Death and the Brain

Abstract

Traditionally, death has been determined by observing the cessation of respiration and circulation. Technological developments in the middle of the twentieth century led to a new conception of death based on neurological criteria: the cessation of the functioning of the entire brain. This development greatly facilitated the emerging life-saving technology of organ transplantation. In this chapter, drawing on scientific research, we challenge the established view that "brain death" constitutes death. Not only do patients who meet the diagnostic criteria for "brain death" retain some brain-mediated functions, they also continue to maintain a broad array of biological functions with the aid of mechanical ventilation. We conclude that "brain death" is inconsistent with the biological definition of death that underlies medical practice in determining death. A recent effort by the President's Council on Bioethics to uphold "total brain failure" as compatible with a biological conception of death fails to withstand critical scrutiny.