Americans United for Life published “Studies in Law and Medicine” in the 1970s and 1980s, spotlighting issues pertaining to the human right to life across the bioethics spectrum. As Americans United for Life celebrates our 50th anniversary, we are making these issues available for the first time since their print publication.
Euthanasia and Brain Death: Ethical and Legal Considerations by Dennis J. Horan
Defining death is not as simple as it used to be. In the mid-20th century, death was defined in the law as a moment when life had ceased, when blood stopped circulating and caused respiration and pulsation to cease. Technology advances such as resuscitation and maintaining patients through machinery have complicated this standard, opening a world of new ethical concerns.
“Brain death” is novel term that holds grave danger to living persons. The clinical judgement involved in declaring a person brain-dead gives way to two important technical questions: 1) Is a person who is brain-dead really dead? If the answer is yes, then 2) What means of proof is acceptable to society that brain death has occurred?
Public policy involvement is necessary to create clear criteria for declaring a person dead because 1) the public and policy makers lag behind physicians in understanding these concepts and 2) the declaration of brain death has been misused. The medical community had begun to consider death of the cerebrum alone as brain death, a position not accepted by broader society. This position would challenge current homicide laws and open the door to euthanasia. The American Bar Association sought to clarify the legal standard and offered a “Current Definition of Death” specifying “for all legal purposes, a human body with irreversible cessation of total brain function, according to usual and customary standards of medical practice, shall be considered dead.” This definition, among other purposes and advantages, was formed to avoid passive euthanasia and active euthanasia on the incomplete basis of partial brain death.
Cerebral death is not an acceptable legal, ethical, medical or moral manner of declaring persons dead. Cerebral death is akin to euthanasia, which is morally and legally unacceptable. In order to discontinue therapy, the prognosis for life (not meaningful life) must be very poor. The beauty of the law is that is has the same great respect for the young and hearty as the old and aged. The question for physicians that is paramount to the integrity of human behavior is whether we will remember the distinction between killing and letting die. Direct intervention to end life is never licit. Therefore, even a small road toward violating the rights of a human person, such as the acceptance of cerebral brain death, must be opposed.