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- Jocelyn Downie (1990). Brain Death and Brain Life: Rethinking the Connection. Bioethics 4 (3):216–226.
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The Japanese Transplantation Law is unique among others in that it allows us to choose between "brain death" and "traditional death" as our death. In every country 20 to 40 % of the popularion doubts the idea of brain death. This paper reconsiders the concept, and reports the ongoing rivision process of the current law. Published in Hastings Center Report, 2001.
Death and Philosophy presents a wide ranging and fascinating variety of different philosophical, aesthetic and literary perspectives on death. Death raises key questions such as whether life has meaning of life in the face of death, what the meaning of "life after death" might be and whether death is part of a narrative that can be retold in different ways, and considers the various types of death, such as brain death, that challenge mind-body dualism. The essays also include explorations of Chinese, Japanese and Tibetan perspectives on death and why death in some cultures, such as in Mexico's day of the dead, is celebrated.
Philosophers have simplified brain death issues by drawing two distinctions--that between dead persons and dead bodies or organisms, and that between the concept of definition of death and the criteria for determining when and that death has occurred. The result has been protracted debates as to whether the death of patients is the death of persons or the death of organisms, and whether physicians should use cardio-respiratory criteria, whole brain criteria, or higher brain criteria. Advocates of the death of persons prefer higher brain criteria; advocates of the death of organisms prefer cardiovascular criteria; but both will compromise, for different reasons, on the whole brain criteria that most legislators have come to accept. Advocates of person-death regard whole brain criteria as unnecessarily demanding and woefully wasteful of transplantable organs and nursing care. Nonetheless, they accept current whole-brain based legislation as a first neurological step away from traditional cardio-respiratory.
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Legally defining “death” in terms of brain death unacceptably obscures a value judgment that not all reasonable people would accept. This is disingenuous, and it results in serious moral flaws in the medical practices surrounding organ donation. Public policy that relies on the whole-brain concept of death is therefore morally flawed and in need of revision.
: Most of the world now accepts the idea, first proposed four decades ago, that death means "brain death." But the idea has always been open to criticism because it doesn't square with all of our intuitions about death. In fact, none of the possible definitions of death quite works. Death, perhaps surprisingly, eludes definition, and "brain death" can be accepted only as a refinement of what is in fact a fuzzy concept.
The new commandments according to Rethinking Life and Death . --If you must take human life, take responsibility for the consequences of your decisions. --All human life is not of equal worth treat beings in accordance to the ethical situation at hand. --Respect a person's desire to live or die. A profound and provocative work, Rethinking Life and Death , in the tradition of Aldous Huxley's Brave New World , examines the ethical dilemmas that confront us as we near the twenty-first century.
This paper reviews moral and cultural assessments which led to the definition of brain death and calls for a similar normative consensus regarding the moral recognition and legal protection of embryonal life related to criteria of brain life. This paper differentiates between cortical brain life I, i.e., the first existence of post-mitotic stationary neurons forming the early cortical plate (54th day post conception), and cortical brain life II, i.e., the beginning of cortical neuro-neuronal synapses (after the 70th day p.c.). The latter are preconditional for establishing the communicative network within the cortex and with subcortical structures. The paper conservatively calls for a tentative moral consensus that could recognize brain life I, i.e., the 54th day p.c., as a stage prior to which embryo research generally would be acceptable in accordance with principles similar to those which led to the acceptance of brain death. Other developmental stages such as fertilization, nidation, viability, as well as the ‘potentiality’ principle are less significant for the moral recognition of early human life. Keywords: brain death, brain life, embryo research, embryonal tissue CiteULike Connotea Del.icio.us What's this?
The current debate regarding the suitability of anencephalics as organ donors is due primarily to misunderstandings. The anatomical and neurophysiological literature shows that the anencephalic lacks a cerebrum because of the failure of neuralplate fusion. However, even the incomplete function of an atrophic brain stem is currently accepted at law in most if not all countries as sufficient for brain life: which is to say, cessation of breathing is currently required in order to make the diagnosis of brain death. Because of the extensive incompleteness of the anencephalic's brain, it is not possible to postpone death significantly by mechanical ventilation and intravenous feeding. It is acceptable to maintain life for a short period of time in order to allow organ transplantation subsequent to the declaration of death at the point of cessation of the capacity for spontaneous respiration. The most important issue is not transplantation, but the issue of brain life raised by the case of anencephalics. Since brain life in any significant sense begins only after the closure of the neural tube on the 30th day after conception, it is reasonable to take this as the point at which brain life begins. Laws should be amended in all countries to allow the abortion of anencephalics at any time, in that they do not at any time possess brain life. Keywords: anencephaly, organ transplantation, beginning of life, brain death, abortion CiteULike Connotea Del.icio.us What's this?
The philosophy of our proposal are as follows: (1) Various ideas of life and death, including that of objecting to brain death as human death, should be guaranteed. We would like to maintain the idea of pluralism of human death; and (2) We should respect a child’s view of life and death. We should provide him/her with an opportunity to think and express their own ideas about life and death.
Brain death is accepted in most countries as death. The rationales to explain why brain death is death are surprisingly problematic. The standard rationale that in brain death there has been loss of integrative unity of the organism has been shown to be false, and a better rationale has not been clearly articulated. Recent expert defences of the brain death concept are examined in this paper, and are suggested to be inadequate. I argue that, ironically, these defences demonstrate the lack of a defensible rationale for why brain death should be accepted as death itself. If brain death is death, a conceptual rationale for brain death being equivalent to death should be clarified, and this should be done urgently.
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