Brain death: a new dimension of death?
Brain death, a concept distinct from traditional circulatory death (when the heart stops beating), has long been a concept difficult for the public to grasp due to the lack of adequate public education.
As defined by the Ad Hoc Committee of the Harvard Medical School, the criteria for brain death is as follows: unreceptive and unresponsive; absence of movement, breathing, and reflexes; and a flat encephalogram (essentially an X-ray picture of the brain that provides information of electrical activity); all in the absence of confounding factors that remain unchanged at an interval of 24 hours or later.
In essence, both traditional cardiorespiratory death and brain death are forms of death accepted by the medical community — the difference is that a brain-dead person, generally supported by a ventilator or machine, does not display the typical visual signs of death such as a stopped heartbeat.
In fact, this difference can raise confusion. Only 28% of family members of patients that had been brain dead could correctly define brain death.
However, debates have been ongoing on whether it is appropriate to accept brain death as death. Criticism for the concept arose in the medical and philosophical-ethical community.
It is hard for many to understand brain death as it differs from our idea of a “sensual perception of death” and does not have a visibly defined time point of death.
From a philosophical-ethical point of view, some medical experts remain concerned that brain death could be used “as a means of pragmatically redefining death.”
In other ways, stopping life support for supposedly brain-dead patients may indicate an inclination to end human life for more utilitarian reasons.
From a neurophysiological perspective, some argue that brain death could not be equated to circulatory death. They reasoned that with the help of new technology and artificial support, brain-dead patients could continue to maintain vital functions such as wound healing, fetus gestation, and even sexual maturation — sometimes for long periods of time. In this case, if the body is growing and developing, they wonder how we can consider it “death.”
However, abandoning the concept of brain death could serve to further complicate the medical-ethical dilemma, perhaps more so than the introduction of the concept itself.
It would result in a step backward in the progress and standards of modern intensive care and transplantation medicine. Not only would it deprive patients of the right to die, it would also reduce organ donations.
Currently, brain death is a widely-accepted concept, but controversies continue to exist. To avoid these controversies, efforts are being made by the global medical community to establish uniform criteria, develop systems to ensure that brain death determination is consistent and accurate, respond to objections to the determination of death by neurological criteria, and finally improve public trust in brain death determination.
However, to completely resolve the debate over brain death may be impossible. As a social construct, it will always be subject to criticism and conflicting opinions.
In the face of this, we must recognize that death is not just a biological process but also the permanent loss of personal characteristics such as personality, identity, culture, and values. With a growing understanding of medicine and increased scientific and technological development, the definition of death is no longer bound to a single standard.
~ Saathvika Diviti ‘25
