A defense of the whole-brain concept of death

Hasting Center Report

Volumn 28, Issue 2, 1998, Pages 14-23

  Bernat, James L ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANALYTICAL APPROACH; ARTICLE; ATTITUDE TO DEATH; BRAIN CORTEX; BRAIN DEATH; BRAIN STEM; CONSENSUS; DEATH AND EUTHANASIA; HUMAN; MEDICAL ETHICS; PATHOPHYSIOLOGY; POLICY; TRANSPLANTATION; UNIFORM DETERMINATION OF DEATH ACT;

ANALYTICAL APPROACH; DEATH AND EUTHANASIA; UNIFORM DETERMINATION OF DEATH ACT;

ATTITUDE TO DEATH; BRAIN DEATH; BRAIN STEM; CEREBRAL CORTEX; CONSENSUS; ETHICS, MEDICAL; HUMANS; PUBLIC POLICY; TISSUE AND ORGAN PROCUREMENT;

EID: 0032016885     PISSN: 00930334     EISSN: None     Source Type: Journal    
DOI: 10.2307/3527567     Document Type: Article

References (53)

1. Robert M. Veatch, "The Whole-Brain-Oriented Concept of Death: An Outmoded Philosophical Formulation," Journal of Thanatology 3 (1975): 13-30.
2. Robert M. Veatch, "The Impending Collapse of the Whole-Brain Definition of Death," Hastings Center Report 23, no. 4 (1993): 18-24.
3. See also Robert M. Veatch, "Brain Death and Slippery Slopes," Journal of Clinical Ethics 3 (1992): 181-87.
4. Even some advocates of adopting the higher-brain formulation have reached this conclusion. See Raymond J. Devettere, "Neocortical Death and Human Death," Law, Medicine & Health Care 18, nos. 1-2 (1990): 96-104;
5. Daniel Wilder and Alan J. Weisbard, "Appropriate Confusion Over 'Brain Death,'" JAMA 261 (1989): 2246.
6. Christopher Pallis, ABC of Brain Stem Death (London: British Medical Journal Publishers, 1983).
7. See for example, Robert D. Truog, "Is It Time to Abandon Brain Death?" Hastings Center Report 27, no. 1 (1997): 29-37;
8. Amir Halevy and Baruch Brody, "Brain Death: Reconciling Definitions, Criteria, and Tests," Annals of Internal Medicine 119 (1993): 519-25;
9. Stuart J. Youngner et al., "'Brain Death' and Organ Retrieval: A Cross-Sectional Survey of Knowledge and Concepts Among Health Professionals," JAMA 261 (1989): 2205-10.
10. See for example, D. Alan Shewmon, "Recovery from 'Brain Death': A Neurologist's Apologia," Linacre Quarterly 64, no. 1 (1997): 30-96;
11. Robert M. Taylor, "Re-examining the Definition and Criterion of Death," Seminars in Neurology 17 (1997): 265-70;
12. Manuel Lavados and Alejandro Serani, Etica Clínica: Fundamentes y Aplicaciones (Santiago, Chile: Ediciones Universidad Católica de Chile, Colección Textos Universitarios, 1993), pp. 181-216;
13. Josef Seifert, "Is 'Brain Death' Actually Death?" The Monist 76, no. 2 (1993): 175-202.
14. Ad Hoc Committee, "A Definition of Irreversible Coma. Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death," JAMA 205 (1968): 337-40.
15. Alexander M. Capron and Leon R. Kass, "A Statutory Definition of the Standards for Determining Human Death: An Appraisal and a Proposal," University of Pennsylvania Law Review 121 (1978): 87-118;
16. Julius Korein, "The Problem of Brain Death: Development and History," Annals of the New York Academy of Sciences 315 (1978): 19-38.
17. James L. Bernat, Charles M. Culver, and Bernard Gert, "On the Definition and Criterion of Death," Annals of Internal Medicine 94 (1981): 389-94.
18. President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, Defining Death: Medical, Legal and Ethical Issues in the Determination of Death (Washington, D.C.: U.S. Government Printing Office, 1981), pp. 31-43, 55-84. The Law Reform Commission of Canada reached similar conclusions supporting whole-brain death in its contemporaneously published report.
19. See Law Reform Commission of Canada, Criteria for the Determination of Death (Ottawa: Law Reform Commission of Canada, 1981).
20. Not all scholars accept that death is irreversible. See David J. Cole, "The Reversibility of Death," Journal of Medical Ethics 18 (1992): 26-30.
21. Leon R. Kass, "Death as an Event: A Commentary on Robert Morison," Science 173 (1971): 698-702. This paper rebutted Robert Morison's claim that death was a process.
22. See Robert S. Morison, "Death: Process or Event?" Science 173 (1971): 694-98.
23. D. Alan Shewmon, unpublished manuscript.
24. Bernat, Culver, and Gert, "On the Definition and Criterion of Death," p. 389.
25. Baruch A. Brody, "Brain Death: Philosophical Reflections," in Defining Death in a Technological Age: The Interface Between Medical Science and Society, ed. Stuart J. Youngner, Robert M. Arnold, and Renie Shapiro (Baltimore, Md.: Johns Hopkins University Press, in press);
26. Linda L. Emanuel, "Reexamining Death: The Asymptotic Model and a Bounded Zone Definition," Hastings Center Report 25, no. 3 (1995): 27-35.
27. Jeff McMahan, "The Metaphysics of Brain Death," Bioethics 9, no. 2 (1995): 91-126.
28. Taylor, "Re-examining the Definition and Criterion of Death," p. 267.
29. Veatch, "The Whole-Brain-Oriented Concept of Death," p. 15.
30. Jacques Loeb, The Organism as a Whole (New York: G. P. Putnam's Sons, 1916).
31. James L. Bernat, "Refinements in the Definition and Criterion of Death," in Defining Death in a Technological Age.
32. President's Commission, Defining Death, p. 33.
33. The case was shortened and amended from, D. Alan Shewmon, "Caution in the Definition and Diagnosis of Infant Brain Death," in Medical Ethics. A Guide for Health Professional ed. John F. Monagle and David C. Thomasma (Rockville, Md.: Aspen Publishers, 1988), pp. 38-57.
34. Tom Tomlinson, "The Conservative Use of the Brain-Death Criterion - A Critique," The Journal of Medicine and Philosophy 9 (1984): 377-93.
35. See Stuart J. Youngner and Robert M. Arnold, "Ethical, Psychosocial, and Public Policy Implications of Procuring Organs from Non-Heart-Beating Cadaver Donors," JAMA 269 (1993): 2769-74;
36. Stuart J. Youngner and Robert M. Arnold, eds., "Ethical, Psychosocial, and Public Policy Implications for Procuring Organs from Non-Heart-Beating Cadavers," Kennedy Institute of Ethics Journal 3 (1993): 103-278.
37. University of Pittsburgh Medical Center Policy and Procedure Manual, "Management of Terminally Ill Patients Who May Become Organ Donors after Death," Kennedy Institute of Ethics Journal 3 (1993): A1-A15.
38. See Joanne Lynn, "Are the Patients Who Become Organ Donors under the Pittsburgh Protocol for 'Non-Heart-Beating Donors' Really Dead?" Kennedy Institute of Ethics Journal 3 (1993): 167-78.
39. See for example, Eelco F. M. Wijdicks, "Determining Brain Death in Adults," Neurology 45 (1995): 1003-11.
40. Fred Plum and Jerome B. Posner, The Diagnosis of Stupor and Coma, 3d ed. (Philadelphia: F. A. Davis, 1980), pp. 88-101.
41. President's Commission, Defining Death, pp. 73.
42. Bernat, Culver, and Gert, "Defining Death in Theory and Practice," pp. 7-9.
43. See Robert M. Arnold and Stuart J. Youngner, "The Dead Donor Rule: Should We Stretch It, Bend It, or Abandon It?" Kennedy Institute of Ethics Journal 3 (1993): 263-78;
44. and Truog, "Is It Time to Abandon Brain Death?" pp. 33-35.
45. Frank J. Veith et al., "Brain Death: A Status Report of Medical and Ethical Considerations," JAMA 238 (1977): 1651-55.
46. For example, see Paul A. Byrne, Sean O'Reilly, and Paul M. Quay, "Brain Death - An Opposing Viewpoint," JAMA 242 (1979): 1985-90. However, the 1992 position of the Pontifical Academy of Sciences and the 1994 position of the Pontifical Council for Pastoral Assistance supported the concept of whole-brain death.
47. See Working Group on the Determination of Brain Death and Its Relationship to Human Death, Scripta Varia 83 (Vatican City: Pontifical Academy of Sciences, 1992);
48. Pontifical Council for Pastoral Assistance, Charter for Health Care Workers (Boston: St. Paul Books and Media, 1994).
49. The rabbinic debate is explained in Fred Rosner, "Definition of Death in Jewish Law," New York State Journal of Medicine 83 (1983): 973-8.
50. New Jersey Declaration of Death Act. New Jersey Statutes Annotated. Title 26, §6A1-8, 1991.
51. The desirability of physicians honoring such wishes from patients' families was discussed in Robert D. Orr and Leigh B. Genesen, "Requests for 'Inappropriate' Treatment Based on Religious Beliefs," Journal of Medical Ethics 23 (1997): 142-47.
52. See Robert A. Veatch, "The Conscience Clause: How Much Individual Choice Can Our Society Tolerate in Defining Death?" in Defining Death in a Technological Age;
53. Dan W. Brock, "The Role of the Public in Public Policy on the Definition of Death," in Defining Death in a Technological Age.