Is someone truly dead if his brain stops functioning?
In the midst of grief and loss when a loved one is deemed brain dead, we are urged to accept this diagnosis, consider organ donation, and begin saying goodbye. But is that really the end of the story?
When we hear the term “brain death,” do we ever pause to ask what that truly means? Behind this term lies a deeper and more controversial reality, one that deserves closer examination.
What is Brain Death?
A simple Google search will tell you that brain death is both a medical and legal term used to describe the complete and irreversible cessation of all brain function, including the brainstem. In short, brain death means that the brain is no longer functioning, and under U.S. law, it is considered equivalent to death.
Translation: while the heart may still be beating and the body warm, the absence of brain activity leads physicians to declare death.
The History of Brain Death
On August 5, 1968, a group of thirteen doctors from the Harvard Medical School wrote a report titled, “A Definition of Irreversible Coma,” in which they proposed redefining irreversible coma as death, which is now known as brain death.[1]
Two reasons were given as to why there was a need for this new definition:
- Thanks to modern medicine, doctors could now keep a person’s heart beating even if his brain was permanently damaged, creating a difficult situation for everyone involved: the patient in a coma, the family, the hospital staff, and even other patients who needed the bed and resources.
- They said that using the old idea of death, such as only deeming someone dead when his heart stops beating, could lead to confusion about organ donation and make it harder to help people in need of transplants.
Not only was this committee’s report pivotal in establishing “brain death” as a legal and medical definition of death, but it also significantly impacted organ donation practices and bioethics.
This impact is clear in its incorporation into U.S. law through the creation of the Uniform Determination of Death Act (UDDA) in 1981. The UDDA ensures a consistent, nationwide standard for defining death, both medically and legally.[2] Even a quick Google search confirms how deeply this definition has shaped our current system.
Slippery Slope
Interestingly, while the UDDA was meant to ensure nationwide consistency in how death is defined, even this legal standard is now being questioned.
In 2023, the American Academy of Neurology (AAN) released updated brain death guidelines to state that a person can be declared “brain dead” even if:
- Electrical activity, brain waves, are still present on an EEG or
- Parts of the brain, like the hypothalamus, are still functioning.[3]
This means that the current medical criteria for diagnosing brain death does not fully comply with the legal definition in the UDDA, which requires the irreversible loss of all functions of the entire brain.
One could reasonably speculate that, just as the brain death guidelines were updated in 2023, future changes might expand these guidelines to include other vulnerable patients, such as those who are profoundly brain-injured.
Personhood and Human Dignity
How does personhood fit into this situation?
Many argue that the loss of brain function signals the loss of the individual, that without consciousness or awareness, personhood ends. But is this truly how we define the value of human life?
Human dignity is not determined by brain function, cognitive capacity, or self-awareness. It is rooted in the inherent worth of every human being, made in the image and likeness of God, regardless of their abilities or stage of development.
We must not get swept up in the legal and medical jargon and forget this basic truth.
Natural Death vs. Declared Death
The principle of “natural death” means allowing a person to die without deliberately causing his death.
Dr. Paul Byrne, MD, explains in his article “Brain Death”:
If “brain death” and death were identical and equivalent, there would not be a need for the term “brain death.” Everyone knows that the body, the remains that are viewed at a funeral home, is dead. Compare that body to the patient in an intensive care unit who has been declared “brain dead” but who is receiving ventilatory support. The heart is beating, the blood pressure and temperature are being recorded, the color is normal, if the knee is tapped the knee jumps, and many internal organs and systems are functioning.[4]
What is Brain Death from a Personhood Perspective?
From a perspective of personhood, life is not defined solely by neurological function but by the presence of a living human body. Unless there is total biological cessation of life, the moral presumption must be in favor of preserving that life, not ending it to benefit others.
Philosopher and professor Josef Seifert, from the International Academy of Philosophy in Liechtenstein emphasizes: “Even if a small reasonable doubt exists that our acts kill a living human person, we must abstain from them”.[5]
In the face of moral uncertainty, we must remember that human dignity is not defined by function, but by being. The pro-personhood perspective calls us to err always on the side of life, to protect the most vulnerable, especially when they cannot speak for themselves.
Brain death, as currently understood and applied, demands deeper ethical scrutiny to ensure that we do not cross the line from care into killing.
Sources:
[4] “Brain Death,” by Paul Byrne, MD
[5] Josef Seifert, On ‘Brain Death’ in Brief: Philosophical Arguments For and Against Equating It with Actual Death, prepared for possible discussion at the Conference on the “Signs of Death,” The Pontifical Academy of Sciences, Vatican City, February 3–4, 2005, p.27. [PDF available here]
Alondra Flores
Georgia Right to Life
Writer