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Death: Beyond Whole-Brain Criteria pp 111–144Cite as

Legal Issues Leading to the Notion of Neocortical Death

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Part of the book series: Philosophy and Medicine ((PHME,volume 31))

Abstract

All human beings know the fact and reality of death, yet like Alice, our existence is in many ways a search to understand death. As Samuel Johnson observed to Boswell, “the whole of life is but keeping away the thoughts of it.” Theologians, philosophers, and poets struggle with the meaning of death. Saint Augustine asks what type of death did God intend to enforce His commands. “Was it the death of the soul, or of the body, or of the entire man, or the so-called second death?”1 Yet for Dylan Thomas, “After the first death, there is no other.” The law, too, must face death, particularly the dilemma created by advances in medical science that permit the artificial maintenance of heart, lung, and nourishment functions. This article examines the law’s approach to death by inquiring into the legal issues raised by cardiopulmonary, whole-brain, and neocortical definitions of death. The term “cardiopulmonary death” means the irreversible cessation of heart and lung functions.2 “Whole-brain death” means the irreversible cessation of all functions of the entire brain, including the brain stem. “Neocortical death” means the irreversible loss of consciousness and cognitive functions.3 Several arguments and a proposal emerge from this inquiry. The law should and does define criteria for death.

(After consuming the bottle labeled “DRINK ME” and shrinking to a height of ten inches, Alice contemplates her fate): “[S]he waited for a few minutes to see if she was going to shrink any further: she felt a little nervous about this; ‘for it might end you know,’ said Alice, ‘in my going out altogether, like a candle. I wonder what I should be like then?’ And she tried to fancy what the flame of a candle is like after it is blown out, for she could not remember ever having seen such a thing.” L. Carroll, Alice’s Adventures in Wonderland [55].

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Authors and Affiliations

  1. Vanderbilt University, Nashville, Tennessee, USA

    David Randolph Smith

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  1. David Randolph Smith
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  1. Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA

    Richard M. Zaner Ph.D. (Ann Geddes Stahlman Professor of Medicical Ethics) (Ann Geddes Stahlman Professor of Medicical Ethics)

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© 1988 Kluwer Academic Publishers

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Smith, D.R. (1988). Legal Issues Leading to the Notion of Neocortical Death. In: Zaner, R.M. (eds) Death: Beyond Whole-Brain Criteria. Philosophy and Medicine, vol 31. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-2707-0_6

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  • DOI: https://doi.org/10.1007/978-94-009-2707-0_6

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