The Social Controversy Surrounding Brain Death Diagnosis Around the World during the Early 21st Century |
Gabrielle Ueberroth |
1. History, definition, and social issues
According to recent studies, brain death “is a clinical diagnosis based on the absence of neurologic function with a known diagnosis that has resulted in irreversible coma.”(Pediatrics) The brain is what defines humanity and is vital to a human’s personhood. Many doctors today, just as Dr. Alan Shewman dismiss brain death believing that they should be judged biologically not by personhood. Prior to the 20th century the circulatory-respiratory formulation was used to determine death. The neurological determination of death (NDD) was considered after that and defined as “the irreversible loss of the capacity for consciousness combined with the irreversible loss of all brainstem function including the capacity to breathe.”(M.H.Harirchian) This new concept was used to shorten the time a patient was artificially maintained in the ICU before transplantation occurred and also to prevent wasting time after transplantation. The history of the brain death criteria began in 1959 in which Wertheimer P/Mollaret and Foulon studied 23 cases where the patients were considered to be in “coma dépassé” meaning “a state beyond coma.” In 1963 Guy Alexander, a Belgian surgeon, used the phrase ‘brain dead’ to describe a patient from whom a kidney was procured for transplant but still had a heartbeat. The year 1968 was the foundation on which all criteria for brain death have been founded on. The Ad Hoc Committee of the Harvard Medical School formulated a set of criteria that included unreceptivity and unresponcivity, no movements or breathing, no reflexes, and flat electroencephalogram after being repeated at least 24 hour later with the exclusion of hypothermia or CNS depressants. In 1971 Mohandas and Chou were sure to emphasize the importance of irreversible loss of...