Whole-brain death reconsidered--physiological facts and philosophy

Area of Science:

• Neuroscience
• Medical Ethics
• Philosophy of Medicine

Background:

• Discussions on brain death often suffer from conceptual confusion.
• Key areas of ambiguity include the relationship between death criteria and death concepts.
• Distinguishing between death as an event versus a process remains contentious.

Purpose of the Study:

• To identify and clarify major sources of confusion in the discourse surrounding brain death.
• To propose a framework for understanding brain death in relation to the organism as a whole.
• To advocate for the ethical and practical implications of diagnosing whole-brain death.

Main Methods:

• Conceptual analysis of philosophical and medical definitions of death.
• Review of neurological criteria for determining death.
• Ethical argumentation regarding the determination of death and end-of-life care.

Main Results:

• Four primary areas of confusion in brain death discussions were identified: criteria vs. concepts, event vs. process, neurological entities with varying cardiac prognoses, and conflation of 'determining death' with 'allowing to die'.
• The study argues that whole-brain death, defined as the irreversible dissolution of the human organism as a whole, constitutes death.
• It posits that behaviors permissible with a cadaver should be acceptable from the point of whole-brain death diagnosis.

Conclusions:

• Resolving conceptual ambiguities is crucial for accurate brain death determination.
• Whole-brain death aligns with the concept of the irreversible loss of the organism as a whole.
• The diagnosis of whole-brain death should permit the same actions as the presence of a cadaver.