Summaries / Resúmenes - Studia Moralia

IS THE BRAIN-DEAD PATIENT REALLY DEAD? 287and resuscitative efforts. The Commission wrote: “Even withextraordinary medical care, these [somatic] functions cannot besustained indefinitely – typically, no longer than several days.” 29In other words, the Commission argued that the brain must bethe central integrator of the body because in its absence, the BDbody is unable to stay alive for an extended period of time, i.e.,it has lost its homeostatic integration. Next, the Commissionwent on to argue that the brain was the complex organizer andregulator of bodily functions because “[o]nly the brain candirect the entire organism.” 30 Thus, according to theCommission, the BD body has lost many integrative functions.Commenting on this point, James L Bernat, an influential proponentof TBD has written:“It is primarily the brain that is responsible for the functioningof the organism as a whole: the integration of organ and tissuesubsystems by neural and neuroendocrine control of temperature,fluids and electrolytes, nutrition, breathing, circulation, appropriateresponses to danger, among others. The cardiac arrest patientwith whole brain destruction is simply a preparation of unintegratedindividual subsystems, since the organism as a whole hasceased functioning.” 31Thus, loss of the brain necessarily leads to the loss of the integrationof the body, which is death. This argument proposed bythe President’s Commission has become what one philosopherhas called the standard paradigm used to justify the TBD criteriafor death. 32Finally, there is one more important event that needs to bementioned in this historical overview of the development ofbrain-based criteria for death. This is the 1975-76 case of Karen29Ibid., p. 35.30Ibid., p. 3431James L. BERNAT, “The defintion, criterion, and statute of death,”Semin. Neurol. 4 (1984): 45-51, p. 48.32Michael POTTS, “A Requiem for Whole Brain Death: A Response to D.Alan Shewmon’s ‘The Brain and Somatic Integration,” Journal of Medicineand Philosophy 26 (2001): 479-491.