BOOK REVIEW: The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers–How Medicine Is Blurring the Line Between Life and Death by Dick Teresi

“Are you dead or alive?”

The Undead opens with a question that seems like it should have an easy answer. But Teresi, a science writer, argues that in today’s age of beating-heart cadavers that can breathe, urinate and even give birth while legally dead, it can be hard to tell.

Historically, Egyptians and ancient Greeks considered a heartbeat to be the telltale indicator; Christian and Hebrew interpretations of the Bible pointed to breath. The Samburu people in Africa still contend that someone is not dead until hyenas will eat the body.

In the modern era, Teresi says, the need for organ donors has brought about a new kind of death: the “loss of personhood,” or brain death. Coma patients who require ventilators to breathe can be declared dead long before their hearts stop beating on the basis of simple, low-tech exams — a Q-tip touched to the surface of the eye, a splash of ice water in the ears, a gag reflex test. Despite this, researchers disagree on how “dead” a brain-dead person really is. For instance, some still show EEG activity when tested. “If you are finding any dead people with brain waves,” Teresi asks pointedly, “what’s waving?”

Teresi is critical of this hard-to-define state of personhood, and his investigations into the matter can make the book an uncomfortable read at times. With all this debate over who’s dead and who’s not, one might start to see the wisdom in letting the hyenas decide.

Pantheon Books, 2012, 350 p., $26.95