The brain during life and in adjudicating death: Reduced brain identity of persons as a critique of the neurological criteria of death.

Abstract

The determination of death by neurological criteria (brain death) is practiced in at least 80 countries, though it is a matter of continuing controversy. At the same time, the brain is central to human life, thinking, and behavior; however, a growing "neurocentrism" or a brain-focused image of human identity became established in most Western and in many non-Western societies and acts as a forceful ideology. This paper seeks a broader theoretical and sociocultural basis to approaching death bioethically by analyzing criticisms aimed at a neurologically focussed vision of human life, and then turning these towards the brain death criteria exposed to the criticism. The overall critique of the "neuro-self" has scope to offer alternative perspectives to the contested issues in brain-death criteria. Specifically, the paper examines two major shortcomings of a narrow brain view of life and culture. First, it considers the reduction of the individual to the brain: this is the crux of the neurological way of determining death, and is a way that is seemingly context-independent and culturally neutral. Second, it considers how dimensions of society and culture for humans are detached from the brain and have little impact on clinical practice and thinking in brain-death criteria; however, a deeper exploration reveals that they actually have direct relevance and that social and cultural factors have greater contributions to make to the current debates.