An Assessment Of Brain Death As A Means For Procuring Transplantable Organs -- By: D. Scott Henderson
CAJ 8:1 (Spring 2009) p. 41
An Assessment Of Brain Death As A Means For Procuring Transplantable Organs
Since its inception in 1968, brain death, as a criterion for human death, has enjoyed the status of one of the few relatively “well settled” issues in bioethics. Indeed, its almost universal acceptance in law and medical practice seems to confirm this depiction. However, over the last fifteen years or so, a growing number of experts in medicine, philosophy, and religion regard brain death as an untenable criterion for human death. Given that the debate about brain death has occupied a relatively small group of professionals, few are aware that brain death fails to correspond to any coherent biological or philosophical conception of death. This is significant, for if the brain–dead are not dead, then the removal of their unpaired vital organs for transplantation is the direct cause of their deaths. The purpose of this paper is to relate the historical, biological, and philosophical underpinnings for brain death. After assessing the components of its conceptual foundation, I argue that brain death is fundamentally flawed and ought to be rejected as a criterion for death.
CAJ 8:1 (Spring 2009) p. 42
A Short History of Brain Death
The emergence of brain death stems from the issuance of two seminal reports. The first of these occurred in1968 when an Ad Hoc Committee from the Harvard Medical School published a report recommending the first neurological diagnostic criteria for determining death. The second occurred in 1981 when a President’s Commission issued a report on the ethical and legal implications of defining death with the inclusion of a model statute to standardize death in the United States. Over the next 20 years, all states adopted, through either legislation or common law, the brain death standard.1 Despite its prevalence, brain death continues to generate both controversy and criticism. Examining the historical development of brain death discloses many of the reasons why it remains a contentious issue.
The Harvard Ad Hoc Committee
In December 1967, Christian Barnard successfully transplanted the first human heart into a patient dying from heart failure in South Africa. Although the recipient died eighteen days later, the well–publicized event lead to the advent of heart transplantation, with over a hundred attempted the following year.2 Early failures were attributed to the problems of organ rejection by recipients’ immune systems and organ deterioration due to the need to wait for sufficient time after cardiac arrest to ensure that the donor would not spontaneously resuscitate.
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