scholarly journals Brain Death and the Formation of Moral Conscience

2019 ◽  
Vol 86 (4) ◽  
pp. 335-346
Author(s):  
Christopher Ostertag ◽  
Kyle Karches
Keyword(s):  
Brain Death ◽  
Medical Practice ◽  
Current Status ◽  
Determination Of Death ◽  
Widespread Application ◽  
Medical Practitioners ◽  
Tentative Approval ◽  
Human Death ◽  
Catholic Bishops

In this article, we provide an update to Catholic ethicists and clinicians about the current status of Catholic teaching and practice regarding brain death. We aim to challenge the notion that the question has been definitively settled, despite the widespread application of this concept in medical practice including at Catholic facilities. We first summarize some of the notable arguments for and against brain death in Catholic thought as well as the available magisterial teachings on this topic. Although Catholic bishops, theologians, and ethicists have generally signaled at least tentative approval of the neurological criteria for the determination of death, we contend that no definitive magisterial teaching on brain death currently exists; therefore, Catholics are not currently bound to uphold any position on these criteria. In the second part of the article, we describe how Catholics, particularly Catholic medical practitioners, must presently inform their consciences on this issue while awaiting a more definitive magisterial resolution. Summary: Some prominent Catholic theologians and physicians have argued against the validity of brain death; however, most Catholic ethicists and physicians accept the validity of brain death as true human death. In this paper, we argue that there is no definitive magisterial teaching on brain death, meaning that Catholics are not bound to uphold any position on brain death. Catholics in general, but especially Catholic medical practitioners, should inform their consciences on this intra-Catholic debate on brain death while awaiting more definitive magisterial teaching.

scholarly journals Pope John Paul II and the Neurological Standard for the Determination of Death: A Critical Analysis of his Address to the Transplantation Society

2017 ◽  
Vol 84 (2) ◽  
pp. 155-186 ◽  
Author(s):  
Doyen Nguyen
Keyword(s):  
Brain Death ◽  
Catholic Church ◽  
The Body ◽  
Human Organism ◽  
Determination Of Death ◽  
Pope John Paul Ii ◽  
John Paul Ii ◽  
The Brain ◽  
The Catholic Church

The introduction of the “brain death” criterion constitutes a significant paradigm shift in the determination of death. The perception of the public at large is that the Catholic Church has formally endorsed this neurological standard. However, a critical reading of the only magisterial document on this subject, Pope John Paul II's 2000 address, shows that the pope's acceptance of the neurological criterion is conditional in that it entails a twofold requirement. It requires that certain medical presuppositions of the neurological standard are fulfilled, and that its philosophical premise coheres with the Church's teaching on the body-soul union. This article demonstrates that the medical presuppositions are not fulfilled, and that the doctrine of the brain as the central somatic integrator of the body does not cohere either with the current holistic understanding of the human organism or with the Church's Thomistic doctrine of the soul as the form of the body. Summary The concept of “brain death” (the neurological basis for legally declaring a person dead) has caused much controversy since its inception. In this regard, it has been generally perceived that the Catholic Church has officially affirmed the “brain death” criterion. The address of Pope John Paul II in 2000 shows, however, that he only gave it a conditional acceptance, one which requires that several medical and philosophical presuppositions of the “brain death” standard be fulfilled. This article demonstrates, taking into consideration both the empirical evidence and the Church's Thomistic anthropology, that the presuppositions have not been fulfilled.

scholarly journals The ethical and legal implications of the Human Tissue Amendment Act 2020 (Vic)

2021 ◽  
Vol 23 (3) ◽  
pp. 245-247
Author(s):  
Steve Philpot ◽  
◽  
David Anderson ◽  
◽  
◽  
...  
Keyword(s):  
Organ Donation ◽  
Human Tissue ◽  
Medical Practitioner ◽  
Determination Of Death ◽  
Medical Practitioners ◽  
Legal Implications ◽  
Tissue Act ◽  
Human Tissue Act ◽  
Circulation Of The Blood

The Human Tissue Act 1982 (Vic) has recently been amended by the Human Tissue Amendment Act 2020(Vic). In an effort to better reflect the modern practice of organ donation, the intention of the amendment is to include a process for the authorisation of ante-mortem procedures in patients being considered for organ donation after circulatory determination of death(DCDD). As part of this process, the amendment introduces a new requirement for consent for such ante-mortem procedures, and specifies that: A designated officer for a hospital must not give an authority … in respect of a person unless, where the respiration or the circulation of the blood of the person is being maintained by artificial means, two registered medical practitioners, neither of whom is the designated officer and each of whom has been for a period of not less than five years a registered medical practitioner, have each certified in writing — ​ that the practitioner has carried out a clinical examination of the person while the respiration or the circulation of the blood of that person was being maintained by artificial means; and that, in the practitioner’s opinion, at the time of examination, death of the person would occur as a result of the withdrawal of the artificial means of maintaining the respiration or the circulation of the blood of the person.

Building a Fence Around Brain Death: The Shielded-Brain Formulation

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012641
Author(s):  
Douglas J Gelb
Keyword(s):  
Clinical Practice ◽  
Brain Death ◽  
Determination Of Death ◽  
Clinical Standards ◽  
History Of ◽  
Uniform Law ◽  
New Formulation ◽  
Law Commission ◽  
Current Practices

The concept of brain death was proposed more than 50 years ago and it has been incorporated in laws and clinical practice, but it remains a source of confusion, debate, and litigation. Because of persistent variability in clinical standards and ongoing controversies regarding policies, the Uniform Law Commission (ULC), which drafted the Uniform Determination of Death Act (UDDA) in 1980, has appointed a committee to study whether the act should be revised. This article reviews the history of the concept of brain death and its philosophical underpinnings, summarizes the objections that have been raised to the prevailing philosophical formulations, and proposes a new formulation that addresses those objections while preserving current practices.

Challenges to the Determination of Death by Neurological Criteria

2019 ◽  
Vol 19 (4) ◽  
pp. 583-599
Author(s):  
Tadeusz Pacholczyk ◽  
Stephen Hannan ◽  
Keyword(s):  
Brain Death ◽  
Determination Of Death ◽  
Ethical Concerns ◽  
Diagnostic Practices ◽  
Testing Potential ◽  
Brain Dead ◽  
Testing Protocols ◽  
The Brain ◽  
Apnea Testing

Ethical concerns regarding the conceptual framework for the determination of death by neurological criteria, including several clinical and diagnostic practices, are addressed. The significance of a diagnosis of brain death, diagnostic criteria, and certain technical aspects of the brain-death exam are presented. Standard and ancillary tests that typically help achieve prudential certitude that an individual has died are indicated. Ethical concerns surrounding interinstitutional variability of testing protocols are evaluated and considered, as are potential apnea-testing confounders such as hypotension, hypoxemia, hypercarbia, and penumbra effects during ancillary testing. Potential adjustments to apnea-testing protocols involving capnography, thoracic impedance monitors, or spirometers to assess respiratory efforts are discussed. Situations in which individuals determined to be brain dead “wake up,” or fail to manifest the imminent cessation of somatic functioning typically seen when supported only by a ventilator, are also briefly reviewed.

Determination of Death: Perspectives from Psychological Assessment

1978 ◽  
Vol 42 (3) ◽  
pp. 851-857
Author(s):  
D. J. Woods ◽  
T. Royder
Keyword(s):  
Psychological Assessment ◽  
False Positive ◽  
False Negative ◽  
Clinical Death ◽  
Determination Of Death ◽  
Technological Advances ◽  
Assessment Problems ◽  
Combining Information ◽  
Human Death

The judgment that human death has occurred is not easily, reliably, or confidently arrived at in increasing numbers of cases. In this paper difficulties surrounding the definition and determination of death are regarded as assessment problems to which concepts familiar to many psychologists are applicable. These concepts include multiple operational ism, exclusionary screening, false positive and false negative errors, and the idea of a “cutting score” for decisions regarding death. Recommendation is made for the examination of implicit weights used by physicians in combining information from various sources, to arrive at decisions regarding clinical death. Recent technological advances and concomitant social pressures have changed the nature of the assessment of death from a primarily criterion-related to a largely construct-oriented procedure.

The Determination of Death

1977 ◽  
Vol 7 (4) ◽  
pp. 277-296 ◽  
Author(s):  
Gerald M. Devins ◽  
Robert T. Diamond
Keyword(s):  
Brain Death ◽  
Science And Technology ◽  
Medical Science ◽  
Determination Of Death ◽  
Recent Developments ◽  
The Brain

Recent developments in medical science and technology have rendered obsolete the traditional medical criteria for determining death in a small but growing number of terminal patients. Philosophical problems encountered in attempts to develop a more sophisticated set of operational procedures are discussed. Both the traditional conditions indicating death as well as more recent reformulations required to pronounce a state of brain death in those moribund individuals in whom the traditional signs have been obscured are reported. Finally, some of the medical, legal, and social considerations which arise from recognition of the brain death definition are discussed briefly.

Definition of Brain Death

1983 ◽  
Vol 40 (1) ◽  
pp. 5-14
Author(s):  
John J. Paris ◽  
Ronald E. Cranford
Keyword(s):  
Public Policy ◽  
Brain Death ◽  
Policy Position ◽  
Determination Of Death ◽  
Definition Of

“It is important to be clear on what determination of death statutes involve…. It is equally important to understand the objections to such legislation, analyze and evaluate them, and devise a coherent public policy position on the issue. That policy must be medically sound, ethically appropriate, and theologically acceptable.”

scholarly journals Brain Blood Flow in the Neurological Determination of Death: Canadian Expert Report

2008 ◽  
Vol 35 (2) ◽  
pp. 140-145 ◽  
Author(s):  
Sam D. Shemie ◽  
Donald Lee ◽  
Michael Sharpe ◽  
Donatella Tampieri ◽  
Bryan Young
Keyword(s):  
Blood Flow ◽  
Brain Death ◽  
Imaging Techniques ◽  
Radionuclide Angiography ◽  
Brain Blood Flow ◽  
Determination Of Death ◽  
Xenon Ct ◽  
Clinical Criteria ◽  
Canadian Council

The neurological determination of death (NDD, brain death) is principally a clinical evaluation. However, ancillary testing is required when there are factors confounding the clinical determination or when it is impossible to complete the minimum clinical criteria. At the time of the 2003 Canadian Forum clarifying the criteria for brain death, 4-vessel cerebral angiography or radionuclide angiography were the recommended tests and the electroencephalogram was no longer supported. At the request of practitioners in the field, the Canadian Council for Donation and Transplantation sponsored the assembly of neuroradiology and neurocritical care experts to make further recommendations regarding the use of ancillary testing. At minimum, patients referred for ancillary testing should be in a deep unresponsive coma with an established etiology, in the absence of reversible conditions accounting for the unresponsiveness and the clinical examination should be performed to the fullest extent possible. For newborns, children and adults, demonstration of the absence of brain blood flow by following recommended imaging techniques fulfill the criteria for ancillary testing: 1. radionuclide angiography or CT angiography 2. traditional 4-vessel angiography 3. Magnetic resonance angiography or Xenon CT. In the absence of neuroimaging, an established cardiac arrest, as defined by the permanent loss of circulation, fulfills the ancillary criteria for the absence of brain blood flow. Acknowledging the existing limitations in this field, further research validating current or evolving techniques of brain blood flow imaging are recommended.

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