Who Says You're Dead When Your Brain Is Dead?
However, it has now become an article of faith in the medical community of the developed West that a patient has died when his or her brain is dead. But there is good reason to think that not all human organisms with dead brains are also dead as human organisms.
Consider that in many cases when first being cut open to harvest her organs, the "dead" patient reacts strongly to the incision -- with heart rate and blood pressure increasing dramatically (at least until a general anesthetic is given). Some "dead" patients also have pituitary function after brain death, as well as functioning of the spinal cord, and both can help to integrate the human organism and help her achieve homeostasis.
Indeed, brain-dead individuals can live for months, and can evengestate children to a successful birth.Brain-dead humans need help to breath and eat, of course, but many human organisms at the beginning and end of life need such help.
Some scientists and medical professionals are beginning to realize that the current brain death criterion just doesn't fit the science or their current practices. For instance, a recent Nature editorial argues that "the law should be changed to describe more accurately and honestly the way death is determined in clinical practice." The current law requires that brain death be established, but the editorial admits that often the pituitary gland at the base of the brain is still functioning.
"That activity has nothing to do with the person being alive in any meaningful sense," argues the editorial. But it does seem to undermine the claim that all functions of the entire brain have ceased.
Greedy Harvesters Eager to Remove Organs
Another question asked by the editorial involves how long a physician should wait to determine brain death. Physicians have "occasionally observed a brainstem-mediated reflex -- a cough, for example -- [in patients] up to 36 hours after they would have been declared dead" had they been being used for organ transplant.
The lack of any clear boundary means that we should once again change "laws that push doctors towards a form of deceit" and that make them seem like "greedy harvesters eager to strip living patients of their organs." The editorial concludes that although death is a "sensitive" issue, concerns about "declaring death in someone who will never again be the person he or she was should be weighed against the value of giving a full and healthy life to someone who will die without a transplant."
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Cite this: Death of the Brain Is Not the Death of the Human Being - Medscape - Sep 23, 2013.