Neither dead nor alive, but quite the opposite. Reflections on brain death
DOI:
https://doi.org/10.3989/arbor.2013.763n5004Keywords:
Death determination, Organ transplantation, Gradualism, Pluralism, Definition of death, Brain death, BioethicsAbstract
Determining the precise moment of death has always been a difficult problem. Traditional and contemporary attempts to justify legally accepted standards for death determination have been based on social interests —particularly related, more recently, to organ transplantation policies. Legally accepted criteria for declaring death still lack both conceptual and scientific support. In this context of absence of consensus about the exact location of the boundary between life and death, this article aims to address the following issues: How can we define death? Is the task of determining death strictly based on facts, or do values also play a role? Should brain death be equated to death? What role should bioethics play in the debates related to death determination and organ procurement?
Downloads
References
Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death (1968). "A definition of irreversible coma. Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death". Jama, 205 (6), pp. 337-340. http://dx.doi.org/10.1001/jama.1968.03140320031009 PMid:5694976
Allen, C. M. (1993). "Conscious but paralysed: releasing the locked-in". Lancet, 342 (8864), pp. 130-131. http://dx.doi.org/10.1016/0140-6736(93)91340-R
Arnold, R. M. and Youngner, S. J. (1993). "The dead donor rule: should we stretch it, bend it, or abandon it?". Kennedy Inst Ethics J, 3 (2), pp. 263-278. http://dx.doi.org/10.1353/ken.0.0153
Baggini, J. and Fosl, P. S. (2007). The ethics toolkit. Cambridge: Blackwell.
Bagheri, A. (2007). "Individual choice in the definition of death". J Med Ethics, 33 (3), pp.146-149. http://dx.doi.org/10.1136/jme.2006.016014 PMid:17329384 PMCid:PMC2598255
Bernat J. L. (2010). "Brain death is a scientific concept". Lancet; 375 (9714), 554; author reply. http://dx.doi.org/10.1016/S0140-6736(10)60230-9
Bernat J. L. (2013). "Determining Death in Uncontrolled DCDD Organ Donors". The Hastings Center report; 43 (1), 30-3. Epub 2013/01/15.
Bernat J. L. (1992). "How much of the brain must die in brain death?". The Journal of clinical ethics; 3 (1), 21-6; discussion 7-8. PMid:1301825
Bernat, J. L. (1999). "Refinements in the definition and criterion of death". En S. J. Youngner, R. Arnold and R. Schapiro, The definition of death: contemporary controversies. Baltimore: The Johns Hopkins University Press, pp. 83-92.
Bernat, J. L.; Culver, C. M. et al. (1981). "On the definition and criterion of death". Ann Intern Med, 94 (3), pp. 389-394. http://dx.doi.org/10.7326/0003-4819-94-3-389 PMid:7224389
Botkin, J. R. and Post, S. G. (1992). "Confusion in the determination of death: distinguishing philosophy from physiology". Perspect Biol Med, 36 (1), pp. 129-138. PMid:1475153
Capron, A. M. (1999). "The bifurcated legal standard for determining death: does it work?". En S. J. Youngner, R. Arnold and R. Schapiro, The definition of death: contemporary controversies. Baltimore: The Johns Hopkins University Press, pp. 117-136.
Council on Ethical and Judicial Affairs AMA (1995). "The use of anencephalic neonates as organ donors". JAMA: the journal of the American Medical Association, 273 (20), 1614-8. http://dx.doi.org/10.1001/jama.1995.03520440068039 PMid:7745776
Chiong, W. (2005). "Brain death without definitions". Hastings Cent Rep, 35 (6), pp. 20-30. PMid:16396202
Escalante, J. (1996). "La definición de la muerte". En J. Gafo (ed.), Trasplante de órganos: problemas técnicos, éticos y legales. Madrid: Universidad Pontificia de Comillas, pp. 53-74.
Gervais, K. (1986). Redefining Death. New Haven: Yale University Press.
Gomila, A. (1999). Cómo se viene la muerte. Universidad de la Laguna, Volumen extraordinario, pp. 337-347.
Green, M. B. and Wikler, D. (1980). "Brain death and personal identity". Philos Public Aff, 9 (2), pp. 105-133. PMid:11661844
Halevy, A. and Brody, B. (1993). "Brain death: reconciling definitions, criteria, and tests". Ann Intern Med, 119 (6), pp. 519-525. http://dx.doi.org/10.7326/0003-4819-119-6-199309150-00013
Herpin, N. and Paterson, F. (2000). "Le don d'organes et la perception de la mort par les Français: les systémistes et les intégralistes". En R. Carvais and M. Sasportes, La greffe humaine. Paris: PUF, pp. 789-814.
Hoffenberg, R.; Lock, M.; Tilney, N; Casabona, C; Daar, A. S.; Guttmann, R. D. et al. (1997). "Should organs from patients in permanent vegetative state be used for transplantation? International Forum for Transplant Ethics". Lancet; 350 (9087), 1320-1. http://dx.doi.org/10.1016/S0140-6736(97)02306-4
Lane, A.; Westbrook, A. et al. (2004). "Maternal brain death: medical, ethical and legal issues". Intensive Care Med, 30 (7), pp. 1484-1486. http://dx.doi.org/10.1007/s00134-004-2305-6 PMid:15107974
Lock, M. (1999). "The problem of brain death: Japenese disputes about bodies and modernity". En S. J. Youngner, R. Arnold and R. Schapiro, The definition of death: contemporary controversies. Baltimore: The Johns Hopkins University Press, pp. 239-256.
Lock, M. (2002). Twice Dead. Organ transplants and the reinvention of death. London: University of California Press.
Machado C. (1999). "Consciousness as a definition of death: its appeal and complexity". Clin Electroencephalogr; 30 (4), 156-64. PMid:10513322
Machado, C. (2005). "The first organ transplant from a brain-dead donor". Neurology 64 (11), pp. 1938-1942. http://dx.doi.org/10.1212/01.WNL.0000163515.09793.CB PMid:15955947
Molina, A.; Rodríguez-Arias, D. et al. (2008). "Should individuals choose their definition of death?". Journal of medical ethics, 34 (9), pp. 688-9. http://dx.doi.org/10.1136/jme.2007.022921 PMid:18757642
Mollaret, P. and Goulon, M. (1959). "Le coma dépassé". Rev Neurol (Paris), 101, pp. 3-15.
Munjal, K. G.; Wall, S. P.; Goldfrank, L. R.; Gilbert, A.; Kaufman, B. J. and Dubler, N. N. (2013). "A rationale in support of uncontrolled donation after circulatory determination of death". The Hastings Center report, 43 (1), 19-26. Epub 2012/12/21.
Nelson, H. L. (1994). "The architect and the bee: some reflections on postmortem pregnancy". Bioethics, 8 (3), pp. 247-267. http://dx.doi.org/10.1111/j.1467-8519.1994.tb00257.x
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1981). "Guidelines for the determination of death. Report of the medical consultants on the diagnosis of death to the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research". Jama, 246 (19), pp. 2184-2186. http://dx.doi.org/10.1001/jama.1981.03320190042025 PMid:7289009
Putnam, H. (1981). "Hecho y valor". En Razón, verdad e historia. Tecnos: Madrid, pp. 132-152.
Putnam, H. (2004). El desplome de la dicotomía hecho-valor y otros ensayos. Barcelona: Paidós.
Robertson, J. A. (1999). "The dead donor rule". Hastings Cent Rep, 29 (6), pp. 6-14. http://dx.doi.org/10.2307/3527865
Rodríguez-Arias, D.; Molina, A. (2007). "Pluralismo en torno al significado de la muerte cerebral y/o revisión de la regla del donante fallecido". Laguna, 21, pp. 65-80.
Rodríguez-Arias, D.; Deballon, I. O. (2012). "Protocols for uncontrolled donation after circulatory death". Lancet, 379 (9823), 1275-6. Epub 2012/04/10.
Rorty, R. (2000). El pragmatismo, una versión. Barcelona: Ariel.
Schwartz, P. H. (2007). "Decision and discovery in defining 'disease'". En H. Kincaid and J. McKitrick, Establishing medical reality. Essays in the metaphysicis and epistemology of biomedical science. Dordrecht: Springer, pp. 47-63. http://dx.doi.org/10.1007/1-4020-5216-2_5
Shewmon, A. D. (2001). "The brain and somatic integration: insights into the standard biological rationale for equating "brain death" with death". J Med Philos, 26 (5), pp. 457-78. http://dx.doi.org/10.1076/jmep.26.5.457.3000 PMid:11588655
Shewmon, A. D. (1998). "Chronic 'brain death': meta-analysis and conceptual consequences". Neurology 51 (6), pp. 1538-1545. http://dx.doi.org/10.1212/WNL.51.6.1538
Shewmon D. A.; Capron, A. M.; Peacock, W. J.; Schulman, B. L. (1989). "The use of anencephalic infants as organ sources. A critique". JAMA: the journal of the American Medical Association; 261 (12), 1773-81. http://dx.doi.org/10.1001/jama.1989.03420120111036
Singer, P. (1997). Repensar la vida y la muerte. El derrumbe de nuestra ética tradicional. Barcelona: Paidós.
Siegler, M. and Wikler, D. (1982). "Brain death and live birth". Jama, 248 (9), pp. 1101-1102. http://dx.doi.org/10.1001/jama.1982.03330090071036
Siminoff, L. A.; Burant, C. et al. (2004). "Death and organ procurement: public beliefs and attitudes". Soc Sci Med, 59 (11), pp. 2325-2334. http://dx.doi.org/10.1016/j.socscimed.2004.03.029 PMid:15450707
Slettedal, J. K.; Lyberg, T. et al. (2007). "Regeneration of the epithelium in organcultured donor corneas with extended post-mortem time". Acta Ophthalmol Scand, 85 (4), pp. 371-376. http://dx.doi.org/10.1111/j.1600-0420.2006.00840.x PMid:17559462
Spike, J. (1999). "Brain death, pregnancy, and posthumous motherhood". J Clin Ethics, 10 (1), pp. 57-65. PMid:10394539
Stoecker, R. (2012). "Der Tod als Voraussetzung der Organspende?". Zeitschrift für medizinische Ethik, 58. Jahrgang 2012 Heft2, 99-116.
The Multi-Society Task Force on PVS. (1994a). "Medical aspects of the persistent vegetative state (1)". The New England journal of medicine, 330 (21), 1499-508. http://dx.doi.org/10.1056/NEJM199405263302107 PMid:7818633
The Multi-Society Task Force on PVS. (1994b). "Medical aspects of the persistent vegetative state (2)". The New England journal of medicine, 330 (22), 1572-9. http://dx.doi.org/10.1056/NEJM199406023302206 PMid:8177248
Truog, R. D.; Fletcher, J. C. (1990). "Brain death and the anencephalic newborn". Bioethics; 4 (3), 199-215. http://dx.doi.org/10.1111/j.1467-8519.1990.tb00083.x
Van-Hooft, S. (2004). Life, Death, and Subjectivity: Moral Sources in Bioethics. Amsterdam: Value Inquiry Book Series. PMCid:PMC387384
Veatch, R. M. (1999). "The conscience clause: how much individual choice in defining death can our society tolerate?". En S. J. Youngner, R. Arnold and R. Schapiro, The definition of death: contemporary controversies. Baltimore: The Johns Hopkins University Press, pp. 137-160.
Verheijde, J. L.; Rady, M. Y. (2011). "Justifying physician-assisted death in organ donation". The American journal of bioethics: AJOB, 11 (8), 52-4. 08/03. http://dx.doi.org/10.1080/15265161.2011.585275 PMid:21806443
Wijdicks, E. F. (2002). "Brain death worldwide: accepted fact but no global consensus in diagnostic criteria". Neurology, 58 (1), pp. 20-25. http://dx.doi.org/10.1212/WNL.58.1.20
Wittgenstein, L. (2004). Investigaciones filosóficas. Barcelona: Crítica.
Youngner, S. J.; Arnold, R. et al. (1999). The definition of death: contemporary controversies. Baltimore: The Johns Hopkins University Press.
Youngner, S. J.; Arnold, R. M. et al. (1999). "When is 'dead'?". Hastings Cent Rep, 29 (6), pp. 14-21. http://dx.doi.org/10.2307/3527866
Youngner, S. J. and Arnold, R. M. (2001). "Philosophical debates about the definition of death: who cares?". J Med Philos, 26 (5), pp. 527-37. http://dx.doi.org/10.1076/jmep.26.5.527.3002 PMid:11588658
Youngner, S. J.; Landefeld, C. S.; Coulton, C. J.; Juknialis, B. W.; Leary, M. (1989). "'Brain death' and organ retrieval. A cross-sectional survey of knowledge and concepts among health professionals". JAMA : the journal of the American Medical Association, 261 (15), 2205-10. http://dx.doi.org/10.1001/jama.1989.03420150055037 PMid:2926968
Published
How to Cite
Issue
Section
License
Copyright (c) 2013 Consejo Superior de Investigaciones Científicas (CSIC)
This work is licensed under a Creative Commons Attribution 4.0 International License.
© CSIC. Manuscripts published in both the printed and online versions of this Journal are the property of Consejo Superior de Investigaciones Científicas, and quoting this source is a requirement for any partial or full reproduction.All contents of this electronic edition, except where otherwise noted, are distributed under a “Creative Commons Attribution 4.0 International” (CC BY 4.0) License. You may read here the basic information and the legal text of the license. The indication of the CC BY 4.0 License must be expressly stated in this way when necessary.
Self-archiving in repositories, personal webpages or similar, of any version other than the published by the Editor, is not allowed.
