Bioethics Blogs

Bioethics and the Dogma of “Brain Death”

Two cases involving “brain death” have received considerable public attention, including commentary by several well-known bioethicists. In commenting on these cases the bioethicists have stated, in no uncertain terms, that an individual correctly diagnosed as “brain dead” is dead, pure and simple.  Contrary to appearances of being alive, in reality the “brain dead” individual is a corpse.  These statements are misleading because they have ignored the long-standing controversy and debate in the professional literature over the determination of death:  specifically, whether individuals diagnosed as “brain dead” should be considered dead and, if so, why they are dead. 

One of the recent cases involved Jahi McMath, a young patient who suffered massive brain injury following an operation; her parents have insisted that she is alive and that mechanical ventilation and other life-sustaining treatment should be maintained.  In the other case a hospital, appealing to state law, continued life-sustaining treatment for a Marlise Munoz, a pregnant “brain dead” woman, over the objection of her family. That treatment ended earlier this week after a Texas judge ruled in favor of the family.

While brain death is legally recognized as death in all 50 states, we are not alone in arguing that the “brain dead” remain alive in view of the biological conception of death established within medicine:  the irreversible cessation of the functioning of the organism as a whole. [1] The diagnostic criteria for “brain death,” when correctly applied, demonstrate definitively the presence of an irreversible coma without the capacity to breathe spontaneously. But does that mean that the “brain dead” are known to be dead? 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.