Veatch Robert M., Ross Lainie F. (eds.) Defining Death: The Case for Choice

Georgetown University Press, 2016. — 176 p.New technologies and medical treatments have complicated questions such as how to determine the moment when someone has died. The result is a failure to establish consensus on the definition of death and the criteria by which the moment of death is determined. This creates confusion and disagreement not only among medical, legal, and insurance professionals but also within families faced with difficult decisions concerning their loved ones.Distinguished bioethicists Robert M. Veatch and Lainie F. Ross argue that the definition of death is not a scientific question but a social one rooted in religious, philosophical, and social beliefs. Drawing on history and recent court cases, the authors detail three potential definitions of death — the whole-brain concept; the circulatory, or somatic, concept; and the higher-brain concept. Because no one definition of death commands majority support, it creates a major public policy problem. The authors cede that society needs a default definition to proceed in certain cases, like those involving organ transplantation. But they also argue the decision-making process must give individuals the space to choose among plausible definitions of death according to personal beliefs.Taken in part from the authors' latest edition of their groundbreaking work on transplantation ethics, Defining Death is an indispensable guide for professionals in medicine, law, insurance, public policy, theology, and philosophy as well as lay people trying to decide when they want to be treated as dead.Defining Death: An Introduction
The Emergence of the Controversy
Three Groups of Definitions
The Emergence of a Uniform Brain-Oriented Definition
Irreversible vs. Permanent Loss of Function
Defining Death and Transplanting Organs
The Structure of the Book
The Dead Donor Rule and the Concept of Death
The Dead Donor Rule
Candidates for a Concept of "Death"
The Public Policy Question
The Whole-Brain Concept of Death
The Case for the Whole-Brain Concept
Criteria for the Destruction of All Brain Functions
Problems with the Whole-Brain Definition
Alternatives to the Whole-Brain Definition
The Circulatory, or Somatic, Concept of Death
Two Measurements of Death
Circulatory Death and Organ Procurement
The DCD Protocols
Shewmon's Somatic Concept
The Two Definitions of the US President's Council on Bioethics
The Higher-Brain Concept of Death
Which Brain Functions Are Critical?
Altered States of Consciousness: A Continuum
Measuring the Loss of Higher-Brain Function
Ancillary Tests
The Legal Status of Death
The Conscience Clause: How Much Individual Choice Can Our Society Tolerate in Defining Death?
The Present State of the Law
Concepts, Criteria, and the Role of Value Pluralism
Explicit Patient Choice, Substituted Judgment, and Best Interest
Limits on the Range of Discretion
The Problem of Order: Objections to a Conscience Clause
Implementation of a Conscience ClauseCrafting a New Definition-of-Death Law
Incorporating the Higher-Brain-Function Notion
The Conscience Clause
Clarification of the Concept of "Irreversibility"
A Proposed New Definition of Death for Public Policy Purposes