Adelaide College of Divinity, Brooklyn Park, South Australia, Australia.
Bioethics. 2022 Jul;36(6):628-634. doi: 10.1111/bioe.13022. Epub 2022 Mar 28.
The determination of death by neurological criteria (brain death) is practiced in at least 80 countries, though it is a matter of continuing controversy. At the same time, the brain is central to human life, thinking, and behavior; however, a growing "neurocentrism" or a brain-focused image of human identity became established in most Western and in many non-Western societies and acts as a forceful ideology. This paper seeks a broader theoretical and sociocultural basis to approaching death bioethically by analyzing criticisms aimed at a neurologically focussed vision of human life, and then turning these towards the brain death criteria exposed to the criticism. The overall critique of the "neuro-self" has scope to offer alternative perspectives to the contested issues in brain-death criteria. Specifically, the paper examines two major shortcomings of a narrow brain view of life and culture. First, it considers the reduction of the individual to the brain: this is the crux of the neurological way of determining death, and is a way that is seemingly context-independent and culturally neutral. Second, it considers how dimensions of society and culture for humans are detached from the brain and have little impact on clinical practice and thinking in brain-death criteria; however, a deeper exploration reveals that they actually have direct relevance and that social and cultural factors have greater contributions to make to the current debates.
通过神经标准(脑死亡)来确定死亡在至少 80 个国家得到实施,尽管这仍然存在争议。与此同时,大脑是人类生命、思维和行为的核心;然而,一种日益增长的“神经中心主义”或大脑为中心的人类身份形象在大多数西方和许多非西方社会中已经确立,并成为一种强有力的意识形态。本文通过分析针对以神经为中心的人类生命观的批评,寻求更广泛的理论和社会文化基础,从而在生物伦理学上更全面地探讨死亡问题,然后将这些批评转向受到批评的脑死亡标准。对“神经自我”的总体批判有可能为脑死亡标准的争议问题提供替代视角。具体来说,本文考察了狭隘的大脑观在生命和文化方面的两个主要缺陷。首先,它考虑了将个体还原为大脑:这是神经学确定死亡的核心,也是一种看似与上下文无关且文化中立的方法。其次,它考虑了人类的社会和文化维度如何与大脑分离,并且对脑死亡标准的临床实践和思维几乎没有影响;然而,更深入的探索表明,它们实际上具有直接的相关性,社会和文化因素可以为当前的辩论做出更大的贡献。