Perspectives in Biology and Medicine

Abstract:

This essay examines the development of the seminal report, “A Definition of Irreversible Coma,” by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death in 1968. Detailed examination of original documents archived in the Henry K. Beecher Papers at Harvard’s Countway Library reveals a variety of concerns and values at play in the development of the report, along with disagreement on a few key points among Committee members. One important goal of the Committee was to render treatment removal from patients in severe coma mandatory—not merely permissible—and without need for permission or consultation with the patient’s family. Protecting and supporting organ transplantation also played a significant role in the Committee’s writings and deliberations. Multiple concepts of death and justifications for brain death can be found, most of them inconsistent with each other and offered without a clear rationale. The essay emphasizes what is perhaps the most important aspect of this period in history: this is the moment when, without clear physiologic justification, the social and legal status of “corpse” became compulsorily applied to living human bodies.