Reflections on the Problem of Brain Death

Abstract

The report by the Study Group on Brain Death has recently been published by the Ministry of Public Welfare In Japan. As we are members of the new committee concerned with the guide-lines of in vitro fertilization and organ transplantation at UOEH, and at the same time being in charge of the unique course of this university, i.e. Humanics, we feel that it is necessary to express our views concerning brain death and the above-mentioned report The first section of this paper summarizes the main points of the report, with a criticism that EEG is not essential in the diagnosis of whole-brain death. Also, unnecessary over-treatment of patients in "vegetative state" is discussed. Finally, a warning is given against hasty authorization of brain death requested by some specialists of transplantation, who are possibly intending to use the Committees on Ethics in many medical schools as tools for realization of their dream. In the second section stress is placed on the problem of brain death as logically independent from the debate around organ transplantation by showing that life and death cannot be defined solely by the terms of physical sciences, but they are essentially humane, value-laden concepts. Death is not an event which occurs at a certain time-point but a process which continues from birth to when man returns to dust. Each diagnosis of death, therefore, should be made taking the importance of human life into consideration, especially when the point of no return has been passed in whole-brain death, as well as in cardiac death.