Human brain

Greetings. I am a philosophy professor at Methodist University in Fayetteville, North Carolina. Most of my academic work has been in medical ethics, especially the issue of the determination of death, but I have also written in the philosophy of religion. I edited, with Paul A. Byrne, M.D., and Richard G. Nilges, M.D., an anthology, Beyond Brain Death: The Case Against Brain Based Criteria for Human Death, which was published by Kluwer Academic Publishers in 2000. I also have several articles and book chapters in that area. I have also written on near-death experiences, philosophy and literature, against the consumer model of higher education, and on chess and education. I enjoy creative writing, and have a poetry chapbook, From Field to Thicket, which won the 2006 Mary Belle Campbell Chapbook Award of the North Carolina Writers’ Network. I’m currently working on more academic pieces, my second novel (I’m seeking a publisher for my first), and more poetry. I enjoy playing chess (USCF rating: 1646), vegetable gardening, canning, and reading in just about every subject. Recently, I’ve been focusing on horror fiction.

As my first topic for this blog, I’ll write about brain death criteria. In 1968, The Harvard Ad Hoc Committee on Brain Death formulated the first set of brain-based criteria for human death. It was a version of “whole brain death,” and said that an individual could be declared dead when the entire brain, including the brainstem, ceases to function. This view was affirmed by the President’s Commission report of 1981 on the determination of death, and enshrined in law in the Uniform Determination of Death Act, which has now been passed by almost all states. The President’s Commission report became the “Bible” on brain death, and was rarely questioned until recently.

Many people who sign their organ donor cards do not realize that if they are declared dead by brain death criteria, rather than by cardiovascular criteria, their hearts will still be beating when they are wheeled into surgery to remove their organs. They are not “dead” in the usual sense of the word. The President’s Commission claimed that brain dead individuals are dead because their bodies no longer have organic unity; once the brain is dead, their bodies are just isolated sets of organs that are dependent on machines to function. But this is sloppy reasoning. Dependence on machines does not mean a person is dead; many conscious people are dependent on ventilators but are not considered “dead”. Even if it were true, as the Commission claimed, that brain dead peoples’ hearts stop quickly after brain death, this is only a prognosis of impending death, not a diagnosis that death has already occurred. In any case, there have been long-term survivors of brain death–brain dead pregnant women have been maintained over 200 days until they gave birth to healthy children. And Alan Shewmon, Professor of Pediatric Neurology at UCLA, has written about a boy who survived over 14 years with his brain totally liquified. He was on a ventilator, but he maintained a normal blood pressure. To deny his body was functioning as an organic unity is ludicrous.

EEG activity has been noted in an number of brain dead patients, though this is said to be “residual.” Some brain dead patients maintain normal body temperature, a sign that a part of the brain, the hypothalamus, is still working. Some brain dead patients have had heart rate and blood pressure increases during organ donation surgery. This evidence suggests that the “whole” in “whole brain death” is inaccurate. Given the ignorance of the generation of consciousness in the brain, do we really want to remove organs from individuals with some brain function?

I argue, then, that “brain dead” individuals whose circulation and respiration (in the important sense of oxygen exchange in the lungs and at the cellular level) continue, are living human persons, and that removing unpaired vital organs, such as the heart or liver, from these patients, kills them. Although some scholars in this area, such as Robert Truog, say, in effect, “Since brain dead people are in such bad shape, it’s okay to kill them for their organs,” those who accept a sanctity of life ethic are being inconsistent when they support the current system of organ donation.