Summaries / Resúmenes - Studia Moralia

292 NICANOR AUSTRIACOmeningitis at age 4, causing such intracranial pressure that hisskull bones split. Since then, multiple brain-wave EEG testshave been flat, and no spontaneous respirations or brain stemreflexes have been observed over the subsequent 18 years.Physicians suggested discontinuing support, but his motherwould not consider it. TK was eventually transferred home,where he remains on a ventilator, assimilates food placed in hisstomach by tube, urinates spontaneously, and requires littlemore than nursing care. While BD, he has grown, undergonepuberty, overcome infections and healed wounds. Shewmon’sclinical examination of TK revealed that there is no blood flowinto his cranium and an MRI scan revealed that the entire brain,including the brain stem, has been replaced by disorganizedmembranes and fluid. As Shewmon put it, there is no questionthat he became brain dead at age 4, but neither is there anyquestion that he is still alive at age 19. Counter to the claims ofthe President’s Commission and those who hold that BD patientsare imminently dying, TK’s case is a clear demonstration thatBD patients are able to maintain a physiological stability superiorto that found in many ICU patients still considered alive.Second, to counter the claim that BD patients lacking brainmediatedintegrative functions lack physiological integration,Shewmon has made the following argument. 47 First he definesintegrative unity. For him, ‘integrative unity’ is possessed by aputative organism if the latter possesses at least one emergent,holistic-level property. A property of a composite is defined as“emergent” if it derives from the mutual interaction of the parts,and as “holistic” if it is not predicable of any part or subset ofparts but only of the entire composite. Next, he points out thatany body requiring less technological assistance to maintain itsvital functions than some other similar body that is neverthelessa living whole must possess at least as much robustness of integrativeunity and hence also be a living whole. Finally, he makesa distinction between brain-mediative functions and somatically-mediativefunctions. For instance, “breathing” is a brain-the Universidad de Navarra, Pamplona, Spain, 21-23 October 1999.47SHEWMON, “The Brain and Somatic Integration,” pp. 459-471.