Re: Dr. Dobson

From: jack syme <drsyme@cablespeed.com>
Date: Tue Aug 09 2005 - 22:14:06 EDT

It is not possible to check to see "if there is no brain function at all".
Is someone dead if 10% of their neurons work, or 5% or 25 %? The only tests
involved are very gross tests and in no way could they actually test whole
brain function.

This has nothing to do with whether or not the relevant medical personnel
know the criteria accurately. It is a limitation of the definition.

Why is it that the majority of patients that fit the criteria for brain
death, do not develop neurogenic diabetes insipidus, for example? (DI is
not part of the standard definition of brain death.) I guess you could
claim that the pituitary gland is not a part of the brain, even though it is
inside the brain. But again, there is no way to test if the WHOLE brain is
not functioning. And in fact there are patients that can be kept alive
indefinitely, (at least their bodies anyway), even after being declared
dead. There was a case in northern Virginia that just ended earlier this
month, about a woman with malignant melanoma, who had a severe recurrence
and ended up being declared brain dead, but, was pregnant at the time, and
her husband decided to keep her on life support for three months until the
baby was delivered. So even arguments that the brain integrates the
function of the body, are not supported by the facts.

http://msnbc.msn.com/id/8801899/

(Please note the ironic language, "A brain-dead woman who was kept alive
for three months so she could deliver the child she was carrying was removed
from life support Wednesday and died, a day after giving birth." If she was
already dead, how could she die?)

But my major point is that I think that our current definition of brain
death, is not based at all on what it means to be alive or not alive, (but
is based only whether or not the patient can recover,) is no help at all in
determining when an embryo becomes alive; when it becomes a person.

Instead of whole brain death, I think what you are trying to say is more
akin to definitions of death based on neocortical death. In these cases
people in PVS would be considered dead because they have lost their
identity, their personhood.

One problem with using higher cortical function definitions of death, is
that some patients in these conditions improve, and it is not possible,
early on anyway, to declare that patients that have lost higher cortical
function, have lost those functions permanently.

----- Original Message -----
From: "George Murphy" <gmurphy@raex.com>
To: <drsyme@cablespeed.com>; <asa@calvin.edu>; "Carol or John Burgeson"
<burgytwo@juno.com>
Sent: Tuesday, August 09, 2005 9:21 PM
Subject: Re: Dr. Dobson

> ----- Original Message -----
> From: <drsyme@cablespeed.com>
> To: "George Murphy" <gmurphy@raex.com>; <asa@calvin.edu>; "Carol or John
> Burgeson" <burgytwo@juno.com>
> Sent: Tuesday, August 09, 2005 4:30 PM
> Subject: Re: Dr. Dobson
>
>
>> Whole brain death is a concept with very little meaning behind it. It is
>> accepted as a legal definition of death this is true, but outside of
>> organ transplantation, it isnt used in a legalistic way such as this.
>>
>> If you look at hospital records the time of death is often not given as
>> the moment the brain death declaration was made, it is given as the time
>> the ventilator is removed and the patient no longer has a pulse.
>>
>> It is not a very useful concept as a means of making health care
>> decisions, because the concept has no meaning beyond "this person has
>> such severe and irreversible brain damage that there is no hope for
>> recovery", but we can make determinations like that without having to
>> make the claim that the person is dead.
>
> I think that the concept of whole brain death is meaningful enough: There
> is no brain function at all. Problems arise with (a) how one tests for
> that & (b) whether or not relevant medical personnel know the criteria
> accurately. (The article I'm going to mention cites a study indicating
> that 35% of personnel dealing with transplant matters didn't.) I found
> Robert D. Truog's "Is It Time to Abandon Brain Death?", Hastings Center
> Report 27.1, 1997, p.29, helpful. As the title suggests, the article is
> rather critical of the concept & its use.
>
> I don't think though that the problems with the concept destroy whatever
> usefulness it may have for reflections at the beginning of life. If total
> lack of brain function means that a person is no longer alive (& please
> note that I say "if") then there is some logic to the argument that a
> total lack of a brain in an embryo means that a person has not yet come
> into being.
>
> In this thread I have not been arguing for any of these views but have
> simply been trying to lay out some of the options. In a couple of days
> I'll be on a panel as a representative of the clergy to talk about
> embryonic stem cell research & will probably take a pretty conservative
> position because I suspect that the others on the panel will take a "Let's
> get on with it view" & the discussion needs some ethical balance. But in
> general I think it's unfortunate that many Christians simply assume that
> personhood (or ensoulment) begins at "the moment of conception" & then
> because of that assumption think that they're obligated to try to shoot
> down any & all arguments that disagree with it. On the other side, of
> course, there are those whose arguments amount to a kind of ethical
> blackmail: "Are you in favor of embryonic stem cell research or do you
> want people to suffer from Alzheimer's?"
>
> Shalom,
> George
>
Received on Tue Aug 9 22:16:42 2005

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