The concept of brain death has served us well and has been the ethical and legal justification for thousands of lifesaving donations and transplantations. Even so, there have been persistent questions about whether patients with massive brain injury, apnea, and loss of brain-stem reflexes are really dead. After all, when the injury is entirely intracranial, these patients look very much alive: they are warm and pink; they digest and metabolize food, excrete waste, undergo sexual maturation, and can even reproduce. To a casual observer, they look just like patients who are receiving long-term artificial ventilation and are asleep.
Translated from jargon to English:
Calling people "brain dead" so we can take their organs and give them to other people -- who, after all, need them to survive -- has worked really well for organ recipients. However, some people insist that "brain dead" isn't dead. After all, these "brain dead" people are warm and pink; they digest and metabolize food, excrete waste, undergo sexual maturation, and can even reproduce. They certainly don't look dead. They look asleep.
Well, yeah, because they're not dead.
The author goes on to concede that "brain dead" patients aren't really dead. Not that he has any problem with gutting them for their organs. After all, somebody else needs them. What he proposes isn't that we stop killing incapacitated people to get organs that livelier people need. He simply proposes that we start being honest about what we're doing.
It's a start. I've been agitating for it already.
Prospective donors need to know exactly how "dead" they will be when their organs are taken -- which is not dead. Some people will have a problem with this; others won't. But ought it not to be their choice whether or not they get cut open while they're still warm, pink, and showing all the signs of life except consciousness?
Prospective recipients need to know exactly how "dead" the donor will be when his or her organs are taken-- which is not dead. Some people will have no problem with this. Others -- myself included -- will, and will voluntarily abstain from getting on any waiting lists for organs. It remains to be seen how much this will reduce the wait for organs.
Here, for your edification, are some photos of a "brain dead" woman, taken from this PDF flier:
Maybe I'm naive, but she just doesn't look very dead to me. And I'd bet that if you were to walk into her room and drive a knife into her heart, you'd be charged with murder. Why should it be okay to take her to the OR, strap her to a table, and start taking her organs out?
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