Moreover, with the expiration of all critical brain functions, even the most primitive life-sustaining reflexes, such as the ability to breathe, gag, or respond to pain become susceptible to termination as well (Potts, 2011). Without these three critical functions being initiated uniformly by the brain, a patient is sanctioned as dead despite the existence of trivial brain functions like electroencephalographic activity and hypothalamic functioning.
Advantages to brain death are that it enables organ transplantation in a brain dead body. This is facilitated by granting a pronouncement of death and the salvation of viable organs while circulation and respiration persist under mechanical assistance (Potts, 2011). Another convenient benefit is the sanctioning, without direct or substituted authorization, of withdrawal from costly life-support systems on patients who have encountered complete brain failure. Furthermore the lifeless cadaver can also operate as a plant for manufacturing hormones or other biochemical compounds in demand (Potts, 2011). Tempting also are the promises of a self-replenishing blood bank and the ability to facilitate research. Researchers can use the cadaver for surgical and grafting experiments without any restrictions therefore, permitting immunological explorations, investigations of infections with diseases, and the testing of drugs (Potts, 2011). This is significant for we can benefit from of a living donor while exempting ourselves from the handicaps inflicted by the individual’s rights and interest.
Although Brain death theory is seen as the most credible of the two death theories, it does encompass two noteworthy disadvantages. The first disadvantage deals with the fact that many of the patients who experience brain death and unable to give their consent to organ transplantation. Then secondly, research has concluded that patients have the potential to receive substandard care if they are of minority races, lower socioeconomic status or have public insurance (Kamal, 2008). Sorrowfully, some physicians view these individuals as worthless and work to accelerate a brain death state for organ extraction.
Another differentiating theory on death is the Neocortical Death theory aka: higher-brain standard. This theory states that human death is the irreversible cessation of the capacity for consciousness (DeGrazia, 2011). The term consciousness is implied broadly, encompassing any subjective experiences, which permits both wakeful and dreaming states (Webster, 2011). It is only when an individual is unable to return to consciousness upon entering a state, that they are pronounced dead. Furthermore, when envisioning a person in a coma, we can presume that if a person descends into a permanent coma (PVS), they are identified as deceased regardless of a sustained brainstem function that facilitates cardiopulmonary operations. This fatality is due to the loss of neurological hardware which generates consciousness.
Some advantages that correspond with neocortical death theory are conceptually dependent on a view of what constitutes our personhood. A person’s personhood is dependent on the idea that conscious beings are individuals that retain complex psychological capacities such as rationality, self-awareness and memory. If a person was unable to maintain this capacity for consciousness at any given time they would ultimately be considered dead based on neocortical death standards. The advantage to this view is that it makes it easier to harvest organs from vegetative patients who are typically viewed as permanently unconscious beings.
Disadvantages to neocortical death view, pertains to the inability to reliably gauge the presences or absence of consciousness. At this time we are currently unable to determine what the neural correlations of consciousness are, which in turn would help us determine which higher-brain functions are irretrievably lost (Farah, 2010). Furthermore, since neocortical death theory primarily pertains to persons in a vegetative state, we cannot necessarily assume that function won’t return because of the presence of reduced cortical blood flow. The diagnosis of PVS is uncertain for a period of time, resulting in the potential for misdiagnosis.
Considering the defining characteristics within each of the three death theories, I argue in favor of the brain death theory. This theory is more credible for it closely follows the organismic definition of death and accentuates on the brains role as a chief integrator of all bodily functions. When referencing back to the organismic definition, it places great emphasis on the philosophy of death as a biological incident ordinarily observed in all organisms. In death, the organism stops operating as a unified entity and decomposes, turning what was once an animated object that procured energy from the natural world to sustain its own structure and converting into an indolent piece of matter subject to disintegration and decay (DeGrazia, 2011). In the case of humans, no less than other organisms, mortality incorporates the collapse of unified bodily operations.
Furthermore, I would like to also assert that the brain death theory is more convincing than neocortical death theory because we can accurately determine if a patient is brain dead. Neocortical theory is unfortunately unable to accurately determine this because we have to measure consciousness in a patient and as of today we don’t have the resources capable of accomplishing this. Also consider a person who becomes progressively demented. Dementia is a loss of brain function that affects memory, thinking, language, judgment, and behavior. This means that there is a loss of critical psychological capacities for consciousness, thus claiming that patients suffering from dementia are dead (DeGrazia, 2011). Another problematic implication correlates with newborns. According to neocortical theory, newborns lack the capacity that constitutes personhood, so they don’t come into existence until after his or her birth (DeGrazia, 2011). Surely this cannot be accurate for the fetus that progressively matures prior to the transpiration of sentience (capacity for consciousness) and the emergence of a mind, was alive.
Cardiopulmonary death theory also tries to contend against the brain death theory by claiming that brain death doesn’t follow the organismic conception of death straightforwardly. One might insist, after all, that a human organism's death transpires upon irreparable loss of cardiopulmonary operation, so why deem the brain significant? According to the mainstream brain death approach, the human brain plays the primary role of unifying major bodily operations so only the mortality of the brain as a whole is essential and satisfactory for a human being's death (Potts, 2011). Life encompasses unified operations of the entire organism, so while breathing and a heartbeat generally signify life, they do not constitute it (DeGrazia, 2011). Maintenance of body temperature, hormonal regulation, along with several other functions are just as vital as circulation and respiration for a higher beings consciousness (Potts, 2011). Therefore, we can deduce that the brain is the central integrator necessary for these vital functions to operate.
It has been perceived by theorist in favor of brain death, that the heart and lungs, organs utilized to simulate circulation and respiration, are just measurements of vital signs. These vital signs are simplistic and are seen as just “signs” that indicate a superior instrument at work, the brain (DeGrazia, 2011). According to this view, mechanical assistors, such as machines that provide cardiopulmonary life support to a nonfunctional brain are seen as promoters of deception. These life support machines produce an illusory presence of life, while veiling the fact that the patient has lost all integrated functioning.
Although brain death theory has many benefits, some cardiopulmonary theorists believe that the brain death theory is insufficient for determining death in all cases where individuals with complete brain failure utilize respirator-assisted life support technologies. They go against brain death theorist in stating that “it’s not important who or what is powering the breathing and heartbeat, just that they occur (DeGrazia, 2011).” Cardiopulmonary theorists believe that even with vital functions being totally reliant on external assistance, one cannot infer that death has taken place. They may further rationalize this claim, by giving supportive evidence that states that fetuses that are completely reliant on their mothers are still alive. Brain death theory counters this assumption by asserting that a body is not truly functioning for the respirator is performing all the work, indicating death. This is convincing for the body, without the assistance of the respirator will, as a result of the disconnection to the respirator, will die.
Neocortical death also disputes against brain death by claiming that without consciousness we are nonexistent because we have lost our personhood. Brain death theorist will argue that there is no true way of measuring for consciousness so we cannot assume that we are dead based off of a conscious awareness. As discussed earlier some diseases result in a loss of capacity for consciousness such as dementia, but we can see clearly that these people are still alive, just lost in a different mind frame.
In conclusion brain death theory best explains the concept of death for the functioning of the brain and brain stem cannot be replicated deducing its criticality. Cardiopulmonary theory is less creditable in respect to its ability to replicate human functions (respiration and blood circulation) and since we can neither demonstrate nor measure consciousness, neocortical death is to insufficient a criterion for establishing death.
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