An Answer to Condic, Lee, Moschella and other Defenders of Brain Death Definitions and Criteria of Human Death

Josef Seifert† 2018

Abstract After an introduction, the main arguments in favor of identifying “brain death” with actual human death are first presented and then (immediately folowing their presentation) refuted. 1. The first main argument advanced in favor of “brain death” definitions is the following: “brain death” is death because it entails a loss of integration of life, without which properly human life of the organism is lost. This chief argument for “brain death definitions” can be refuted in the following ways:

a) An overwhelming amount of integrative / integrated functions and processes remain in the “brain dead” (first “litany” of Shewmon). Moreover, it is precisely the many brain-independent functions on which human life depends. The “brain-dependent” parts of integration are more important for human health and rational conscious life, not for biological life of the organism as a whole.
b) Condic’s claim that Shewmon confounds integrated with merely coordinated functions is shown invalid by demonstrating the unclear and partly contradictory chracterization of this distinction by Condic and the clear presence of “integration” in what Condic calls mere “coordination”. Condic’s and Moschella’s attempt to show the arbitrariness of Shewmon’s refutation of the “brain death rationale” and their attempt to “deconstruct” Shewmon’s arguments fail entirely and commit a series of logical fallacies.
c) Moreover, human life is not reducible to “integrated biological life” in all organs and parts of the body.
d) That loss of integrated unity is not death, is proven by cases of some farther reaching loss of integration without “brain death” and without loss of consciousness; and hence in clearly living persons: such as after spinal shock or lesions in the high spinal cord.

2. The second main argument in favor of identifying “brain death” with actual human death rests on the singular importance of the brain as the organ needed for conscious and rational activity, and, according to Lee and Grisez, also for sentience (and for this additional reason as well for the rationality of the “rational animal”).
a) A first critique of this argument shows that it is based on a false actualism and dissolution of persons into acts;
b) A second critique of “brain death” definitions and their defense by Lee-Grisez shows that they entail a wrong denial of the unity of the source of rational, sensitive and vegetative life in the single soul of man.
c) The plasticity of the brain allows not only that one cerebral hemisphere replaces the other one, but that even the brainstem is used for basic specific human acts: this constitutes an additional reason why “higher brain death” must not be identified with actual human death.

3. The third main (anthropological) argument for “brain death” claims that the brain is the only seat (or condition) of the presence of the human soul in the body that the brain alone is the body. This claim is refuted in the following ways:
a) Respiration (that is distinct from spontaneous breathing) and blood-circulation or transfer of oxygen through the blood are more important for the presence of human life than brain functions, on which human life does not depend.
b) The brain arises late in the life of the human embryo, but the embryo has human life from the beginning.
c) Hemispherectomy and the extraordinary plasticity of the brain prove that neither the dominant nor the non-dominant cerebral hemisphere is the ‘seat of the soul’.
d) The goal of brain-implantations pursued by neurologists and neuro-surgeons presupposes that “brain death” is not death of the person. e) If there existed such an absolute link between brain activity and presence of human life in the body, why would then temporary dysfunction of the brain not result in death or be biological death? f) ‘Brain death’ is not complete brain destruction and the brain of the ‘brain-dead’ continues to exist and shows some biological functions.

4. The thesis of Lee-Grisez that the radical loss of the capacity for sentience and for consciousness (RCS/RCC) in the “brain dead” reduces these to vegetative life is refuted in the following ways:
a) A false interpretation of man being a “rational animal” lies at the root of the RCS Argument
b) A “potency/capacity” based actualistic error about personhood (rational nature) is shown to lie ultimately at the root of Lee and Grisez’s thesis on “brain death”
c) The false assumption of the plurality of souls and of gradual de-ensoulment is refuted philosophically and theologically. Without the assumption of 3 souls in man (an assumption which Lee-Grisez reject) the gradual de-ensoulment theory they propose, is even far more unplausible than in a Thomist framework of delayed animation. The delayed ensoulment theory of Thomas Aquinas clearly contradicts Church teaching and should thus be unacceptable for devout Catholics as Lee and Grisez.

5. The ethical principle In Dubio pro Vita shows that even if the defenders of brain death definitions” were right theoretically they would be wrong practically.

6. Coimbra’s cogent scientific and ethical argument against testing for “brain death” is defended: “Apnea tests are risking to kill persons in order to test whether they are dead,” constitute a crass violation of the Hippocratic Oath and of medical ethics.

7. The mystery of the moment of death must not be reduced to the level of a ‘calculable problem’.

8. The primacy of the moral question over utility demands from physicians a return to the Hippocratic oath.. 9. Ceterum censeo definitionem mortis cerebralis esse delendam. The medical community should reject the deadly construct of “brain death” that leads to countless homicides and return from the ambiguities and sophisms of “brain death” to the pre-1968 understanding of death which provides a clear, consistent, and firm rational ground of medical activity.

  1. Introduction

There are many arguments in favor of “brain death” amounting to actual death that I do not wish to discuss critically in this essay. These are of three kinds: