Should the Criterion for Brain Death Require Irreversible or Permanent Cessation of Function? Irreversible: The UDDA Revision Series.

Abstract

I argue that death is irreversible and not merely permanent. Irreversible means a state cannot be reversed and entails permanence. Permanent means a state will not be reversed and includes cases where the state could still be reversed though a decision has been made not to attempt this reversal. This distinction is important, as we shall see. Four reasons are given for why death must be irreversible and not merely permanent: no mortal can return from the state of death; unacceptable implications regarding culpability for actions and omissions; death is a physiologic state; and irreversibility is inherent in the standards to diagnose brain death. Four objections are considered including the following: permanence is the medical standard, permanence was the intent of the President's Commission on defining death, irreversible requires many hours to occur, and we should change terminology to reflect our case intuition. These objections are discussed and rejected. Finally, I clarify my views to conclude that the criterion for biological death is irreversible loss of circulation.