Belkin Gary S
Massachusetts General Hospital, USA.
J Hist Med Allied Sci. 2003 Jul;58(3):325-61. doi: 10.1093/jhmas/jrg003.
In a 1968 Report, the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death promulgated influential criteria for the idea and practice known as "brain death." Before and since the Committee met, brain death has been a focal point of visions and nightmares of medical progress, purpose, and moral authority. Critics of the Committee felt it was deaf to apparently central moral considerations and focused on the self-serving purpose of expanding transplantation. Historical characterizations of the uses and meanings of brain death and the work of the Committee have tended to echo these themes, which means also generally repeating a widely held bioethical self-understanding of how the field appeared-that is, as a necessary antidote of moral expertise. This paper looks at the Committee and finds that historical depictions of it have been skewed by such a bioethical agenda. Entertaining different possibilities as to the motives and historical circumstances behind the Report it famously produced may point to not only different histories of the Committee, but also different perspectives on the historical legacy and role of bioethics as a discourse for addressing anxieties about medicine.
在1968年的一份报告中，哈佛医学院审查脑死亡定义特设委员会公布了关于“脑死亡”这一概念及实践的具有影响力的标准。在该委员会召开会议之前及之后，脑死亡一直是医学进步、目的和道德权威的愿景与噩梦的焦点。该委员会的批评者认为，它对一些明显核心的道德考量充耳不闻，且专注于扩大移植这一利己目的。对脑死亡的用途和意义以及该委员会工作的历史描述往往呼应了这些主题，这也意味着通常重复一种广泛持有的生物伦理自我认知，即该领域是如何呈现的——也就是说，作为道德专业知识的必要解毒剂。本文审视了该委员会，发现对它的历史描述受到了这样一种生物伦理议程的歪曲。考虑该委员会著名报告背后的动机和历史背景的不同可能性，可能不仅会指向该委员会不同的历史，还会指向对生物伦理作为一种应对医学焦虑的话语的历史遗产和作用的不同观点。
