Perspect Biol Med. 2022;65(1):41-58. doi: 10.1353/pbm.2022.0002.
This essay examines the development of the seminal report, "A Definition of Irreversible Coma," by the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death in 1968. Detailed examination of original documents archived in the Henry K. Beecher Papers at Harvard's Countway Library reveals a variety of concerns and values at play in the development of the report, along with disagreement on a few key points among Committee members. One important goal of the Committee was to render treatment removal from patients in severe coma mandatory-not merely permissible-and without need for permission or consultation with the patient's family. Protecting and supporting organ transplantation also played a significant role in the Committee's writings and deliberations. Multiple concepts of death and justifications for brain death can be found, most of them inconsistent with each other and offered without a clear rationale. The essay emphasizes what is perhaps the most important aspect of this period in history: this is the moment when, without clear physiologic justification, the social and legal status of "corpse" became compulsorily applied to living human bodies.
这篇文章探讨了 1968 年哈佛医学院特别委员会为研究脑死亡定义而撰写的开创性报告《脑死亡定义》的发展历程。对亨利·K·比彻(Henry K. Beecher)论文集存放在哈佛库赛图书馆(Countway Library)中的原始文件的详细审查揭示了报告制定过程中存在各种关注和价值观,委员会成员在一些关键点上也存在分歧。委员会的一个重要目标是规定必须从严重昏迷的患者身上移除治疗措施——不仅仅是允许,而且不需要获得患者家属的同意或咨询。保护和支持器官移植也在委员会的著作和审议中发挥了重要作用。可以发现多种死亡概念和脑死亡的理由,其中大多数相互不一致,也没有明确的基本原理。这篇文章强调了历史上这个时期最重要的一个方面:这是一个时刻,没有明确的生理依据,“尸体”的社会和法律地位就强制性地适用于活着的人体。