The Impending Collapse of the Whole-Brain Definition of Death
Veatch (Robert M.)
Source: The Hastings Center Report, Vol. 23, No. 4 (Jul. - Aug., 1993), pp. 18-24
Paper - Abstract

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Author’s Abstract

  1. No one really believes that literally all functions of the entire brain must be lost for an individual to be dead.
  2. A better definition of death involves a higher brain orientation.

Author’s Introduction
  1. For many years there has been lingering doubt, at least among theorists, that the currently fashionable "whole-brain-oriented" definition of death has things exactly right.
  2. I myself have long resisted the term "brain death1" and will use it only in quotation marks to indicate the still common, if ambiguous, usage. The term is ambiguous because it fails to distinguish between the biological claim that the brain is dead and the social/legal/moral claim that the individual as a whole is dead because the brain is dead.
  3. An even greater problem with the term arises from the lingering doubt that individuals with dead brains are really dead. Hence, even physicians are sometimes heard to say that the patient "suffered brain death2" one day and "died" the following day. It is better to say that he "died" on the first day, the day the brain was determined to be dead, and that the cadaver's other bodily functions ceased the following day.
  4. For these reasons I insist on speaking of persons with dead brains as individuals who are dead, not merely persons who are "brain dead." The presently accepted standard definition, the Uniform Determination of Death Act, specifies that an individual is dead who has sustained "irreversible cessation of all functions of the entire brain, including the brain stem." It also provides an alternative definition specifying that an individual is also dead who has sustained "irreversible cessation of circulatory and respiratory functions."
  5. The President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research made clear, however, that circulatory and respiratory function loss are important only as indirect indicators that the brain has been permanently destroyed (p. 74)

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