重新思考大脑死亡-为什么"足够死的"还不够好:UDDA修订系列
Daniel P Sulmasy1, Christopher A DeCock2
1From the The Kennedy Institute of Ethics (D.P.S.), Georgetown University, Washington, DC; and Essentia Health and The University of North Dakota School of Medicine and Health Sciences (C.A.D.), Fargo. sulmasyd@georgetown.edu.
Neurology
|July 10, 2023
概括
慢性脑死亡病例挑战了死亡的定义. 真正的死亡需要失去自我整合,而不仅仅是生物的整合,需要除了呼吸暂停和不响应之外的额外测试.
科学领域:
- 生物哲学是一种哲学.
- 神经科学是一个神经科学.
- 医学伦理 医学伦理
背景情况:
- 脑死亡作为真正死亡的概念受到"慢性脑死亡"病例的挑战.
- 这些病例涉及严重神经损伤的患者,由人工支持维持,看起来是整合的.
- 这就提出了关于脑死亡标准的哲学理由的问题.
研究的目的:
- 重新评估脑死亡的生物哲学理由.
- 提出基于自我整合的死亡声明的修订标准.
- 确保大脑死亡概念的持续可行性.
主要方法:
- 生物整合和自我整合的哲学分析.
- 批评当前的大脑死亡标准 (呼吸暂停,不响应).
- 关于确定死亡的额外标准的建议.
主要成果:
- 仅仅是有机体的整合是不够的定义一个生物;实质性的自我整合是必要的.
- 无法逆转的呼吸暂停和无反应是必要的,但不足以宣布死亡.
- 失去了心脏功能或脑体同源控制,以及呼吸暂停和不反应,表明真正的死亡.
结论:
- 当自我整合失去了时,整合的位置转移到外部支持团队.
- 虽然细胞和器官可能仍然是可行的,但自主,整个人类生物体不再存在.
- 脑死亡的概念仍然有效,但需要扩展测试,包括自我整合能力的丧失.
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