The Bible says death is irreversible without a divine miracle (Hebrews 9:27; 1 Corinthians 15:22). What it does not say, explicitly, is when death becomes “official.” Medical developments have provided means to resuscitate those previously beyond hope. That has led to the question of where, exactly, the line is drawn between being “alive” and being “dead.” It has even raised the debate of whether a person’s body can be medically alive, while the soul and spirit have permanently departed. Such circumstances are rare but puzzling. While Scripture provides guidance, we cannot find absolute, black-and-white identifiers for declaring a person “really” dead.
From a biblical perspective, “real” death occurs when the soul and spirit leave the physical body. Obviously, this is not an event that can be observed with the eyes or measured with medical equipment. Rather, a biblical approach would be to compare physical signs to the functions of the soul and spirit. When a person seems to irreversibly lose those functions, it’s reasonable to believe he or she is truly dead.
There are many examples of those in a coma or persistent vegetative state who recovered, and even in the coma they sometimes showed signs of awareness. Biblically speaking, such persons were never “truly dead.” Spiritually, they were in a similar condition to someone who is sleeping: the soul is present but not actively aware of its surroundings. Those diagnosed with “brain death,” on the other hand, appear to be biologically alive, with cells that continue to function, but their brain has ceased all activity, and they lack any awareness of spirit; therefore, they are most likely devoid of a soul or spirit.
The medical community considers death a process, rather than a single moment. Measurements used to diagnose death have varied throughout history. For many centuries, breathing was considered the litmus test for life. Those not apparently breathing were declared dead. As medical equipment improved, that standard shifted to the heartbeat. Today, it’s possible to measure breathing, heartbeat, and brain activity on a scale imperceptible to the unaided eye. As a result, medical professionals today distinguish between “clinical death,” “biological death,” and even “legal death,” depending on the topic of conversation.
We can be certain that death, when it truly occurs, cannot be undone by medicine or technology. Once a person is “truly dead,” his soul and spirit are entirely separated from the body. That separation can only be undone by the direct intervention of God in a true miracle. So, when people speak of being “brought back” from death in an ambulance or being “dead for ten minutes,” they are using biblically inaccurate terms. In such cases, those persons came very close to death, but they were not truly dead.
Humanity has long recognized the complexity of recognizing when real death occurs. To the casual observer, it’s possible for a person to appear dead but actually be alive. That awareness is reflected in prophecy and miracles in the Bible. For example, Jesus deliberately delayed resurrecting Lazarus until the fourth day after his death (John 11:17). This delay precluded any possible claim that it was a trick or that Lazarus was merely in a coma or sleeping. In fact, by the time Jesus arrived, Lazarus’s family was concerned about the stink of decomposition (John 11:39).
Likewise, Jesus prophesied that He would be in His grave for “three days and three nights,” since that was the customary waiting period after which death was considered official (Matthew 12:40). Not that this was absolutely necessary—Jesus was killed by professional executioners (John 19:13–18), stabbed through the heart (John 19:33–34), and buried in a guarded tomb (Matthew 27:62–66). The three-day time period, in Jesus’ case, was more for prophetic reasons than “proof” reasons.
In the cases of Jesus and Lazarus and most people in history, defining the exact moment of death is unnecessary—they were unmistakably dead. Debates over when exactly death occurs involve a very thin “gray” area and don’t apply to most of human experience. Most controversial are instances when a person’s body exhibits biological signs of life but there is doubt about brain function. Comas, vegetative states, and “brain death” encroach into this territory.
For the most part, those in comas and vegetative states are still considered “alive,” albeit with limited awareness. Allowing such a person to die by removing life support or withholding care would presumably cause the separation of the soul and spirit from the body; that is, it would cause “true” death. A body exhibiting brain death, on the other hand, would appear to be one that the soul and spirit have already left behind. Removing mechanical support from a body diagnosed with brain death would not appear to cause death, in the biblical sense, since that line has already been crossed.
For this reason, most Christians are opposed to ending the life of a person in a coma or vegetative state. In cases of brain death, or when life is only possible with extreme measures, Christians are often split on the morality of allowing a person to die naturally. Living wills were created specifically to address these concerns. Obviously, this is a topic open to considerable differences of opinion. When discussing or deciding such a topic, Christians should prioritize the sanctity of life while being graceful with and forgiving of others.