Class Note for PHIL 164 at UMass(14)
Class Note for PHIL 164 at UMass(14)
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Date Created: 02/06/15
Medical Ethics 020309 Phil 1643 Spring 2009 l Kiistoffer Ahlstrom leayrmpyzarumamedu l httppeopleumassedukahlstro164 BRAIN DEATH PART II Classical account of death A person is dead when there is a permanent cessation of blood flow Meshes fairly well with our intuitive notion ofa dead person as someone that is white and stif Contemporary medical account ofbrain death A person is dead when her brain is permanently non functioning Note that this de nition does no imply whiteness and stiffness Consider Marshall and Bloch Why is it relevant when a person dies Because when she does she looses her basic l mum 723715 She s not given lifeisupport and with her relatives consent we can cut her open and harvest her for organs THE STORY BEHIND quotIIIE NEW DEFINITION The respirator was developed during the polio epidemic in the 1950 s by a Danish doctor who noticed how chili dren stricken with polio died because they couldn t breathe He developed a means of using air bags to pump oxy7 gen into the children s lungs At rst this was done by a nurse or student Eventually a mechanical pump was at tached instead and the respirator was born Two uses Temporay ipped Some accident victims people who had taken drug overdoses and diabetics who had gone into a temporary coma Pemanenl mpporl People who would never regain consciousness The latter use was problematic for two reasons 7 It prolonged the agony of the family 7 It claimed a lot of resources from hospital and for an inde nite period of time In 1967 the rst heart transplant was performed by a South African surgeon Dr Christiaan Barnard To maxi mize the chances of successful transplant the heart had to be removed as soon as possible after it has stopped working In other words suddenly the increasing number of people on permanent support could save the lives of other patients What was the problem Taking their hearts would amount to murder It was in this context that Harvard Medical School set up the Ad Hoc Committee to Examine the De nition of Brain Death or the HarvardBrain Deal7 Committee HBDC as it is usually referred to The committee states its purpose as follows Our primary purpose is to de ne irreversible coma as a new criterion for death There are two reasons why there is a need for a de nition 1 Improvements in resuscitative and supportive measures have led to in creased efforts to save those who are desperately injured Sometimes these efforts have only a partial success so that the result is an individual whose heart continues to beat but whose brain is irreversibly damaged The burden is great on patients who suffer permanent loss ofintellect on their families on the hospitals and on those in need ofhospital beds already occupied by these comatose patients 2 Obsolete criteria for the de i nition of death can lead to controversy in obtaining organs for transplantation What ts quottttevetstble coma Constdetthe tollowtngeontanuum Dfunxespunsweness O 0 O O O W 31quot Wang th M4 th amt Wu out 5mm atmt antnntt eatmt monotmntt eatmt bmpmlmged eptmtutnnmtnntt epttmtott eutmumteme utmg erypeutyuutounnonty mtnmtmntt ectmettutmtg bum osutbntn n bntn ton of oxygen n bntn em bntn wont emu netteotoeu bntn mm wont utyttttmu eetnuebntnmm The wotd coma aetually eomes tom the Gteek wotd canny whteh ust means quotdeep sleep Howevee someone tn deep sleep ts tn the contempuuxysense nattn a eoma Rathet a eoma toughly encompasses evexythmgspnnr nmg the spectxum tom pmlungeduncunscmusness to btatn death When the eommtttee ulks about quottttevetstble eoma they have tn mtnd btatn death A DILEMMAFORTHEDEFINITION Aeeotdtng to stnget thete ts no quotfact otthe mattex when tt eomes to de nmg death He elatms that tt tnvolves tnstead an quotednczl udgment What does he mean by thtsa What wouldttmean totthete to be a fact ufdle mattet about death It would mean that thete was a clenxrcut ttuth about whensomeone ts dead It tums out that thete ts not 7 1n addttaonto Ptucessxng mfumuhun thtough the netvous system the btatn also subbltes the body wtth Immanuel tegulate vanous bodtly tunetaons and eontanues to do so tn battents eonstdeted btatn dead 7 When btatn dead battents ate eut open tn otdetto aeeess thett otgans thett blagpmmuwmny nse and hawtbmtquxcken Thts suggests that the btatn bettotms some baste funcths even tn btatn dead panean 1n othetwotds the btatns Dfpeuple eonstdetedbtatn deadby meddcnlpucnce ate not completely votd otaetavtty Thts Fusean a dtlemma d Etthet we bnng meddcnlpucnce tn ltne wtth the mote stnet teadng Df39rbxmn death and accept that many people euttently eonstdetedbtatn dead then would have to be eonstdeted altve ot b we gtve up the tdea otdeath as lanytatacessnhun otbtatn aettvtty sttelt wtth medteal Ptacncemd1denhfy a new dstanetton between ltte and death stnget eonstdets talnng the tatsthom otthe dtlemma to be unvtable and atgues thatwe needto go wtth the lattet 1n domgso howeveg we needto malte a demon tegatdtngwhat level otaetavtty madts the butdexbeNeen Me and death stnee thete ts no way tn whteh that deetston ean be made on enelustvely scxenh c gtounds the deetston ts tn essenee an my one NEWYORKTIME Amen The case A 13 yuxruldbay ts deelated btatn dead as a tesult otasevete btatn tnteetton Due to mtseommunteataon alegal eoncltet ensues between the tamtly that wants to keep the boy on the tesbttatoe andthe huspxul that wants to tum tt ott Eventually the tamtly agtees to tum ottthe tesbttatot Questions 7 What was the mtseommunteatton about 7 What taetots pmbnbly eontnbutedto the eontustona e Wouldyousay that Smges entaque otthe btatn death detantoon has any beanng on the ease Explmn why otwhy not
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