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  1. Critical analysis of three arguments against consent requirement for the diagnosis of brain death.Osamu Muramoto - manuscript
    In modern hospitals in developed countries, deaths are determined usually after a prearranged schedule of resuscitative efforts. By default, death is diagnosed and determined after “full code” or after the failure of intensive resuscitation. In end-of-life contexts, however, various degrees of less-than-full resuscitation and sometimes no resuscitation are allowed after the consent and shared decision-making of the patient and/or surrogates. The determination of brain death is a unique exception in these contexts because such an end-of-life care plan is usually not (...)
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  2. Pragmatism and the determination of death.Martin Benjamin - forthcoming - Pragmatic Bioethics:193--206.
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  3. The medical determination of brain death.E. Byrne - forthcoming - Proceedings of the 1984 Conference on Bioethics, Melbourne.
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  4. Death, Definition and Determination of: II. Legal Issues in Pronouncing Death.Alexander Morgan Capron - forthcoming - Encyclopedia of Bioethics.
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  5. The conceptual injustice of the brain death standard.William Choi - forthcoming - Theoretical Medicine and Bioethics:1-16.
    Family disputes over the diagnosis of brain death have caused much controversy in the bioethics literature over the conceptual validity of the brain death standard. Given the tenuous status of brain death as death, it is pragmatically fruitful to reframe intractable debates about the metaphysical nature of brain death as metalinguistic disputes about its conceptual deployment. This new framework leaves the metaphysical debate open and brings into focus the social functions that are served by deploying the concept of brain death. (...)
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  6. Organ Donation and Declaration of Death: Combined Neurologic and Cardiopulmonary Standards.Stephen E. Doran & Joseph Michael Vukov - forthcoming - The Linacre Quarterly 86.
    Prolonged survival after the declaration of death by neurologic criteria creates ambiguity regarding the validity of this methodology. This ambiguity has perpetuated the debate among secular and nondissenting Catholic authors who question whether the neurologic standards are sufficient for the declaration of death of organ donors. Cardiopulmonary criteria are being increasingly used for organ donors who do not meet brain death standards. However, cardiopulmonary criteria are plagued by conflict of interest issues, arbitrary standards for candidacy, and the lack of standardized (...)
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  7. Death, Definition and Determination of: III. Philosophical and theological perspectives.Karen G. Gervais - forthcoming - Encyclopedia of Bioethics.
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  8. Consent to testing for brain death.Barry Lyons & Mary Donnelly - forthcoming - Journal of Medical Ethics.
    Canada has recently published a new Clinical Practice Guideline on the diagnosis and management of brain death. It states that consent is not necessary to carry out the interventions required to make the diagnosis. A supporting article not only sets out the arguments for this but also contends that ‘UK laws similarly carve out an exception, excusing clinicians from a prima facie duty to get consent’. This is supplemented by the claim that recent court decisions in the UK similarly confirm (...)
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  9. Double effect donation or bodily respect? A 'third way' response to Camosy and Vukov.Anthony McCarthy & Helen Watt - forthcoming - The Linacre Quarterly.
    Is it possible to donate unpaired vital organs, foreseeing but not intending one's own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on 'double effect donation.' Where we disagree with these authors is that we see double effect donation not as a morally praiseworthy act akin to martyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond (...)
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  10. Double Effect Donation or Bodily Respect? A "Third Way" Response to Camosy and Vukov.Anthony McCarthy & Helen Watt - forthcoming - Linacre Quarterly:1-17.
    Is it possible to donate unpaired vital organs, foreseeing but not intending one’s own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on “double effect donation.” Where we disagree with these authors is that we see double-effect donation not as a morally praiseworthy act akin to mar- tyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond (...)
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  11. No consent for brain death testing.Thaddeus Mason Pope, Alexander Ruck Keene & Jennifer Chandler - forthcoming - Journal of Medical Ethics.
    The overwhelming weight of legal authority in the USA and Canada holds that consent is not required for brain death testing. The situation in England and Wales is similar but different. While clinicians in England and Wales may have a prima facie duty to obtain consent, lack of consent has not barred testing. In three recent cases where consent for brain death testing was formally presented to the court, lack of consent was not determinative, and in one case the court (...)
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  12. It is reasonable to reject the diagnosis of brain death.Robert Truog & James Fackler - forthcoming - The Journal of Ethics.
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  13. Whole-brain and neocortical definitions of death.R. M. Veatch - forthcoming - Bioethics. New York: Harcourt Brace.
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  14. The Brain Death Criterion in Light of Value-Based Disagreement Versus Biomedical Uncertainty.Ivar R. Hannikainen, Gonzalo Díaz-Cobacho & Daniel Martin - 2024 - American Journal of Bioethics 24 (1):123-126.
    Since the introduction of a new criterion for determining death (i.e., the brain death criterion) in 1968, the research community has been embroiled in debates about whether this criterion should b...
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  15. Response to Commentaries: Frequent Preservation of Neurologic Function in Brain Death and Brainstem Death Entails False-Positive Misdiagnosis and Cerebral Perfusion.Ari R. Joffe & Michael Nair-Collins - 2024 - American Journal of Bioethics Neuroscience 15 (1).
    We thank the authors of commentaries for their thoughtful discussion of our target article. Here we briefly summarize the points made in the target article (Nair-Collins and Joffe 2023). Then we em...
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  16. Parents Have a Right to Refuse Brain Death Testing, Including Apnea Testing.Alexander A. Kon - 2024 - American Journal of Bioethics 24 (1):106-108.
    In the United States, patients have a clear right to determine what is done to them by doctors. Starting in the early 20th century, multiple court cases paved the way for our current understanding...
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  17. Catholic Unity on Brain Death and Organ Donation.David Tomasi - 2024 - A Call to Action 1:1-16.
    Authors: Joseph M. Eble, John A. Di Camillo, Peter J. Colosi. --- NEWS RELEASE For Immediate Release February 27, 2024 Contact: Joseph M. Eble, MD Corresponding author 919-667-5206 -/- The statement, Catholics United on Brain Death and Organ Donation: A Call to Action (HTML), was published on February 27, 2024. It was prepared by Joseph Eble, a physician and President of the Tulsa Guild of the Catholic Medical Association; John Di Camillo, an ethicist of The National Catholic Bioethics Center; and (...)
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  18. Meaningful Residual Function, Permanence and Brain Death.Ramesh K. Batra & Stephen R. Latham - 2023 - American Journal of Bioethics Neuroscience 14 (3):269-271.
    We share Nair-Collins and Joffe's (2023) concern with the accuracy of the “whole brain-death” diagnosis, which fails to take into account current understandings of residual brain function (neurohor...
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  19. Death pluralism: a proposal.Gonzalo Díaz-Cobacho, Alberto Molina-Pérez & David Rodríguez-Arias - 2023 - Philosophy, Ethics, and Humanities in Medicine 18 (1):1-12.
    The debate over the determination of death has been raging for more than fifty years. Since then, objections against the diagnosis of brain death from family members of those diagnosed as dead-have been increasing and are causing some countries to take novel steps to accommodate people’s beliefs and preferences in the determination of death. This, coupled with criticism by some academics of the brain death criterion, raises some questions about the issues surrounding the determination of death. In this paper, we (...)
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  20. Is Death Irreversible?Nada Gligorov - 2023 - Journal of Medicine and Philosophy 48 (5):492-503.
    There are currently two legally established criteria for death: the irreversible cessation of circulation and respiration and the irreversible cessation of neurologic function. Recently, there have been technological developments that could undermine the irreversibility requirement. In this paper, I focus both on whether death should be identified as an irreversible state and on the proper scope of irreversibility in the biological definition of death. In this paper, I tackle the distinction between the commonsense definition of death and the biological definition (...)
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  21. Maybe Whole-Brain Death Was Never the Point.Stephen S. Hanson - 2023 - American Journal of Bioethics Neuroscience 14 (3):277-279.
    As Nair-Collins and Joffe note, the concern that our tests for brain death do not successfully show that all brain functions have stopped is not new (Nair-Collins and Joffe 2023). As our abilities...
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  22. Pediatric Brain Death Testing Over Parental Objections: Not an Ethically Preferable Option.Jonathan M. Marron - 2023 - American Journal of Bioethics 23 (1):90-93.
    In many ways, Maddie’s case brings together some of the most challenging features seen in clinical ethics consultation. First, it centers around a heart-wrenching event—the near-drowning of a young...
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  23. The Indisputable Finality of Brain Death: Debunking Ambiguities and Reasserting a Fundamental Diagnosis.Ricardo Diaz Milian & Pablo Moreno Franco - 2023 - American Journal of Bioethics Neuroscience 14 (3):274-276.
    Brain death, or death by neurological criteria (BD/DNC) is the permanent loss of brain function as defined by an unresponsive coma, loss of brainstem reflexes, and the ability to breathe without me...
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  24. Defining Function in Medicine: Bridging the Gap between Biology and Clinical Practice.Alberto Molina-Pérez - 2023 - American Journal of Bioethics Neuroscience 14 (3):282-285.
    The classification of preserved hypothalamic activity in brain death and brainstem death as functional or non-functional has become a subject of debate. While proponents of the neurological criterion claim that these activities lack functional significance (Shemie et al. 2014), Nair-Collins and Joffe (2023) argue for their functional physiological role. However, the interpretation of the term "function" within the medico-legal framework, where death is characterized by the irreversible cessation of all brain functions, remains unclear. -/- My intention here is not to (...)
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  25. Inconsistency between the Circulatory and the Brain Criteria of Death in the Uniform Determination of Death Act.Alberto Molina-Pérez, James L. Bernat & Anne Dalle Ave - 2023 - Journal of Medicine and Philosophy 48 (5):422-433.
    The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...)
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  26. Abortion, Brain Death, and Coercion.Michael Nair-Collins - 2023 - Journal of Bioethical Inquiry 20 (3):359-365.
    A “universalist” policy on brain death holds that brain death is death, and neurologic criteria for death determination are rightly applied to all, without exemptions or opt outs. This essay argues that advocates of a universalist brain death policy defend the same sort of coercive control of end-of-life decision-making as “pro-life” advocates seek to achieve for reproductive decision-making, and both are grounded in an illiberal political philosophy. Those who recognize the serious flaws of this kind of public policy with respect (...)
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  27. Frequent Preservation of Neurologic Function in Brain Death and Brainstem Death Entails False-Positive Misdiagnosis and Cerebral Perfusion.Michael Nair-Collins & Ari R. Joffe - 2023 - American Journal of Bioethics Neuroscience 14 (3):255-268.
    Some patients who have been diagnosed as “dead by neurologic criteria” continue to exhibit certain brain functions, most commonly, neuroendocrine functions. This preservation of neurologic function after the diagnosis of “brain death” or “brainstem death” is an ongoing source of controversy and concern in the medical, bioethics, and legal literatures. Most obviously, if some brain function persists, then it is not the case that all functions of the entire brain have ceased and hence, declaring such a patient to be “dead” (...)
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  28. Policy change without ethical analysis? Commentary on the publication of Smajdor.Elena Popa, Jakub Zawiła-Niedźwiecki & Michał Zabdyr-Jamróz - 2023 - Theoretical Medicine and Bioethics 44 (4):379-385.
    This commentary addresses the proposal and argumentative line presented in the paper ‘Whole Body Gestational Donation’ (WBGD) by Anna Smajdor (2023), published as an intended ‘outrageous argument’ in a dedicated special issue of Theoretical Medicine and Bioethics. We believe that the paper is fatally flawed due to its lack of engagement with relevant approaches in ethics and essential sources in health sciences as well as its insufficient, superficial, and rash argumentation. Its critical weaknesses include, among others, that it does not (...)
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  29. The Brain Death Problem and the Unimportance of Being Dead.Stoecker Ralf - 2023 - In Handelnde Personen. Paderborn: Brill mentis. pp. 551-559.
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  30. Brain Death False Positives Reliably Track What Matters in Brain Death Cases.Eli Weber - 2023 - American Journal of Bioethics Neuroscience 14 (3):285-286.
    Nair-Collins and Joffe (2023) rightly call attention to an incompatibility between brain-based criteria for death, as defined by the Uniform Determination of Death Act (UDDA), and what the current...
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  31. An American’s Experience with End-of-Life Care in Japan: Comparing Brain Death, Limiting and Withdrawing Life-Prolonging Interventions, and Healthcare Ethics Consultation Practices in Japan and the United States.Alexander A. Kon, Keiichiro Yamamoto, Eisuke Nakazawa, Reina Ozeki-Hayashi & Akira Akabayashi - 2022 - Narrative Inquiry in Bioethics 12 (1):93-102.
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  32. Global Ischemic Penumbra and Brain Death Declaration.Christina Leblang - 2022 - Ethics and Medics 47 (4):3-4.
    Brain death is a contentious subject, especially in the area of Catholic bioethics. Answering the question of when an individual is truly dead has a wide application in the field of medicine, particularly when determining when it is licit to begin the process of organ transplantation. Global Ischemic Penumbra raises an additional issue in that it closely mimics brain death, but is not in fact a terminal condition.
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  33. Brain Death, the Soul, and Material Dispositions.Patrick Lee - 2022 - Christian Bioethics 28 (1):41-57.
    I defend the position argued previously by Germain Grisez and me that total brain death is a valid criterion of death on the grounds that a human being is essentially a rational animal, and a brain-dead body lacks the radical capacity for rational actions. I reply to Josef Seifert’s objection that our positions rest on a reductionist view of the human person, and to other objections concerning the inter-relation between the human soul, its powers, and functions of the brain. I (...)
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  34. Brain Death: Still A Puzzle After All These Years.Richard Maundrell - 2022 - Neuroethics 16 (1):1–9.
    The definition of death as “irreversible coma” was introduced in 1968 by the Harvard University Medical School. It was developed largely in diagnostic terms as the “irreversible cessation of all functions of the entire brain, including the brainstem.” In its review of brain death in 1981, The President’s Commission for the Study of Ethical Problems in Medicine argued that brain death is consonant with circulatory death because the loss of certain brain functions results in the “loss of integrative unity of (...)
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  35. The Demise of Brain Death.Lukas J. Meier - 2022 - British Journal for the Philosophy of Science 73 (2):487-508.
    Fifty years have passed since brain death was first proposed as a criterion of death. Its advocates believe that with the destruction of the brain, integrated functioning ceases irreversibly, somatic unity dissolves, and the organism turns into a corpse. In this article, I put forward two objections against this assertion. First, I draw parallels between brain death and other pathological conditions and argue that whenever one regards the absence or the artificial replacement of a certain function in these pathological conditions (...)
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  36. Brain Death Debates: From Bioethics to Philosophy of Science.Alberto Molina-Pérez - 2022 - F1000Research 11:195.
    50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead (...)
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  37. Neuroethics, Consciousness and Death: Where Objective Knowledge Meets Subjective Experience.Alberto Molina-Pérez & Anne Dalle Ave - 2022 - American Journal of Bioethics Neuroscience 13 (4):259-261.
    Laura Specker Sullivan (2022) makes a fairly compelling case for the value of the perspectives of Buddhist practitioners in neuroethics. In this study, Tibetan Buddhist monks have been asked, among other things, whether consciousness, in brain-injured patients in a minimally conscious state, entails a duty to preserve life. In our view, some of the participants’ responses could be used to inform the bioethical debate on death determination.
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  38. Expanding the Social Status of "Corpse" to the Severely Comatose: Henry Beecher and the Harvard Brain Death Committee.Michael Nair-Collins - 2022 - Perspectives in Biology and Medicine 65 (1):41-58.
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  39. Muslim Disquiet over Brain-Death: Advancing Islamic Bioethics Discourses by Treating Death as a Social Construct that Aligns Purposes with Criteria and Ethical Behaviours.Aasim I. Padela - 2022 - In Mohammed Ghaly (ed.), End-of-life care, dying and death in the Islamic moral tradition. Boston: Brill.
  40. Cases Abusing Brain Death Definition in Organ Procurement in China.Norbert W. Paul, Kirk C. Allison & Huige Li - 2022 - Cambridge Quarterly of Healthcare Ethics 31 (3):379-385.
    Organ donation after brain death has been practiced in China since 2003 in the absence of brain death legislation. Similar to international standards, China’s brain death diagnostic criteria include coma, absence of brainstem reflexes, and the lack of spontaneous respiration. The Chinese criteria require that the lack of spontaneous respiration must be verified with an apnea test by disconnecting the ventilator for 8 min to provoke spontaneous respiration. However, we have found publications in Chinese medical journals, in which the donors (...)
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  41. Eugène Bouchut’s (1818–1891) Early Anticipation of the Concept of Brain Death.Toni Saad - 2022 - Journal of Medicine and Philosophy 47 (3):407-423.
    The conventional historical account of the concept of brain death credits developments and discoveries of the twentieth century with its inception, emphasizing the role of technological developments and professional conferences, notably the 1968 Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. This essay argues that the French physician Eugène Bouchut anticipated the concept of brain death as early as 1846. Correspondence with Bouchut’s understanding of brain death and one important contemporary concept of brain (...)
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  42. How the Body Became Integrated: Cybernetics in the History of the Brain Death Debate.Paul Scherz - 2022 - Journal of Medicine and Philosophy 47 (3):387-406.
    Although the term integration is central to the definition of brain death, there is little agreement on what it means. Through a genealogical analysis, this essay argues that there have been two primary ways of understanding integration in regard to organismal wholeness. One stems from neuroscience, focusing on the role of the brain in responding to external stimuli, which was taken up in phenomenological accounts of life. A second, arising out of cybernetics, focuses on the brain’s role in homeostasis. Recent (...)
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  43. 5. Determining Brain Death.Dieter Birnbacher - 2021 - In Solveig Lena Hansen & Silke Schicktanz (eds.), Ethical Challenges of Organ Transplantation. Transcript Verlag. pp. 103-116.
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  44. Double Effect Donation.Charles Camosy & Joseph Vukov - 2021 - The Linacre Quarterly 88 (2):149-162.
    Double Effect Donation claims it is permissible for a person meeting brain death criteria to donate vital organs, even though such a person may be alive. The reason this act is permissible is that it does not aim at one’s own death but rather at saving the lives of others, and because saving the lives of others constitutes a proportionately serious reason for engaging in a behavior in which one foresees one’s death as the outcome. Double Effect Donation, we argue, (...)
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  45. What It Is To Die.Cody Gilmore - 2021 - In Michael Cholbi & Travis Timmerman (eds.), Exploring the Philosophy of Death and Dying: Classic and Contemporary Perspectives. New York, NY: Routledge.
    A defense of the view that (i) to be alive is to be actively undergoing (not merely capable of undergoing) certain vital processes, that (ii) to die is cease to be capable of undergoing those processes (not to cease undergoing them), and that (iii) organisms in cryptobiosis (suspended animation) are not undergoing those processes but are capable of doing so, and are neither alive nor dead.
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  46. The intractable problems with brain death and possible solutions.Ari R. Joffe, Gurpreet Khaira & Allan R. de Caen - 2021 - Philosophy, Ethics and Humanities in Medicine 16 (1):1-27.
    Brain death has been accepted worldwide medically and legally as the biological state of death of the organism. Nevertheless, the literature has described persistent problems with this acceptance ever since brain death was described. Many of these problems are not widely known or properly understood by much of the medical community. Here we aim to clarify these issues, based on the two intractable problems in the brain death debates. First, the metaphysical problem: there is no reason that withstands critical scrutiny (...)
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  47. It Is Time to Abandon the Dogma That Brain Death Is Biological Death.Franklin G. Miller, Michael Nair-Collins & Robert D. Truog - 2021 - Hastings Center Report 51 (4):18-21.
    Drawing on a recent case report of a pregnant, brain‐dead woman who gave birth to a healthy child after over seven months of intensive care treatment, this essay rejects the established doctrine in medicine that brain death constitutes the biological death of the human being. The essay describes three policy options with respect to determination of death and vital organ transplantation in the case of patients who are irreversibly comatose but remain biologically alive.
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  48. Brain Death, Challenges Between Reality and the New Concept of Death May Not Be Synonymous With the True Meaning and Need Redefining.Davoud Nezamoleslami, Alireza Olyaeemanesh, Ahmad Jonidi, Seyiedhossein Hajimirzaie, Reihaneh Kiamanesh, Ali Akbar Haghveisy & Fattanehsadat Bathaei - 2021 - Health, Spirituality and Medical Ethics 8 (3):191-197.
    : Introduction : This review article is based on jurisprudential rulings, legal approaches, social aspects, medical and ethical approach perspectives, and clarifies decisions related to the issue of brain death. Correct understanding of the brain death phenomenon in terms of brain structure and functioning, and the attitude of the community towards this phenomenon, and in particular the understanding of the condition of a patient with brain death in the future, will modify the form and content of the type of decision (...)
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  49. Brain Death as the End of a Human Organism as a Self-moving Whole.Adam Omelianchuk - 2021 - Journal of Medicine and Philosophy 46 (5):530-560.
    The biophilosophic justification for the idea that “brain death” is death needs to support two claims: that what dies in human death is a human organism, not merely a psychological entity distinct from it; that total brain failure signifies the end of the human organism as a whole. Defenders of brain death typically assume without argument that the first claim is true and argue for the second by defending the “integrative unity” rationale. Yet the integrative unity rationale has fallen on (...)
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  50. The World Brain Death Project: The More You Say It Does Not Make It True.James Tibballs, Gregory Hansen & Ari R. Joffe - 2021 - Journal of Clinical Ethics 32 (2):97-108.
    The World Brain Death Project clarified many aspects of the diagnosis of brain death/death by neurologic criteria. Clearer descriptions than previously published were presented concerning the etiology, prerequisites, minimum clinical criteria, apnea testing targets, and indications for ancillary testing. Nevertheless, there remained many epistemic and metaphysical assertions that were either false, ad hoc, or confused. Epistemically, the project was not successful in explaining away remaining brain functions, complex reflexes as “spinal,” the risk and lack of utility of the apnea test, (...)
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