A plea for the heart

Area of Science:

• Medical Ethics
• Philosophy of Medicine
• Neuroscience

Background:

• Current definitions of death often rely on brain function cessation.
• These definitions can lead to scenarios where a person is considered dead, yet their heart continues to beat spontaneously.
• Neocortical definitions of death specifically focus on the loss of higher brain functions.

Purpose of the Study:

• To critically examine the ethical implications of brain-centered and neocortical conceptions of death.
• To question the consistency in accepting organ explantation from 'beating-heart cadavers' while rejecting the cremation of a 'breathing corpse'.
• To explore the moral distinction between allowing natural bodily functions to cease and actively intervening to stop them in the context of death.

Main Methods:

• Philosophical analysis of ethical arguments surrounding death definitions.
• Conceptual critique of 'brain-centered' and 'neocortical' approaches to determining death.
• Examination of the moral intuitions and potential inconsistencies in medical practices related to organ donation and end-of-life care.

Main Results:

• Brain-centered death definitions present a 'shocking feature' by declaring individuals dead despite spontaneous cardiac activity.
• Neocortical definitions may lead to the ethically problematic classification of individuals as 'breathing corpses'.
• A potential ethical inconsistency arises when organ explantation from 'beating-heart cadavers' is accepted, but the idea of cremating a 'breathing corpse' is rejected.

Conclusions:

• The current brain-centered and neocortical definitions of death warrant deeper ethical scrutiny.
• Active interventions to cease remaining bodily functions in individuals meeting these definitions raise questions akin to killing.
• Reconciling the ethical acceptance of organ explantation with the aversion to cremating a 'breathing corpse' is a significant challenge for current death determination frameworks.