Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA.
Weill Cornell Medical College, Chevy Chase, Maryland, USA.
J Med Ethics. 2017 Nov;43(11):747-753. doi: 10.1136/medethics-2016-103867. Epub 2017 Aug 28.
The established view regarding 'brain death' in medicine and medical ethics is that patients determined to be dead by neurological criteria are dead in terms of a biological conception of death, not a philosophical conception of personhood, a social construction or a legal fiction. Although such individuals show apparent signs of being alive, in reality they are (biologically) dead, though this reality is masked by the intervention of medical technology. In this article, we argue that an appeal to the distinction between appearance and reality fails in defending the view that the 'brain dead' are dead. Specifically, this view relies on an inaccurate and overly simplistic account of the role of medical technology in the physiology of a 'brain dead' patient. We conclude by offering an explanation of why the conventional view on 'brain death', though mistaken, continues to be endorsed in light of its connection to organ transplantation and the dead donor rule.
在医学和医学伦理学中，关于“脑死亡”的既定观点是，根据生物学死亡的概念，通过神经学标准确定为死亡的患者在生物学意义上已经死亡，而不是从哲学意义上的人格、社会构建或法律虚构的角度来看待。尽管这些个体表现出明显的生命迹象，但实际上他们已经（在生物学上）死亡，尽管这种现实被医疗技术的干预所掩盖。在本文中，我们认为，诉诸于表象与现实之间的区别，并不能为“脑死亡”患者已死亡的观点提供辩护。具体来说，这种观点依赖于对医疗技术在“脑死亡”患者生理机能中作用的不准确和过于简单化的描述。最后，我们解释了为什么尽管传统的“脑死亡”观点是错误的，但由于它与器官移植和已故供体规则有关，所以仍然得到认可。
