Four main areas generating confusion in discussion on brain death are identified as a) the relation of criteria of death to concepts of death, b) the argument about whether death is an event or a process, c) the inadequate differentiation of different neurological entities having different cardiac prognoses, and d) insufficient awareness of the separate issues of 'determining death' and 'allowing to die'. It is argued that if by death we mean the dissolution of the human 'organism as a whole', (...) then whole-brain death is death. Behavioural patterns, legitimate in the presence of a cadaver, should be legitimate from the time whole-brain death is diagnosed. (shrink)

Dramatic changes in medical technology challenge mankind’s traditional ways of diagnosing death. Death, Brain Death and Ethics examines the concept of death against the background of these changes, as well as ethical and philosophical issues arising from attempts to redefine the boundaries of life. In this book, David Lamb supports the use of brain-related criteria for the diagnosis of death, and proposes a new clinical definition of death based on both medical and philosophical principles. Death, Brain Death and Ethics articulates (...) the case for a brain death standard, while presenting an informed viewpoint on what constitutes the end points of human life. Although the book is written from a philosophical standpoint, it raises fundamental questions regarding the meaning of life and death, and will interest lay-persons, lawyers, and physicians. Death, Brain Death and Ethics is sure to prompt discussion and reflection on some of the philosophical beliefs which underlie clinical practice. (shrink)

A new human life comes into being not when there is mere cellular life in a human embryo, but when the newly developing body organs and systems begin to function as a whole, the author argues. This is symmetrical with the dealth of an existing human life, which occurs when its organs and systems have permanently ceased to function as a whole. Thus a new human life cannot begin until the development of a functioning brain which has begun to co-ordinate (...) and organise the activities of the body as a whole. (shrink)

The dominant conception of brain death as the death of the whole brain constitutes an unstable compromise between the view that a person ceases to exist when she irreversibly loses the capacity for consciousness and the view that a human organism dies only when it ceases to function in an integrated way. I argue that no single criterion of death captures the importance we attribute both to the loss of the capacity for consciousness and to the loss of functioning of (...) the organism as a whole. This is because the person or self is one thing and the human organism is another. We require a separate account of death for each. Only if we systematically distinguish between persons and human organisms will we be able to provide plausible accounts both of the conditions of our ceasing to exist and of when it is that we begin to exist. This paper, in short, argues for a form of mind-body dualism and draws out some of its implications for various practical moral problems. (shrink)

In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity in the (...) cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)

The concept of brain birth has assumed a position of some significance in discussions on the status of the human embryo and on the point in embryonic development prior to which experimental procedures may be undertaken on human embryos. This paper reviews previous discussions of this concept, which have placed brain birth at various points between 12 days' and 20 weeks' gestation and which have emphasised the symmetry of brain birth and brain death. Major developmental features of brain development are (...) outlined, including the gradualness with which new features generally appear, and also the electroencephalogram (EEG) characteristics of premature infants. From this it is concluded that, if the concept of brain birth is a valid one, it should be placed at 24-28 weeks' gestation. More importantly, it is concluded that the differences between brain development and brain death throw doubt on the concept itself. (shrink)

This paper suggests that medically the term a 'human being' should be defined by the presence of an active human brain. The brain is the only unique and irreplaceable organ in the human body, as the orchestrator of all organ systems and the seat of personality. Thus, the presence or absence of brain life truly defines the presence or absence of human life in the medical sense. When viewed in this way, human life may be seen as a continuous spectrum (...) between the onset of brain life in utero (eight weeks gestation), until the occurrence of brain death. At any point human tissue or organ systems may be present, but without the presence of a functional human brain, these do not constitute a 'human being', at least in a medical sense. The implications of this theory for various ethical concerns such as in vitro fertilisation and abortion are discussed. This theory is the most consistent possible for the definition of a human being with no contradictions inherent. However, having a good theory of definition of a 'human being' does not necessarily solve the ethical problems discussed herein. (shrink)

In an attempt to provide some clarification in the abortion issue it has recently been proposed that since 'brain death' is used to define the end of life, 'brain life' would be a logical demarcation for life's beginning. This paper argues in support of this position, not on empirical grounds, but because of what it reflects of what is valuable about the term 'life'. It is pointed out that 'life' is an ambiguous concept as it is used in English, obscuring (...) the differences between being alive and having a life, a crucial distinction for bioethical questions. The implications of this distinction for the moral debate about abortion are discussed. (shrink)

ABSTRACT In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity in (...) the cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin (immature) cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude (tentatively) that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)

In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity in the (...) cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)