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An Alternative to Brain Death

Published online by Cambridge University Press:  01 January 2021

Jeff McMahan
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Extract

Most contributors to the debate about brain death, including Dr. James Bernat, share certain assumptions. They believe that the concept of death is univocal, that death is a biological phenomenon, that it is necessarily irreversible, that it is paradigmatically something that happens to organisms, that we are human organisms, and therefore that our deaths will be deaths of organisms. These claims are supposed to have moral significance. It is, for example, only when a person dies that it is permissible to extract her organs for transplantation.

It is also commonly held that our univocal notion of death is the permanent cessation of integrated functioning in an organism and that the criterion for determining when this has occurred in animals with brains is the death of the brain as a whole – that is, brain death. The reason most commonly given for this is that the brain is the irreplaceable master control of the organism's integration.

Type
Symposium
Information
Journal of Law, Medicine & Ethics , Volume 34 , Issue 1 , Spring 2006 , pp. 44 - 48
Copyright
Copyright © American Society of Law, Medicine and Ethics 2006

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References

Bernat, J. L., “A Defense of the Whole-Brain Concept of Death,” Hastings Center Report 28, no. 2 (1998): 14–23, at 17. 2. See Bernat, J. L., “Defending Challenges to the Concept of ‘Brain Death,’” at <http://www.lahey.org/NewsPubs/Publications/Ethics/JournalFall1998/Journal_Fall1998_Feature.asp> (last visited December 5, 2005); and DeVita, M. A. and Arnold, R. M., “The Concept of Brain Death,” at <http://www.lahey.org/NewsPubs/Publications/Ethics/JournalWinter1999/Journal_Winter1999_Dialogue.asp> (last visited December 5, 2005).CrossRefGoogle Scholar
For an early suggestion of this sort, see Green, M. B. and Wikler, D., “Brain Death and Personal Identity,” Philosophy and Public Affairs 9 (1980): 105–33, at 113.Google Scholar
Bernat, , supra note 1, at 19.Google Scholar
Bernat also claims that “consciousness, which is required for the organism to respond to requirements for hydration, nutrition, and protection, among other needs,” is therefore among the “critical functions of the organism as a whole.” Ibid., at 17. But this still does not make it a somatic regulatory function of the brain.Google Scholar
See, for example, Shewmon, A., “Recovery from ‘Brain Death’: A Neurologist's Apologia,” Linacre Quarterly 64 (1997): 30–96; Shewmon, A., “Chronic ‘Brain Death,’” Neurology 51 (1998): 1538–45; and Shewmon, A., “The Disintegration of Somatic Integrative Unity: Demise of the Orthodox but Physiologically Untenable Physiological Rationale for ‘Brain Death,’” manuscript on file with the author.Google Scholar
Bernat, , supra note 2.Google Scholar
See McMahan, J., The Ethics of Killing: Problems at the Margins of Life (New York: Oxford University Press: 2002): Chapter 5, section 1.2.CrossRefGoogle Scholar
For further argument, see McMahan, , supra note 8, at 7–24.Google Scholar