Critique of Redefinitions of Man’s Death in Terms of ‘Brain Death’
Josef M. Seifert, Ph.D., Dr. phil.habil., Rektor and Professor of Philosophy, International Academy of Philosophy, Obergass 75, FL 9494 Schaan, Fürstentum Liechtenstein.
The 1968 statement of an ‘Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death’ has given rise to a virtually world-wide movement towards a new conception of death as brain death. 1 The question ‘what is death?’ is by no means exclusively or primarily a question of medical science. It is, in the last analysis, a philosophical (and, if divine revelation is accepted, a theological) question. The philosopher’s role in the discussion of death is twofold: On the one hand, he has to explore those highly intelligible and essentially necessary aspects of death which no other human science investigates2 This task includes a phenomenology of life and death, an ontology and metaphysics, as well as a philosophical anthropology of death.3 It likewise includes an analysis of the language of death and life and of the logical structure of the arguments used in the debates about life and death. On the other hand, the philosopher has to warn representatives of other disciplines against concluding too much from the little they know and extending their methods to areas where they are not appropriate. Careful reflection on both philosophical knowledge and philosophical ignorance concerning death shows, I shall argue, that the definition of death in terms of ‘brain death’ ought to be rejected. 4 1.
WHAT IS ‘BRAIN DEATH’?
Brain death is defined in confusingly different ways. Some have spoken of brainstem death, sometimes excluding the possibility of verifying the death of the whole brain. Others prefer to speak of ‘whole-brain death’. Still other authors want to replace a definition of whole-brain death by ‘neocortical death’ as a sufficient definition of human death.5 The latter term risks the additional confusion between ‘brain death’ and the ‘vegetative state’ (which is also called ‘cerebral death’). Several authors have extended the category of cortically dead humans or ‘anthropoid animals’ further and even feel entitled to accept the death by starvation and dehydration in ‘hopeless cases’ which they do not regard as live human persons but only as live human beings. In May 1987 doctors at the University Hospital Münster had transplanted successfully organs (kidneys) from anencephalic children to children and adults. Professor Fritz Beller justified this by a logical application of the criterion of cortical brain death, saying: “The anencephalic child is being developed, not born – for he does not live.” The irony is that these children precisely do have brainstem activity – dysfunction of which (brainstem death as such or as part of wholebrain death) constitutes in many legal systems today the criterion of brain death. Yet other definitions of death and brain death do not directly refer to the brain at all, but make explicit reference only to consciousness or to mental activity.6 Some relativistic definitions of brain death leave it entirely up to a society to decide what definition of brain death it wants to accept.