She had lost higher brain function due to a heart attack, and was left in a persistent vegetative state. One of the more famous cases was that of Terri Schiavo.
These are the stories that tend to make the news, including the rare cases where someone shows some recovery. Often the controversy surrounding brain death involves patients who have lost higher brain function, but maintain brain stem activity. With the use of medical technology, the person’s body may appear to be normal, and they may seem to be “alive.†The historical reasons for the change in the definition of death (to facilitate organ retrieval) contribute to the discomfort many have with defining death based on brain function rather than heart and lung function. By allowing for brain death as a valid definition of death, blood and oxygen could be continued even if the patient is declared dead, until the organs can be transplanted. Once blood flow stops, there is a very narrow window of time in which organs can be removed from a person and transplanted to another patient. However, the motivations behind changing the definition of death also came along because of organ transplantation and respirator technology. The reasoning was that biological components must not be the only identifier of life and death. A person could receive a kidney, liver, heart, or lung transplant, all vital organs, and maintain his or her identity. A person could lose all of his or her limbs, receive prosthetics and still be the same person. There was a move to change from a biological definition of death to a mental definition of death ( Engelhardt, 242, 243). This change was being considered in the 1950s when transplantation and prosthetics were becoming more commonplace. Whole-brain death was accepted as a definition of death in the 1970s, and is considered an accepted definition of death in all fifty states in the United States. If the heart stops pumping and there is no respiration, then the person is considered dead.  According to a statement from Jahi’s family in the Los Angeles Times, they will accept her death if her heart stops beating while she is on the respirator, but do not accept brain death as a valid criterion for death. The “traditional†definition of death is based on cardiopulmonary (heart-lung) function. In Jahi McMath’s case, five physicians, two from the attending hospital and three chosen by the parents, declared her whole-brain dead. In the U.S., different may states have different requirements, but typically, brain death must be determined by two different doctors at two different times.
#BRAIN STEM FUNCTION BUT NO BRAIN ACTIVITY SERIES#
Whole brain death is only declared after a series of tests, which include physical tests, EEGs and imaging. All involuntary actions must be maintained by machines and medication. In this case (brain death) there is no brain function, even in the brain stem. Loss of higher brain function is different from whole-brain death or losing both higher and lower brain function. However, someone in a coma is not awake and does not respond to stimuli. Someone in a PVS will undergo sleep-wake cycles and can respond to stimuli.Ĭoma is related to PVS in that it is due to a lack of higher brain function, and the person maintains brain stem activity.
There is brain stem activity, which regulates involuntary actions such as breathing, circulation, and digestion. When someone is diagnosed as being in a PVS, this means that the person does not have higher brain function, but maintains lower brain function. With the recent case of Jahi MacMath, the thirteen-year-old girl who was declared brain dead after complications from tonsil surgery, rather than evaluating a new technology, it might be helpful to discuss the definition of brain death.īrain death is not to be mistaken for persistent vegetative state (PVS). Typically, in these posts my goal is to discuss the science behind a certain technique to help us understand the ethical issues surrounding the technique.
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