Abstract
We provide a brief overview of the history of brain death showing how the cardiopulmonary model (CPM) of death became problematic due to the technological innovation of mechanical ventilation beginning with its use in the 1950s. We then examine difficulties that emerged with what was to become the received view of brain death known as Whole Brain Death (WBD). We argue that these challenges were never satisfactorily met by defenders of WBD. We also argue that a return to a CPM leads to even greater conceptual difficulties. Given that there are serious difficulties with both WBD and the CPM, we introduce a new version of higher brain death which we refer to as a functionalist view. We argue that a functionalist view of higher brain death can be defended more consistently than WBD and the CPM. Our defense introduces the notion of basing death on mental processing as opposed to traditional notions of higher brain death which used problematic and imprecise concepts such as consciousness and personhood.
Highlights
Brief Overview on the History of Brain DeathThere are three standards that have been considered for determining the death of a human being
We provide a brief overview of the history of brain death showing how the cardiopulmonary model (CPM) of death became problematic due to the technological innovation of mechanical ventilation beginning with its use in the 1950s
For the first time in human history, it seemed legitimate to declare a human being dead based on the permanent cessation of brain activity even if a person had a beating heart and breathing lungs
Summary
There are three standards that have been considered for determining the death of a human being. Under the CPM human beings are considered dead when they permanently cease to breathe and circulate blood. This view of death worked quite well, and it is relatively easy to document.. The Commission set a more specific standard for determining death which became fully enacted, more or less as in the model code, as law in all 50 states of the United States and in many other international countries [7] Alan Shewmon wrote a seminal article questioning the legitimacy and consistency of determining WBD [11] Shewmon bases his view on several functions brain dead patients have been able to carry out. In the White Paper the notion of WBD is defended as the best standard for determining the death of a human being
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