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Death, Dying, and Organ TransplantationReconstructing Medical Ethics at the End of Life$
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Franklin G. Miller and Robert D. Truog

Print publication date: 2011

Print ISBN-13: 9780199739172

Published to Oxford Scholarship Online: January 2012

DOI: 10.1093/acprof:oso/9780199739172.001.0001

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Death and the Brain

Death and the Brain

Chapter:
3 Death and the Brain
Source:
Death, Dying, and Organ Transplantation
Author(s):

Franklin G. Miller

Robert D. Truog

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780199739172.003.0010

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.

Keywords:   definition of death, brain death, total brain failure, integrative functioning of the organism as a whole, homeostasis

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