Death is an irreversible end of life marked by a cessation of brain function or circulatory or respiratory functions. It's a crucial medical and legal determination in the healthcare system, and roughly 68 million people die worldwide annually. Throughout history, human death has been seen as a central life phase event. Communities have formed distinct rituals, mourning practices, and religious beliefs about the human experience tied to this milestone.
Approximately 3.1 million Americans die annually, with about 98% declared dead based on cardiopulmonary criteria—meaning they're not breathing and have no heartbeat. The other 2% are declared brain-dead, a medical diagnosis based on an extensive series of neurological tests.
Death triggers a series of events in the body that ultimately lead to decomposition. Muscles relax, including the bladder and bowels, so feces and urine are typically expelled soon after death. Within hours, as the body stops producing adenosine triphosphate—a molecule needed to relax muscles—a rigid state called rigor mortis takes hold. This temporary condition fades within about 24 hours. Next, within 24 to 48 hours, the body begins to consume its own tissues through autolysis and produces discoloration, gas, and unpleasant odors.
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Watch this video exploring the evolution in how researchers are studying and understanding death in the context of recent scientific research. CPR to restart hearts, ventilators, and other discoveries have challenged the way we think of death and scientifically upended the idea of death as a single moment.
For most of the 21st and 20th centuries most Americans died in hospital settings. But in 2016, home-based deaths overtook hospitals; most Americans are now dying at home, likely fueled by individual preferences to die at home or to receive at-home palliative care.
Heart disease killed more than 680,000 people in 2023 and cancer killed around 613,000 people that year. Both causes of death are far above the next leading cause of death—accidents, which numbered around 223,000. Provisional data for 2024 indicates the leading causes of death remained the same.
After the president was killed in April 1865, he became one of the first well-publicized embalming examples in the US. The burgeoning science enabled his body to go on a multistate tour. Prices soon climbed for the process and fueled more wakes, perhaps helping to lay the foundation for the pricy funeral industry.
Traumatic brain injury-related deaths have generally increased between 2000 and 2023, growing from roughly 49,000 to more than 68,000 in 2023. Firearm-related suicide is the most common cause of TBI-related deaths in the US, according to the Centers for Disease Control and Prevention. People also experience TBIs from falls, motor vehicle crashes, or assaults.
Recent research indicates that organs, including the brain, are better at handling a lack of oxygen after the heart stops beating than previously known. Such findings may open up possibilities that include someday reversing certain death processes and expanding the availability of organs available for organ donations. (Some users may experience a paywall.)
The 1981 model law, now enacted in most states, is the legal basis for death in the US. There have been many efforts to amend this law, citing the need for more transparency to improve trust between families and the medical profession, though none have moved forward. Alterations to the law could have implications for organ donations and removing life support.
A growing share of the funeral home industry is being acquired by private equity-backed firms. A 2022 article states that about 20% of this $23B business is owned by funeral home chains, and private equity-backed firms own about a quarter of those.
Seeking to resolve long-standing variations between hospitals and state procedures, in 2023 several expert groups published comprehensive step-by-step guidance for clinicians to follow when determining brain death in kids and adults. Among other guidelines, it stated that doctors don't need to get family consent to do the tests needed to make this determination.
This video and accompanying article in the peer-reviewed New England Journal of Medicine show the then-standard steps of a full brain death examination—demonstrating the process on a medical dummy to search for pain, blinking, eye movement, cough, gagging, or other forms of responsiveness. (May need to sign up for a free account to view.)
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