Hektoen International

A Journal of Medical Humanities

Defining Death in Whose Life is it Anyway?

Morven Cook 
United Kingdom



© Photo by Tim Matheson. This image is taken from a production of Whose Life is it Anyway? staged by Realwheels Theatre*

Death itself is a social construct, and in a pluralistic society such as ours, a conclusive definition of death, or determination of the moment of death, is out of reach of both medical science and philosophy.1

Brian Clark’s Whose Life is it Anyway? is a play that tells the story of Ken, a young man left quadriplegic after a car accident.Although Ken’s condition is stable, he is informed by doctors that his paralysis is permanent. On realizing that he will never live outside of specialized care facilities, Ken refuses the treatment and support keeping him alive. The hospital authorities challenge this decision, believing that Ken is not in the right frame of mind and will come to see his situation differently in time. Ken disagrees and becomes frustrated by the doctors’ failure to accept or even acknowledge that an individual’s beliefs may differ from those held by the dominant power. Ultimately, Clark’s play seeks to critique the way in which institutions and authorities construct definitions, which they rely on to justify their values and what they determine to be ethical.

Whose Life is it Anyway? was first staged in 1978, just ten years after a committee of physicians at Harvard Medical School published a paper offering a revised definition of death. Death had been defined as the complete stoppage of circulation and subsequent cessation of respiration for most of the twentieth century; however, developments between the 1940s-60s seriously challenged this understanding. Advances in biotechnology led to mechanical devices which could sustain heart function and respiration.Physicians also recognized that patients with catastrophic brain injuries could maintain other functions and were thus potential donors for transplantation. Transplantation, however, could only be carried out after a patient was declared legally deceased. Subsequently, the new definition of death insisted that brain activity was the most appropriate means of determining whether someone was alive or not. Clark’s play directly references these events as Ken argues:

Any reasonable definition of life must include the idea of self-supporting. I seem to remember something in the papers—when all the heart transplant controversy was on, about it being alright to take someone’s heart if they require constant attention from respirators and so on to keep them alive.5

By directly referencing events in the “real world”—the world that the audience inhabits—the play questions how institutions construct new definitions to reflect a particular world view. Ken contends that establishing a new definition of death made it ethically permissible to remove organs from an individual whose body was being supported by technology, and would likely always require that support. Thus, while the hospital argues that his definition of death is not appropriate, he argues that language only gives the illusion of conveying fixed and determinate meanings. Meaning is always attributed by the human mind and there is no absolute truth outside of construction.

Nor do I wish to live at any price. Of course I would like to live but as far as I’m concerned, I am dead already. I merely require the doctors to recognize the fact. I cannot accept this condition constitutes life in any real sense at all.6

The repetition of personal pronouns such as “I” and “me” reinforce the fact that definitions can take on personal and subjective meanings. However, this can prove a barrier to communication as Ken challenges the set norms and expectations regarding the use of language. Ken struggles to communicate what he means as he belongs to a speech community that does not recognize his definitions of life and death. Thus, the phrase “I am dead already” appears illogical as according to the prevailing definition of death it is not possible to declare oneself dead—it is a contradiction in terms. Furthermore, Ken’s vague description of  “this condition” emphasizes that he essentially finds himself in some kind of indeterminate state between life and death, an experience which has no word in English, or indeed no word at all. French philosopher and literary critic Jacques Derrida was acutely aware of such a problem. Derrida argued that language is constructed around oppositions—such as life and death. However, these oppositions are reductive as they mask the complex and fluid nature of our experiences and the world.7 It was for this reason that he stressed the importance of “deconstruction.”  In his foundational text, On Grammatology, he adopts a technique originally developed by Martin Heidegger in which a cross was placed through words or phrases which seemed to commit him to something he wished to deny. Derrida claimed that writing “under erasure” was necessary to indicate that a word was inadequate and remove some of the metaphysical baggage which accompanies words.7 This reflects Ken’s own difficulties and inclination to make seemingly contradictory statements as a means of communicating his ascribed meaning.

In 1983, Derrida stated in an interview that his ” ‘first’ inclination wasn’t really toward philosophy, but rather towards literature—no, towards something that literature accommodates more easily than philosophy.”8 Derrida was confident that literature was capable of embodying the principles of deconstruction by offering a more nuanced perspective, and by being conscious of language construction as a means of forcing a shared viewpoint.9 Whose Life is it Anyway is not necessarily literature as described by Derrida—it does not abandon form or relinquish the desire for completion—however, that is not to say that it does not accomplish what Derrida believes literature to be capable of. While the play can seem a little didactic with Ken, by Clark’s own admittance having “all the best lines”10 it simultaneously recognizes its own bias. The judge presiding over Ken’s case states:

We must, in this case be most careful not to allow Mr. Harrison’s obvious wit and intelligence to blind us to the fact that he could be suffering from a depressive illness.11

Clark alerts the audiences to his handling of Ken’s dialogue and to his use of rhetoric, which can obscure the “true” meaning or nature of a situation. Ken’s dialogue can, at points, seem detached, lacking emotion and too carefully articulated. And yet, when read alongside these remarks it is clear that Clark does not wish to deceive his audience. The Judges’ comments not only pertain to the characters in the play but act as a warning to the audience, reminding them that language is a tool for persuasion and that we must remain critical of the way it is used.

Our understanding of language and the impact this has on the world is neither fixed nor inevitable; we must always be willing to challenge the conceptual structures which mould and shape our thoughts. This is seen in the debates regarding end of life care. Whilst our enhanced understanding of the body has helped us comprehend the biological processes surrounding death, and recognize the potential we have to prevent it, it has also complicated the responsibility we now have in deciding whether this is always appropriate. The elusive goal of saving and extending life is filled with unintended consequences, most notably the potential to interfere with patients’ autonomy and prolong their suffering. If we cannot be sure that what we are doing is right and that the conventions of our society are just, then we must always be willing to question everything, even if this means living on unstable ground. A deconstructive approach does not provide a moral code which must be followed in order to achieve clearly defined positive or moral outcomes. Rather it is, what Simon Critchley rightfully argues, that “Deconstruction ‘is’ ethical.”1 It is the process of deconstruction which is ethical—demanding that we always view situations from a variety of perspectives—at all times questioning our own motives and concepts. Literature, such as Brian Clark’s Whose Life is it Anyway?, can aid us in this process by further deconstructing the very terms with which these bioethical debates have been built on.


* The Realwheels Theatre is a Vancouver-based company that aims to inspire a new generation of artists to participate in the arts and further develop an audience to embrace the inclusion of disability onstage and offstage.



  1. Younger, “The Definition of Death,” 286.
  2. There are actually two versions of Brian Clark’s play, the original 1978 version which I’ll be focusing on, and the 2005 version which was adapted to suit a female lead.
  3. Spellman, A Brief History of Death, 177.
  4. Younger, “The Definition of Death,” 286.
  5. Clark, Whose Life is it Anyway[a], 76.
  6. Ibid.
  7. Critchley, The Ethics of Deconstruction: Derrida and Levinas, 2.
  8. Derrida, “An Interview with Derrida,” 73.
  9. Derrida, On Grammatology.
  10. Clark, Whose Life is it Anyway[b], 4.
  11. Clark, Whose Life is it Anyway[a], 79.



  1. Clark, Brian. Whose Life is it Anyway?[a]Oxford: Amber Lane Press, [1978], 2010.
  2. Clark, Brian. Whose Life is it Anyway?[b]Oxford: Amber Lane Press, 2005.
  3. Critchley, Simon. The Ethics of Deconstruction: Derrida and Levinas. Edinburgh: Edinburgh University Press, [1992], 1999.
  4. Derrida, Jacques. Of Grammatology. Translated by G. Spivak. Baltimore: John Hopkins University Press, 1974. Originally published in French as De La Grammatologie. Paris: Les Editions de Minuit, 1967.
  5. Derrida, Jacques. “An Interview with Derrida.” In Derrida and Difference, edited by D. Wood and R. Bernasconi, 71- 82.  Evanston: Northwestern University Press, 1988.
  6. Spellman, W.M. A Brief History of Death. London: Reaktion Books, 2014.
  7. Younger, Stuart J. “The Definition of Death.” In The Oxford Handbook of Bioethics, edited by Bonnie Steinbeck, 285- 303. Oxford: Oxford University Press, 2008.



MORVEN COOK is a first-year PhD student at the University of Hull, having recently completed her MA (Hons) in English Literature at the University of St Andrews. Her current research is supervised by Dr. Jennie Chapman and focuses on depictions of end of life care in contemporary British and American texts. She has undertaken research as part of a competitively funded internship scheme where she worked on the process of composing poetry related to traumatic personal events. During her undergraduate degree she worked as a research assistant for Dr. Chris Jones on the archive of Douglas Dunn.


Spring 2016  |  Sections  |  End of Life

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