Tuesday, May 8, 2012

The Brain- Death Revolution by Dick Teresi

The author suggests that ‘Brain Death’ has replaced cardiopulmonary failure as the main criteria by which doctors decide whether a person is alive or dead and that this has been done in order to facilitate the lucrative business of organ transplantation. The author’s primary beef (or ‘dead-horse’) are the conclusions of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, as published in the August 5th 1968 edition of The Journal of the American Medical Association entitled “A Definition of Irreversible Coma”. Though he admits that this definition and its tests and procedures have no legal standing, he claims that they are the gold standard used by the medical establishment in the U.S.

According to Mr. Teresi the only infallible way to confirm the death of an individual who has been declared ‘brain dead’ or demonstrates the symptoms of irreversible cardio-pulmonary failure is the age-old wait for certain signs of decomposition. Of course this would make it impossible for organ donors and their families to get paid for their gifts (as Teresi suggests they should through-out his book) since transplantation (except in the rare and ethically challenged case of live donors) would thus be taken completely off the table.

Teresi complains that the Harvard Committee and Medicine in general have substituted a philosophical definition of ‘dead’ for a biological one but, of course, that is what he does as well, besides exploit people’s fears that they will be ‘buried alive’, sacrificed for their organs in a mammonish sort of way or helplessly experience excruciating pain in the last minutes, hours, days, weeks, months or years of their lives. So there is a definite ‘tabloid’ aspect to the book and, as far as I know, significant mischaracterization of transplant programs (at least at Massachusetts General Hospital) though not written without some imagination and interest for the general reader who may not be facing the complex reality of his/her own death as honestly and practically as they might.

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