Bioethics Blogs

Brain Death Is a Flash Point in End-of-Life Law, Ethics and Policy

by Thaddeus M. Pope, J.D., Ph.D.

The August 2014 issue of the American Journal of Bioethics includes nearly 20 articles on the status of death determined by neurological criteria (DDNC or “brain death”).  Not coincidentally, this summer, several other leading bioethics journals are also covering “brain death.”  (See recent and forthcoming articles in the Cambridge Quarterly of Healthcare Ethics, the Hastings Center Report, and the Journal of Medical Ethics.)  I have myself contributed to a multi-article examination of the topic in the imminently forthcoming Journal of Clinical Ethics 25(3).

I am pleased to see all this attention focused on “brain death.”  It validates a decision I just made.  I have just returned from a fantastic conference hosted by the Queensland University of Technology in Brisbane:  “International Conference on End of Life: Law, Ethics, Policy, and Practice.”  We had over 300 participants from more than 20 countries.  In one plenary panel session, five law professors from five different nations identified “comparative flash points in end of life law, ethics and policy.”  On behalf of the United States, I identified “brain death” as the “flash point” of the year.

Growing Uncertainty over Brain Death
Contrast brain death with medical futility.  As I have written and presented many times, there is legal uncertainty whether clinicians can stop treatment without consent.  For years, many have contrasted this uncertainty with the bright line situation of brain death.  After all, for three decades, this has been settled.  Total brain failure has been a diagnosis on which death can be pronounced and physiological support stopped.

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.