Philosophical And Theological Perspectives

The bioethics debate concerning the definition and criteria of human death emerged during the rise of organ transplantation in the 1960s, prompted by the advent of functional mechanical replacements for the heart, lungs, and brain stem, and by the ability to diagnose the pervasive brain destruction that is termed brain death. Previously, there had been no need to explore the conceptual or definitional basis of the established practice of declaring death or to consider additional criteria for determining death, since the irreversible cessation of either heart or lung function quickly led to the permanent loss of any other functioning considered a sign of life. New technologies and advances in resuscitation changed all this by permitting the dissociated functioning of the heart, lungs, and brain. In particular, society experienced the phenomenon of a mechanically sustained patient whose whole brain was said to be in a state of irreversible coma. And there were an increasing number of vegetative patients sustained by feeding tubes, whose bodies had been resuscitated to the status of spontaneously functioning organisms, but whose higher brains had permanently lost the capacity for consciousness. Such phenomena as these pressed a decision as to whether the irreversible loss of whole or higher-brain functioning should be considered the death of the individual, despite the continuation of respiration and heartbeat. With mounting pressure to increase the number of viable organs for transplant within the unquestioned constraint of the Dead Donor Rule which requires that the organ donor be dead before organ removal, the debate concerning whole-brain death arose.

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