Death of the Brain Is Not the Death of the Human Being

Charles C. Camosy, PhD

Disclosures

September 23, 2013

In This Article

Now You're Dead, Now You're Not

This is a remarkable argument, not least because it appears to claim that the time of death can be different for the exact same kind of organism in different contexts. In one context, when organs are not available or needed, death is defined in one way. In another context, when organs are needed and available, death is defined in a different way -- one which makes them easier to procure.

We see this in another possible organ donation situation when the medical team is concerned with cardiovascular function instead of brain activity. In one context, when organs are not needed and the goal is to save the patient's life, absolutely no one would consider a patient "dead" who had arrested for a mere 5 minutes. But in another context, when organs are needed and available, death is defined a different way so that organs are easier to procure. In such a context, the same exact patient is determined to be "dead" 5 minutes after cardiac arrest.

Where is the end point for this kind of reasoning? We could get even more good, fresh organs by deciding to define death such that, say, all team members of the New York Giants are considered dead. This, I hope each of you are thinking right now, would be absolutely ridiculous.

But why? I think the answer must be that death should be determined by who or what the patient is (or was) and why she is no longer there. This is determined by evidence and standards that are independent of the interests of scientists, physicians, and those waiting for organ transplants. And this is true whether we are speaking about the New York Giants, or patients who have a dead brain.

"Dead or Alive" Status Changes by Locale

For those who know how our current organ transplant practices began, however, it is anything but surprising that a patient's status as dead or alive is being determined by her suitability for organ transplant.

Princeton University philosopher Peter Singer has pointed out that the invention of the ventilator, which allowed many permanently or persistently unconscious patients to continue to breathe, also tempted medical professionals to take vital organs from brain-dead patients while they were still breathing and while their heart was still beating.[2]

But, as Singer points out, there was a seemingly insuperable barrier to doing this: To remove a vital organ of a living patient would be murder. At least, it seemed that way 2 generations ago. But the now-famous Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death changed everything.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.

processing....