Skip to main content
SpringerLink
Log in

Brain Death

Updating a valid concept for 2004

  • Conference paper
Brain Death and Disorders of Consciousness

Part of the book series: Advances in Experimental Medicine and Biology ((AEMB,volume 550))

Abstract

Various investigators have presented criticisms about the concept of brain death.1–8 We propose that for medical purposes the fundamental biological neurocentric definition of death of the human being is valid based on the irreversible cessation of operation of the critical system of the brain. This concept of death itself requires a paradigm shift and modification dictated by our current understanding of living systems, new observations, and further experience in applications of the diagnosis of death. However, the criterion and tests previously used to diagnose death as essentially brain death are for practical purposes unchanged. The relationships among “life,” “death,” “brain death,”and irreversible intrinsic cessation of function of the “critical system of the brain” during the human life cycle will be detailed. The significance of the many aspects of consciousness will be stressed, and applied to the problems of persistent vegetative states and anencephaly.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 259.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 329.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 329.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Shewmon DA. Recovery from “brain death”: A neurologist’s apologia. Linacre Q 1997; 64: 30–96.

    PubMed  Google Scholar 

  2. Shewmon, DA. Chronic ‘brain death’. Meta-analysis and conceptual consequence. Neurology 1998; 51: 1538–1545.

    Article  PubMed  CAS  Google Scholar 

  3. Singer P. Rethinking Life and Death; The Collapse of Our Traditional Ethics. New York: St. Martin’s Griffen, 1994: 1–256.

    Google Scholar 

  4. Youngner SJ. Defining death: A superficial and fragile consensus. Arch Neurol 1992; 49: 570–572.

    Article  PubMed  CAS  Google Scholar 

  5. Youngner SJ, Arnold MR, Schapiro R, eds. The Definition of Death. Contemporary Controversies. Baltimore: The Johns Hopkins University Press, 1999: 346.

    Google Scholar 

  6. Zaner RM, ed. Death: Beyond Whole Brain Criteria. Dordrecht, Netherlands: Academic Publishers, 1988.

    Google Scholar 

  7. Veatch RM. Brain death and slippery slopes. J Clin Ethics 1992; 3: 181–187.

    PubMed  CAS  Google Scholar 

  8. Gervais KG, ed. Redefining Death. New Haven, CT: Yale University Press, 1986: 1–231.

    Google Scholar 

  9. Korein J. Ontogenesis of the brain in the human organism: definitions of life and death of the human being and person. In: Edwards RB, Bittar EE, eds. Advances in Bioethics,Greenwich Connecticut: JAI Press Inc, 1997 :1–74.

    Google Scholar 

  10. Williams RJP, Frausto da Silva JJR, eds. The Natural Selection of the Chemical Elements: The Environment and Life’s Chemistry. Oxford: Clarendon Press, 1996: 1–646.

    Google Scholar 

  11. Depew DJ, Weber BH, eds. Darwinism Evolving: Systems Dynamics and the Genealogy of Natural Selection. Cambridge, Massachusetts: The MIT Press, a Bradford Book, 1995: 429–495.

    Google Scholar 

  12. Kauffman SA, ed. At Home in the Universe: the Search for the Laws of Self-Organization and Complexity. New York: Oxford University Press,1995:1–321.

    Google Scholar 

  13. Collier J. The dynamics of biological order. In: Weber BH, Depew DJ, Smith JD, eds. Entropy, Information, and Evolution: New Perspectives on Physical and Biological Evolution. Cambridge, MA: MIT Press, 1988: 227–242.

    Google Scholar 

  14. Korein J. Towards a general theory of living systems. In: Masturzo A, Giannino F, Figli, eds. The 3r d International Conference of Cybernetic Medicine, Naples, Italy, 1966: 232–248.

    Google Scholar 

  15. Korein J, ed. Brain Death: Interrelated Medical and Social Issues. Ann NYAcad Sci I978; 315:1–454.

    Article  Google Scholar 

  16. Korein J. Ontogenesis of the fetal nervous system: The onset of brain life. Transplant Proc 1990; 22: 982–983.

    PubMed  CAS  Google Scholar 

  17. Prigogine I, ed. From Being to Becoming: Time and Complexity in the Physical Sciences. San Francisco: Freeman Co, 1980: 1–272.

    Google Scholar 

  18. Goodsell DS, ed. The Machinery of Life. New York: Springer-Verlag, 1993: 1–140.

    Book  Google Scholar 

  19. Bernat JL. Brain death: Occurs only with destruction of the cerebral hemispheres and the brainstem. Arch Neurol 1992; 49: 569–570.

    Article  PubMed  CAS  Google Scholar 

  20. Bernat HL. A defense of the whole-brain concept of death. Hastings Cent Rep 1998; 28: 14–23.

    PubMed  CAS  Google Scholar 

  21. Machado C. Consciousness as a definition of death: Its appeal and complexity. Clin Electroencephalogr 1999; 30: 156–164.

    PubMed  CAS  Google Scholar 

  22. Kinney HC, Korein J, Panigrahy A, Dikkes P, Goode R. Neuropathological findings in the brain of Karen Ann Quinlan: The role of the thalamus in the persistent vegetative state. N Engl J Med 1994; 330: 1469–1475.

    CAS  Google Scholar 

  23. Crick F, ed. The Astonishing Hypothesis: The Scientific Search for the Soul. New York: Charles Scribner’s Sons, 1994 :1–317.

    Google Scholar 

  24. Damasio AR, ed. Descartes Error: Emotion,Reason and the Human Brain. New York: G.P. Putnam’s Sons, 1994 :1–312

    Google Scholar 

  25. Humphrey N., ed. A History of the Mind: Evolution and the Birth of Consciousness. New York: Simon & Schuster, 1992 :1–238

    Book  Google Scholar 

  26. Dennett DC, ed. Consciousness Explained. Boston: Little, Brown and Company, 1991: 1–511.

    Google Scholar 

  27. Edelman GM, ed. Neural Darwinism: The Theory of Neuronal Group Selection. New York: Basic Books, Inc., Publisher, 1987: 1–370.

    Google Scholar 

  28. Milner AA, Rugg MD, eds.The Neuropsychology of Consciousness. New York: Academic Press, 1992:137, 91–158 and 178–233.

    Google Scholar 

  29. Posner MI, Raichle ME, eds. Images of Mind. New York: Scientific American Library, 1994: 1–257.

    Google Scholar 

  30. Association for Research in Nervous and Mental Disease (1998). The Conscious Brain: Normal and Abnormal. 77th Annual Program. December 5, 6, New York. New York University School of Medicine. In: The Royal Society, ed. Philosophical Transactions: Biological Sciences. London, 1997: 1797–1942.

    Google Scholar 

  31. Baars BJ, ed. In the Theater of Consciousness: The Workplace of the Mind. New York: Oxford University Press, 1997: 1–193.

    Google Scholar 

  32. Milner AD, Goodale MA, eds. The Visual Brain in Action. New York: Oxford University Press, 1995 :1248.

    Google Scholar 

  33. Mountcastle VB. An organizing principle for cerebral function: The unit module and the distributed system. In: Edelman GM, Mountcastle VB, eds. The Mindful Bra in: Cortical Organization and Group-selective Theory of Higher Brain Function .Cambridge, MA: MIT Press, 1978 :7–34.

    Google Scholar 

  34. Destexhe A, Contreras D, Steriade M. Cortically-induced coherence of a thalamic-generated oscillation. Neuroscience 1999; 92 :427–443

    Article  PubMed  CAS  Google Scholar 

  35. Llinas R, Ribary U, Joliot M, Wang XJ, eds. Content and context in thalamocortical binding. In: Temporal Coding in the Brain. Berlin: Springer-Verlag, 1994.

    Google Scholar 

  36. Steriade M, Timofeev I. Neuronal plasticity in thalamocortical networks during sleep and waking oscillations. Neuron 2003; 37: 563–576.

    Article  PubMed  CAS  Google Scholar 

  37. Steriade M. Synchronized activities of coupled oscillators in the cerebral cortex and thalamus at different levels of vigilance. Cereb Cortex 1997; 7: 583–604.

    Article  PubMed  CAS  Google Scholar 

  38. Amzica F, Neckelmann D, Steriade M. Instrumental conditioning of fast (20- to 50-Hz) oscillations in corticothalamic networks. Proc Nati Acad Sci USA 1997; 94: 1985–1989.

    Article  CAS  Google Scholar 

  39. Steriade M. The corticothalamic system in sleep. Front Biosci 2003; 8: d878 - d899.

    Article  PubMed  CAS  Google Scholar 

  40. Steriade M, Contreras D, Amzica F, Timofeev I. Synchronization of fast (30–40 Hz) spontaneous oscillations in intrathalamic and thalamocortical networks. JNeurosci 1996; 16: 2788–2808.

    CAS  Google Scholar 

  41. Steriade M. Arousal: revisiting the reticular activating system. Science 1996; 272: 225–226.

    Article  PubMed  CAS  Google Scholar 

  42. Steriade M. Corticothalamic resonance, states of vigilance and mentation. Neurocience 2000; 101: 243–276.

    Article  CAS  Google Scholar 

  43. Steriade M, Amzica F, Contreras D. Synchronization of fast (30–40 Hz) spontaneous cortical rhythms during brain activation. JNeurosci 1996; 16: 392–417.

    CAS  Google Scholar 

  44. Steriade M. Awakening the brain. Nature 1996; 383: 24–25.

    Article  PubMed  CAS  Google Scholar 

  45. Contreras D, Steriade M. Cellular basis of EEG slow rhythms: a study of dynamic corticothalamic relationships. JNeurosci 1995; 15: 604–622.

    CAS  Google Scholar 

  46. Plum F, Posner JB, eds. The Diagnosis of Stupor and Coma. Philadelphia: FA Davis Company; 1980.

    Google Scholar 

  47. Machado C. Death on neurological grounds. J Neurosurg Sci 1994; 38: 209–222.

    PubMed  CAS  Google Scholar 

  48. Machado C. A new definition of death based on the basic mechanisms of consciousness generation in human beings. In: Machado C, ed. Brain Death (Proceedings of the Second International Symposium on Brain Death). Amsterdam: Elsevier Science, BV; 1995: 57–66.

    Google Scholar 

  49. Machado C. Is the concept of brain death secure? In: Zeman A, Emanuel L, eds. Ethical Dilemmas in Neurology. London: W. B. Saunders Company; 2000, Vol 36: 193–212.

    Google Scholar 

  50. The Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state. N Engl J Med 1994; 330: 1499–1508.

    Article  Google Scholar 

  51. Plum P. Coma and related global disturbances of the human conscious state. In: Peters A, ed. Cerebral Cortex, Vol 9. New York: Plenum Publishing Corporation, 1991: 359–425

    Google Scholar 

  52. Moruzzi G, Magoun HW. Brain stem reticular formation and activation of the EEG. Electroencephalogr Clin Neurophysio1. 1949; 1: 455–473.

    CAS  Google Scholar 

  53. Singer W, Gray CM. Visual feature integration and the temporal correlation hypothesis. Annu Rev Neurosci 1995; 18 :555–586.

    Article  PubMed  CAS  Google Scholar 

  54. Steriade M. Presynaptic dendrites of thalamic local-circuit neurons and sculpting inhibition during activated states. JPhysiol 2003; 546 (Part 1): 1.

    Article  CAS  Google Scholar 

  55. Kowalik ZJ, Steriade M, Skinner JE, Witte OW. Detecting oscillations in cortical and subcortical structures. Acta Neurobiol Exp (Wars) 2000; 60: 45–8

    CAS  Google Scholar 

  56. Steriade M. Coherent oscillations and short term plasticity in corticothalamic networks. Trends Neurosci 1999; 22 :337–345.

    Article  Google Scholar 

  57. Amzika F, Steriade M. Integration of low frequency sleep oscillations in corticothalamic networks. Acta Neurobiol Exp (Wars) 2000; 60: 229–245.

    Google Scholar 

  58. Mountcastle, VB. An organization principle for cerebral function: the unit module and the distributed system. In: Edelman, GM, Mouncastle, VB, eds. The Mindful Brain. Cambridge: The MIT Press, 1978: 750.

    Google Scholar 

  59. Goldman-Rakic PS. Topography of cognition: Parallel distributed networks in primate association cortex. Annu Rev Neurosci 1988; 11: 137–156.

    Article  PubMed  CAS  Google Scholar 

  60. Feinberg TE. The irreducible perspectives of consciousness. Semin Neurol 1997; 17: 85–93

    Article  PubMed  CAS  Google Scholar 

  61. Shewmon DA. “Brain Death”: A valid theme with invalid variations, blurred by semantic ambiguity. In: Angstwurm H, Carrasco de Paula I, ed. Working Group on The Determination of Brain Death and its Relationship to Human Death. Vatican City: Pontificia Academia Scientiarum, 1992: 23–51.

    Google Scholar 

  62. Shewmon DA. The metaphysics of brain death, persistent vegetative state, and dementia. The Thomist 1985; 49: 24–80.

    PubMed  Google Scholar 

  63. Schrader D. On dying more than one death. Hastings Cent Rep 1986; 16: 12–17.

    Google Scholar 

  64. McFadden J, ed. Quantum Evolution. New York: W.W. Norton & Co, 2000: 1–338.

    Google Scholar 

  65. Schwartz JM, Begley S. The Mind and the Brain. New York: Regan Books, Harper Collins Publishers, 2002: 1–420.

    Google Scholar 

  66. Johnson GA, ed. Shortcut Through Time. The path to the Quantum Computer. New York: Alfred A Knopf, 2003 :1–204.

    Google Scholar 

  67. Llinas RR. I of the Vortex. From Neurons to Self. Cambridge, Massachusetts: MIT Press, 2001 :1–302.

    Google Scholar 

  68. LeDoux J, Debiec J, Moss H, eds. The Self from Soul to Brain. Annals of the New York Academy of Sciences, 2003; 1001 :1–307.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. New York University Medical Center, New York, USA

    Julius Korein MD (Professor Emeritus of Neurology)

  2. 240 Central Park South, Suite 20 D, New York, NY, 10019, USA

    Julius Korein MD (Professor Emeritus of Neurology)

  3. Institute of Neurology and Neurosurgery, Apartado Postal 4268, Havana, 10400, Cuba

    Calixto Machado MD, Ph.D. (Professor of Neurology and Clinical Neurophysiology)

Authors
  1. Julius Korein MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Calixto Machado MD, Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Institute of Neurology and Neurosurgery, Havana, Cuba

    Calixto Machado

  2. David Geffen School of Medicine at UCLA, Los Angeles, California, USA

    D. Alan Shewmon

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer Science+Business Media New York

About this paper

Cite this paper

Korein, J., Machado, C. (2004). Brain Death. In: Machado, C., Shewmon, D.A. (eds) Brain Death and Disorders of Consciousness. Advances in Experimental Medicine and Biology, vol 550. Springer, Boston, MA. https://doi.org/10.1007/978-0-306-48526-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-0-306-48526-8_1

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-0976-6

  • Online ISBN: 978-0-306-48526-8

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation