A Matter of Respect: A Defense of the Dead Donor Rule and of a "Whole-Brain" Criterion for Determination of Death
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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Journal of Medicine and Philosophy 35 (3):330-364 (2010)
Many accounts of the historical development of neurological criteria for determination of death insufficiently distinguish between two strands of interpretation advanced by advocates of a "whole-brain" criterion. One strand focuses on the brain as the organ of integration. Another provides a far more complex and nuanced account, both of death and of a policy on the determination of death. Current criticisms of the whole-brain criterion are effective in refuting the first interpretation, but not the second, which is advanced in the 2008 President's Council report on the determination of death. In this essay, I seek to further develop this second strand of interpretation. I argue that policy on determination of death aligns moral, biological, and ontological death concepts. Morally, death marks the stage when respect is no longer owed. Biologically, death concerns integrated functioning of an organism as a whole. But the biological concepts are underdetermined. The moral concerns lead to selection of strong individuality concepts rather than weak ones. They also push criteria to the "far side" of the dying process. There is a countervailing consideration associated with optimizing the number of available organs, and this pushes to the "near side" of death. Policy is governed by a conviction that it is possible to align these moral and biological death concepts, but this conviction simply lays out an agenda. There is also a prescription—integral to the dead donor rule—that lexically prioritizes the deontic concerns and that seeks to balance the countervailing tendencies by using science-based refinements to make the line between life and death more precise. After showing how these concerns have been effectively aligned in the current policy, I present a modified variant of a "division" scenario and show how an "inverse decapitation problem" leads to a conclusive refutation of the nonbrain account of death
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References found in this work BETA
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Citations of this work BETA
M. Nair-Collins, S. R. Green & A. R. Sutin (2015). Abandoning the Dead Donor Rule? A National Survey of Public Views on Death and Organ Donation. Journal of Medical Ethics 41 (4):297-302.
Mohamed Y. Rady & Joseph L. Verheijde (2013). Brain-Dead Patients Are Not Cadavers: The Need to Revise the Definition of Death in Muslim Communities. [REVIEW] HEC Forum 25 (1):25-45.
A. S. Iltis & M. J. Cherry (2010). Death Revisited: Rethinking Death and the Dead Donor Rule. Journal of Medicine and Philosophy 35 (3):223-241.
Stephen Napier (2013). Brain Death, Souls, and Integrated Functioning: Reply to Verheijde and Potts. Christian Bioethics 19 (1):25-39.
Frank Chaten (2014). The Dead Donor Rule: Effect on the Virtuous Practice of Medicine. Journal of Medical Ethics 40 (7):496-500.
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