title: Philosophical considerations on brain death and the concept of the organism as a whole.
abstract: Since intensive care medicine enables us to maintain blood circulation and respiration artificially for some time, the usual criteria for death, such as cardiac arrest and cessation of respiration, are not applicable in all cases. Thus, the irreversible breakdown of the brain functions have come to be accepted as the most prominent factor for the occurrence of death. This criterion is linked primarily to the disintegration of the organism as a whole. Yet the controversy surrounding the moment when a man can be declared dead has not yet been resolved. The decisive weak point in this controversial discussion seems to be that the notion of the "organism as a whole" is inadequately defined. The aim of this work is to fill this void. We developed four general criteria of life: integration, coordination, dynamics, and immanency. Moreover, four additional characteristics are necessary for a living being (organism as a whole): completion, indivisibility, autofinality, and identity. If one of these four characteristics is missing we can only speak of derivative life but not of a living being. In a brain dead body one finds a number of signs of life. These signs of life, however, are not signs of an organism as a whole but signs of a physiological combination of organs whose parts - directed from the outside - are dependent on each other. The brain dead body lacks the four criteria of a living being. Thus it is no longer a living person but purely derivated biological life.
authors.affiliation: Institute of Medical Anthropology and Bioethics, Landstrasser Hauptstrasse 4/13, Vienna, Austria. ordination@bonelli.info
authors.forename: Raphael M
authors.initials: RM
authors.lastname: Bonelli
authors.forename: Enrique H
authors.initials: EH
authors.lastname: Prat
authors.forename: Johannes
authors.initials: J
authors.lastname: Bonelli
mesh_terms: D001921:Brain / Q000503:physiopathology; D001926:Brain Death / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology; D004992:Ethics, Medical; D006323:Heart Arrest / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008020:Life Support Care / Q000941:ethics; D008606:Mental Processes / Q000502:physiology; D010686:Philosophy, Medical; D009927:Tissue and Organ Procurement / Q000941:ethics