. Death can no longer be defined merely as the irreversible cessation of brain function, because, as Dr. Farahany pointed out, there remains the possibility of cellular resurrection in human brains. Our definition of death is set to evolve again, with previous definitions concerning cessation of the heart and breath being invalidated due to the advancement of technology. And with the evolution of death comes an ever-evolving definition of life alluding back to the interconnected nature of life and death. As Dr. Farahany led us through the changes in the legal and medical definitions of death, it became apparent that scientific progress and innovation is beginning to challenge the tenets of medicine and law, in addition to sparking a conversation about the ethics surrounding these advances.
I was most intrigued by Dr. Farahany’s discussion of one such medical advance’s intersection with ethics: the brain organoid. As Dr. Farahany mentioned the utility of these models in neurodegenerative diseases and mental illness, I couldn’t help but reflect back to the impact of these models within my lab’s research concerning neurodegeneration in Huntington’s disease and Parkinson’s. We consistently struggle with the limitations of our research findings due to the use of mouse models, which are significantly less complex than the human brain. Organoids would provide us an opportunity to rapidly expand our understanding of the molecular workings of neurodegeneration and possibly even accelerate the path to a therapeutic treatment.
When presented with such monumental findings, it is often simple to prioritize their long-term impacts over ethical parameters of the research. As most of us were fascinated by the implications of organoids in the field of neuroscience and medicine, Dr. Farahany kindly reminded us to refocus our attention on the moral status of an organoid. Prior to her reminder, I had simply thought of an organoid as a static model. I had forgotten that an organoid’s increased similarity to a human being also poses the possibility of consciousness, begging the question: What is the moral status of this organoid? It’s lack of EEG results support a lower moral status than a human; however, Dr. Farahany challenged the cohort to consider the possibility of non-detectable EEG results and the effects of sensory stimulation exposure. With these considerations, an organoid necessitates a higher moral status than dead cells. Through our discussion and Dr. Farahany’s comments on the fellows’ responses,I began to understand the complex process of establishing ethical standards for scientific advantages. In order to establish ethical precedents, we must consider the innovation or process from an interdisciplinary standpoint. Interdisciplinary thought is essential in the process of setting ethical standards, as these standards will set long-lasting precedents for medical practice, policy creation, and law proceedings.
Looking back at our discussion, I was in awe of the confidence and eloquence with which Dr. Farahany communicated her thoughts throughout the seminar. Though I was overwhelmed by her academic successes, it was comforting to hear that Dr. Farahany struggled with some of the same hesitations I hold about medicine. Like Dr. Farahany, I believe medicine is not the only way to serve the community. For Dr. Farahany, she combined her passion for science and policy to help guide her career into bioethics, allowing her to serve her community by preserving the rights of research subjects, patients, and researchers. I struggle between my passion for solving the blatant healthcare inequities here at home and in the world, realizing that I can attempt to solve such inequities through either research into healthcare access inhibitors or through providing medical care in the future. Whichever path I choose, Dr. Farahany’s talk emphasized the necessity for an interdisciplinary set of experiences to guide my perspective when contemplating the solutions to our most pressing concerns today.
Neha is from Los Angeles, California and is pursuing a co-major in Global Health and Neuroscience.