Online research in philosophy

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.

The President's Council on Bioethics has recently released a report supportive of the continued use of brain death as a criterion for human death. The Council's conclusions were based on a conception of life that stressed external work as the fundamental marker of organismic life. With respect to human life, it is spontaneous respiration in particular that indicates an ability to interact with the external environment, and so indicates the presence of life. Conversely, irreversible apnoea marks an inability to carry out the necessary work of life, an inability which the Council considers an indicator of death. This conception has been conceived to circumvent criticisms of the previous model of loss of somatic integration, a model the Council admits that, in the presence of evidence of continuing functional integration in brain dead patients, was looking less than convincing. Nevertheless, by focusing on external work and ignoring the more essential work of integrative unity, the Council's conception of the nature of life is untenable, and of no assistance in supporting a relation of equivalence between the concepts of brain death and death. Consequently, the Council's conclusions do little to advance the definition of death debate, a potentially intractable debate that may necessitate the investigation of alternate ethical justifications for organ harvesting.

The mainstream rationale for equating brain death (BD) with death is that the brain confers integrative unity upon the body, transforming it from a mere collection of organs and tissues to an organism as a whole. In support of this conclusion, the impressive list of the brains myriad integrative functions is often cited. Upon closer examination, and after operational definition of terms, however, one discovers that most integrative functions of the brain are actually not somatically integrating, and, conversely, most integrative functions of the body are not brain-mediated. With respect to organism-level vitality, the brains role is more modulatory than constitutive, enhancing the quality and survival potential of a presupposedly living organism. Integrative unity of a complex organism is an inherently nonlocalizable, holistic feature involving the mutual interaction among all the parts, not a top-down coordination imposed by one part upon a passive multiplicity of other parts. Loss of somatic integrative unity is not a physiologically tenable rationale for equating BD with death of the organism as a whole.

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.

: 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.

Alan Shewmons article, The brain and somatic integration: Insights into the standard biological rationale for equating brain death with death (2001), strikes at the heart of the standard justification for whole brain death criteria. The standard justification, which I call the standard paradigm, holds that the permanent loss of the functions of the entire brain marks the end of the integrative unity of the body. In my response to Shewmons article, I first offer a brief summary of the standard paradigm and cite recent work by advocates of whole brain criteria who tenaciously cling to the standard paradigm despite increasing evidence showing that it has significant weaknesses. Second, I address Shewmons case against the standard paradigm, arguing that he is successful in showing that whole brain dead patients have integrated organic unity. Finally, I discuss some minor problems with Shewmons article, along with suggestions for further elaboration.

The whole brain-death criterion of death now enjoys a wide acceptance both within the medical profession and among the general public. That acceptance is in large part the product of the contention that brain death is the proper criterion for even a conservative definition of death – the irreversible loss of the integrated functioning of the organism as a whole. This claim – most recently made in the report of the Presidential Commission and in a comprehensive article by James Bernat and others – is based upon a series of fallacious arguments. Chief among these is the argument that whole brain-death is the proper criterion for the conservative definition because the brain is the organ that integrates the rest of the organism. A central part of the paper shows that this argument rests upon a confusion between a function and the mechanism that performs it, and replies to the defenses that the Presidential Commission makes on this point. The concluding portion of the paper argues that this issue is not merely of academic interest, but has the potential for undermining the present consensus that supports the use of whole brain-death criteria. * Keywords: brain-death, definition of death, determination of death * I would like to thank Howard Brody and Bruce Miller for helpful suggestions and criticisms. CiteULike Connotea Del.icio.us What's this?

Most organized religions have indicated a level of support for organ donation including the diagnosis of death by the brain criterion. Organ donation is seen as a gift of love and fits within a communitarian ethos that most religions embrace. The acceptance of the determination of death by the brain criterion, where it has been explained, is reconciled with religious views of soul and body by using a notion of integration. Because the soul may be seen as that which integrates the human body, in the absence of any other signs of human functioning, loss of integration is considered to be an indication that soul and body have separated. To some extent this view would seem to be informed by an Aristotelian notion of the soul, but it fits well enough with religious notions of the person continuing after death.There have been several developments internationally that indicate that the acceptance of so-called ‘brain death’ by organized religions has been challenged by new developments including the acceptance of a lesser standard than loss of all brain function and a rejection by the US President's Council on Bioethics of the notion of loss of integration as an explanation of death by the brain criterion.

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.