bloody zombie hands grasping air

Considerations for a Zombie Apocalypse: The Definition of Death Among the “Walking Dead”

While there has been a great deal in the literature that discusses the ethics of neurologic, cardiopulmonary and biologic death in the context of organ donation, there has been very little attention to this application with regard to zombies. Zombies are often referred to as “living-dead” which creates both a scientific, operational, and ethical conundrum with regard to classification. To date, there is no definitive answer as to whether zombies are truly “dead” or whether they are “living” or that they exist along the spectrum of conscious to coma, from living to dead. In the event of a zombie apocalypse, it is currently unclear whether or not zombies could be considered suitable organ donors.

Zombies: A Definition and Brief History

Zombies are a class of “living dead” that also includes vampires, ghouls, mummies, and wights. The term “zombi” was reportedly first used by the poet Robert Southey in his description of Brazilian history. One of the earliest references to zombies dates back to Mesopotamia in the Descent of Ishtar when the goddess Ishtar threatens to “raise up the dead, and they shall eat the living.”

Since then, there have been hundreds, if not thousands, of descriptions of undead, zombies, and reanimated humans in comics, books, television programs, and movies. Some cultures have an extensive history of zombies, the most well-described and studied being the Haitian Zombies of Voodoo.

Zombies are further divided into subcategories: zombies reanimated by black magic (Voodoo), those created by sorcery (necromantic), viral- induced (Solanum) and those created by mutation from radiation (atomic). There have been case reports of drug-induced zombies, but these were later re-classified as this state was reversible without intervention. There is a movement to utilize the more descriptive terminology Ataxic Neurodegenerative Satiety Deficiency Disorder (ANSDS).

Culturally, the term differently-animated has been used as a more politically correct term for identifying zombies. The varied terms, means by which zombification can occur and the newer, more descriptive and politically correct terminology however, has done little in the way to describe the actual physiologic state of zombies. This requires a more in-depth analysis of what we do and do not know about zombie biologic and specifically neurologic function.

Neurologic Function of Zombies

It is unclear if any physiologic differences exist between these categories of zombies and how they may differ with regard to either neurologic physiology (or pathophysiology). There are sources that argue there are significant differences between zombies that are reanimated by a magical source compared to those that have had a viral or radiation induced reanimation. The argument is that magically created zombies are dead and all of their movement and activity is controlled by the sorcerer or magician. In comparison, those who have been infected or exposed to radiation have some features of living beings with some evidence of central nervous system activity. To date, there is very limited evidence to support either theory.

There are arguments both for and against actual meaningful neurologic activity among zombies. While zombies appear to be “awake,” it is unclear if this is because of meaningful neurologic activity or a result of other mechanisms. Being conscious is defined as being aware of and reacting with one’s environment. It is not entirely clear if this is the case with zombies as the experience and literature on this topic is quite varied.

There are good arguments that while zombies possess activity that can be classified as purposeful, the features of these activities suggest either absence, atrophy, or severe dysfunction of normal brain structure and function and cannot be construed as organized neurologic activity. Zombies lack any real ability to communicate, do not seem to form memories and are limited with regard to emotion, planning and coordination. They possess an awkward, shuffling gait that suggests severe cerebellar dysfunction, if not the cortical motor areas as well. The aggressive behaviors, inability to emote and lack of fear of the zombies suggest significant damage or inactivity of the amygdala as well as the orbitofrontal cortex. The lack of satiety, especially that for human flesh suggests inactivity or absence of ventromedial and hypothalamic impulses. There is one case report of a Zombie MRI, which revealed at best, only scant activity of the brainstem.

One of the most striking arguments for intact neurologic activity is the acute sense of smell characteristic of zombies. Zombies have a keen sense of being able to track living humans, mainly through sense of smell. This suggests at least some parietal lobe function. If the smell of human flesh triggers the zombie to attack and most commonly to eat, this would argue that there is higher cortical functioning as well. There is also some evidence that zombies may retain memory. While it appears that zombies do not remember individuals, they may remember places. There is some evidence that zombies possess some implicit memory and can return to places that they resided or have had some sort of meaningful experience.

The Definition of Dead

The dead donor rule requires that any organ donor is legally dead.

This can either be defined as neurologic death or cardiopulmonary death. Neurologic death is defined as an irreversible loss of all functions of the brain, including the brainstem. Zombies do appear to have some neurologic function, even in the absence of any apparent type of respiratory or cardiopulmonary support. There is evidence for an intact sense of smell as well as memory and motor function in the zombie population. While complex, zombies do not appear to meet the criteria for neurologic death and cannot be considered to be potential donors while in their reanimated state, at least according to the dead donor rule as defined by neurologic criteria.

There however is an argument that zombies in fact meet the criteria for biologic death. One of the features of zombies is that they are in a continual state of decay. Zombies do not have a functioning cardiopulmonary system, do not digest food and do not have any evidence of metabolism. Homeostasis has ceased and decomposition has ensued, which is in fact more in-line with biologic death.

It has been argued that anything outside of actual biologic death is a “legal fiction.” Most sources would argue that biologic death is really the only “true” death, as it represents loss of neurologic function, cardiopulmonary function and loss of cellular metabolism and homeostasis. This is the state by which most people die and that is most widely accepted culturally.

The issue with biological death, however, specifically with regard to organ donation, is loss of organ viability. It is less of a debate that biological death would be the sounder ethical means for organ donation, but the loss of viability is the key factor in preventing that. That zombies meet the widely accepted and more ethically sound definition of biologic death criteria and not neurologic death is a unique conundrum.

This simply does not exist otherwise and thus raises the question: would it be ethical to utilize zombies for the purpose of organ donation based on meeting the criteria for biologic death?

The answer to this as we suggest, lies in the fact that while there is a total loss of cellular homeostasis in all other organs, the brain and neurologic function is still the key. From an array of perspectives, any display of neurologic function suggests that there could be higher neurologic function that still perceives pain, emotion and memory. Considering a human or human sub-type as dead without total loss of neurologic function would violate the ethos of human organ donation.

Thus, while all most of the criteria for biologic death is met, the remnants and uncertainty of neurologic function precludes the possibility of organ donation in this population

Zombies are an entity that are in a state often termed “living-dead.”

They seem to possess at least some basic brainstem function, while simultaneously having lack of any metabolic processes suggesting they meet criteria for biologic death. They are in fact considered a “corpse” in most literature and are in an active state of decay. While this decay may actually be the defining determinant of organ donation among zombies, specifically whether these organs would be viable or not, it is important to have a legal definition of death in this population. While zombies meet biologic death criteria, they are not legally dead. The is evidence of neurologic function that complicates the issue but precludes zombies from being considered dead by definition. While most people would not object to using the zombie pool for a means of organ procurement, by current ethical principles this is unjustified.

Stephen Wood

Stephen P. Wood, MS, ACNP is an acute care nurse practitioner practicing emergency medicine in Boston, Massachusetts, and a fellow in bioethics at the Center for Bioethics at Harvard Medical School in Boston. He is also a consultant for the Southern Middlesex Regional Drug Task Force, and the New England Coalition Against Trafficking; the chair of the Winchester Hospital Substance Use Task Force; and the co-chair of the Southern Middlesex County Mental Health Working Group. In addition, he is a lecturer at Northeastern University in the Bouvé College of Health Sciences.

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