Three years ago my closest friend, for the longest period of time in my life, was attacked by her only son, as he spun out in a psychotic rage in an exile motel room in the middle of a nowhere that is upstate New York as she was bringing him his dinner; a covered dish of pasta and red peppers. It was some moment between that attack, and a couple hours later, when OR techs at St. Elizabeth's hospital in Utica, NY confirmed that she was clinically and legally "brain dead" that she either did or did not pass from the corporeal realm and graduate to the status of a fully viable, eternal human being. And that's the real question here, because her heart - driven by the raw mechanics of her still-functional brain stem - had not yet given up the fight to push blood through her system. Her lungs had not stopped expanding and contracting. Legally, she was still alive, and she would remain "alive" until 5:00 the next morning, when, surrounded by a small family contingent, she finally died in a legal sense and in keeping with her family's Roman Catholic traditions.

On her stone, it reads June 11, 1957 - January 20, 2009, but in my heart I honor her passing today, on the 19th of January, since it's my own belief that she passed on as soon as her brain became permanently incapable of cognitive response of any kind or at any level. But what's the truth about death?

Is the human being the corporeal whole, regardless of how little of that whole is still auto-functional? And why is it a case where the beating heart can ever be any criterion when the question of life is being examined? Dick Cheney hasn't had a beating heart for years now. Is he legally dead because he's got no pulse anymore?

So when does a person cease to be "alive"? In our culture, your heart can stop for quite a while and yet you'll still be considered alive. Your brain can be incapable of any level of function beyond the basic brain stem activity that keeps the heart beating and maybe even the lungs expanding and contracting, but does that mean that you're trapped inside that husk until the heart and lungs stop their activity. Or are you standing by, and watching the drama play out along with the gathering of loved ones that have assembled in a grim vigil as your belligerent body refuses to give up the fight?

This is the question that drove me deep into the field of Metaphysics. Did Rhonda die three years ago today, or did she survive into the small hours of January 20th?

You obviously cared deeply for your friend. I am so sorry for your loss.

This question cannot be answered except by opinion. Medicine believes in both your options. We know for sure a person is gone when the heart no longer beats, however as you say, people "come back". Sometimes they come back from profound coma, but it is exceptional.

Since you were so close to your friend, your feelings regarding when she died, are as valid as it gets in cases like this.

I have seen many people die. What I have observed is that following the heart stopping, a period of time passes, not long, but sometimes longer than you might think, and there is a change in the look/feel of the body, I don't mean physical feel. That is when I always knew the soul had left. With comas often you know, there is no one there and the body is just a husk.

Anniversaries can be hard. My heart goes out to you today.

Such a tragedy, I am sorry for your loss. If I were you, I would use both days (19th and the 20th) to honour her memory by reflecting upon all the happy times you spent together.

You bring forth an interesting question, but one that is difficult to answer. Beliefs towards the existence of the Soul, the Afterlife and attitudes towards Dualism (mind-body debate) are important factors when addressing this question.

Going by my own personal beliefs, I agree with you that she probably did die on January 19th when she was incapable of cognitive responses of any kind. I believe her Soul departed her body at this moment and was in a "intermission" stage when her body was still functioning. Once her body ceased to function, she left this intermission stage and she experienced the next leg of her spiritual journey.

I'm sorry for your loss NE and my following answer does not in any way shape or form imply anyone made the wrong decision to switch off her life support.

But there are many cases where people have lain in a brain dead coma for months and have suddenly 'awakened' again. If your definition of death only extended to the functioning of the brain, then by definition these people would have returned from the dead.

Maybe 'death' only occurs when the body is in a state either through injury or decay that it is no longer capable of being animated through the process we call 'life'. I really don't know about the medical side of things to give an accurate answer, but I do know that many cells in the body stay alive for a significant period after a technical death, and it is because of this doctors can reattach fingers or hands which have been severed many hours prior.

The brain however is obviously the most important organ for determining life and death as it is the seat of consciousness. I would assume that due to its complexity that even just an hour or two after a technical death it will have reached a state where it is no longer able to function at a level capable of supporting life. But if it is kept in a state (for example a coma) where it is still capable of being fully functional, whether it happens to be functional at the time or not is something else; and adds a lot of grey to an answer which should be black or white.