Revising Brain Death: Cultural Imperialism?
There is little doubt that acceptance of the practice of diagnosing death by the death of the whole brain criterion is collapsing. Both the ethical and medical literature contain numerous articles indicating an overwhelming flaw. Robert Veatch puts the case well. I He acknowledges that ~. laboratory testing shows "nests of brain cells" may continue performing brain functions after clinical diagnosis of brain death. This would invalidate the application of the legal definition of death in terms of the irreversible cessation of all brain function. The legal definition of death, in jurisdictions that have formally adopted brain death, usually defines death as either irreversible cessation of the circulation of the blood or the irreversible cessation of all functions of the brain. In practice the latter depended on what came to be known as the Royal Colleges or Harvard Criteria. In 1968 a report entitled "A definition ofIrreversible Coma", prepared by an Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Death, was published. The Committee listed the following purely clinical criteria: unreceptivity and unresponsivity, no movements or breathing ( or absence of spontaneous breathing after turning the respirator off for three minutes), and no reflexes, and the non-clinical criterion of a flat electroencephalogram.