臨床研究と生命倫理ジャーナル

概要

Defending a Functionalist View of Higher Brain Death

LiPuma SH and DeMarco JP

We provide a brief overview of the history of brain death showing how the cardiopulmonary model (CPM) of death became problematic due to the technological innovation of mechanical ventilation beginning with its use in the 1950s. We then examine difficulties that emerged with what was to become the received view of brain death known as Whole Brain Death (WBD). We argue that these challenges were never satisfactorily met by defenders of WBD. We also argue that a return to a CPM leads to even greater conceptual difficulties. Given that there are serious difficulties with both WBD and the CPM, we introduce a new version of higher brain death which we refer to as a functionalist view. We argue that a functionalist view of higher brain death can be defended more consistently than WBD and the CPM. Our defense introduces the notion of basing death on mental processing as opposed to traditional notions of higher brain death which used problematic and imprecise concepts such as consciousness and personhood.