As doctors, we all remember the first time we had to declare a dead patient as officially dead.

For me, I was on night shift, as the ward intern, in a major public hospital in Sydney’s western suburbs. A nurse paged me to declare one of the patients on her ward as dead. I didn’t know how to do it. I’d never done it before.

So, I asked a more senior resident. It’s easy, he told me. Just examine the patient for vital signs, and then write in the notes that they’re dead. And note the time and date you did this.

So that’s what I did. I went to the dead body and examined it. And then I wrote in the notes what would become my standard formula for declaring someone, dead:

Heartbeat – absent
Breathing – absent
Blink reflexes – absent
Pupil reflexes – absent
Gag reflex – absent
The patient is declared officially dead.

Sign it. Date it. And then put a big box around it.

Over the next few years, I would perform this same ritual over and over again.

Dead or alive: What’s the difference?

Every now and then, whenever I was working a shift in the Emergency Department, people from a funeral directory would bring a dead body to the hospital so that a doctor could write a death certificate for them.

It was a mere matter of formality. The body was so obviously dead. It was already in a thick, black, plastic body bag. Often the person had been dead for hours, even days.

But I always thought I should do it properly. Just in case!

I would unzip the body bag. And then I would go through the whole exercise of sticking my stethoscope on the body’s chest and examining for reflexes.

The funeral directors would look at me in disbelief. The person was so obviously dead!

And that’s just it. In the medical profession, we see many, many dead bodies in our lifetime. A dead body is so obviously dead. Even if the person has been dead for only a few minutes, they are so obviously dead.

But what is it that makes them dead? What is the difference between living and not living? What is it that the person had when they were alive, which they no longer have now that they are dead?

Despite what I write in my standard formula of declaring someone to be dead, it’s more than a heartbeat, breathing, and reflexes. We can take these away from a patient during a cardiac bypass operation under general anaesthesia. Yet, we would not declare that person to be dead. That person is still alive, with or without those vital signs.

So, what is it that makes a person alive?

What is it that a living person has, that a dead body no longer has?

The story of humans according to the Bible

“Then the Lord God formed a man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being.” (Genesis 2:7).

What is it that makes a person alive? According to the highly poetic language of the Bible, it is breath (Acts 17:25).

Phenomenologically, this makes a lot of sense. Whenever we see a still, sleeping baby take a breath, we are once again reassured that the baby is alive. Conversely, when someone dies, we say that this person took their final breath.

Without breath, the man, Adam, is merely dust. He is only atoms and molecules. But with breath, he is alive. He is more than a collection of organic chemical compounds. He is a living being.

On the flip side, when he dies, he returns to dust (Genesis 3:19).

But it’s more complicated than this.

The human spirit

In the Bible, the language of “breath” and “spirit” is used interchangeably. That’s why the Bible often talks about death as someone, not just taking their last breath, but also giving up their spirit (e.g. Ecclesiastes 12:7; Matthew 27:50; Acts 7:59).

So, what is it that makes us alive? According to the language of the Bible, it is “breath” or “spirit”. We have a spirit that animates us. This is the spark that keeps us alive.

This is why a patient – under anaesthesia without their vital signs – is still alive. They still have a spirit.

Conversely, this is what is missing when we finally declare someone to be dead. Their spirit is no longer present. Their body might be present, but not their spirit.

This is where most of my medical and non-medical friends will roll their eyes. Any talk of spirit will be laughed away as religious mumbo-jumbo.

For those of us trained in the sciences, who only believe what we can see under a microscope, we’re happy to talk about brains, heartbeats and reflexes. But any talk of the “spirit” or even – gasp! – a “soul”, is deemed fairy-tale nonsense.

The mind-body duality

Or is it? This is where I want to argue that the Bible’s view of “breath”, “spirit” or “soul” gives us a far richer anthropology.

How so? Let me tell you a story about my son Toby. When Toby was four years old, he asked me, “Dad, how do I get my leg to move?”

I answered, “Your brain tells your leg to move.”

But then, Toby replied, “But how do I tell my brain to tell my leg to move?”

At that I immediately grinned. “Aah, Toby,” I replied. “You have stumbled upon what philosophers call the mind-body duality problem.”

Most of us are familiar with the mind-body duality problem. If we are committed to a strictly materialist account of reality, there can be no such thing as the “mind” and a “body”. There can be only a body. We have a physical brain, which is part of our body. But there is no “mind” that tells our body what to do. And there is definitely no “soul”.

Or, as it is often explained, there is no ghost behind the machine.

So, how do we typically account for the phenomenon of human consciousness? When Descartes says: “I think therefore I am,” where is this “I”?

The story of humans … according to materialism

According to materialism, the answer is that human consciousness is an illusion. It’s a trick that our bodies have learned to play upon ourselves.

A good popular representative of this school of thought is Yuval Noah Harari, the author of the bestsellers Homo Sapiens and Homo Deus.

In a recent lecture, Harari said that humans are only a combination of molecules and neural pathways. Any talk of human rights, free will, or love, is basically a useful fictional story that we’ve been telling ourselves. These things don’t exist.

Up until now, they have been useful in helping us to get along and survive.

But here’s the key thing: They don’t exist.

What, then, is a human?

This is where it gets interesting. Once upon a time, we wondered how a human was different from any other animal – a dog, an elephant, or a dolphin?

But now the question for the 21st century is, how is a human different from a computer?

Especially now that we have artificial intelligence – with its deep learning – how is human intelligence different from artificial intelligence (AI)?

At first, we can try to say that a human has consciousness and free will, but a computer doesn’t.

But again, this will not do. If we’re committed to a materialist account of reality, these do not exist.

As Harari would remind us, a human is only a combination of molecules and neural pathways, with our own set of complex algorithms. No more. No less. In the end, this is no different from a computer with its circuits, pathways, and complex algorithms.

Maybe then, like Kai Fu Lee, author of AI Superpowers, we can try to say that a computer will never have human qualities such as love, empathy, or relationships.

But, again, if we’re committed to a strictly materialist account of reality, then this too is fairy-tale nonsense. Love, empathy, and relationships are merely fictional stories we’ve been telling ourselves to get along, survive, and propagate. But they don’t exist in any real, objective sense. They are, in the end, only complex algorithms that we’ve been using to regulate inter-human interactions.

We are now entering uncharted waters.

Once upon a time, scientists laughed at popular media for the way it anthropomorphised computers, robots, and AI – especially by giving it a human face with two eyes.

Take, for example, Joanna Bryson, a professor of computer science. Bryson says that computers are obviously not humans. So why give them a human face? Clearly, computers are only running on an algorithm. A code. So why humanise them – as if they can think for themselves?

But, if a human is also only a set of circuits, with our own algorithms, with no soul or spirit, then aren’t we guilty of the same naïve error when we talk of ourselves as human?

Are we similarly guilty of anthropomorphising a human? Especially when we talk of human rights, free will, love, and consciousness?

A strictly materialist account of humanity has painted us into a corner where there is no essential difference between a human and a machine.

The Bible’s take on all this

But what if we once again return to the Bible’s anthropology?

I remember when I was a junior resident, working a shift in the Emergency Department. Suddenly a triage nurse spoke into the loudspeaker systemL “Could someone take the broken finger to Bed 8?”

It was a cringe-worthy moment.

A patient had been identified. Not as a person, but rather, as a diseased body part. It was so humiliating. It was … de-humanising.

Yet, if all we are is atoms and molecules, then it’s not de-humanising at all. If the materialist account is true, we would make the opposite problem if we anthropomorphised the patient as a human being. They are no more than their body parts. Get over it.

But what if that patient really is more than the sum of their body parts? What if that person is animated by “breath” – a spirit breathed into them from God?

Breath isn’t just the difference between living and not living.

Now, more than ever, our God-given breath is also what gives us human worth and dignity, free will, moral accountability, love and relationships.

This article was first posted on Luke’s Journal, an online newsletter by the Christian Medical and Dental Fellowship of Australia, and is republished with permission.