Word: braining
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Dates: during 1960-1969
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...that as the end approaches there is less and less life in the individual, that there is present quantitative factor, a sort of death by inches. To a certain point this is supportable in that all organ and never centers do not become irreversibly damaged simultaneously: consciousness as a brain function is often irretrievably destroyed months to years before the respiratory and vasomotor centers fail. At the same time one can share Schreiner's (1966, p. 100) disconent and insist that "a coordinating vital principle exists which is either there or not there." This vital principle comes into being when...
From ancient times down to the recent past it was perfectly clear that when the respiration and heart stopped, the brain would die in a few minutes; so the obvious criterion of a heart in standstill as synonymous with death was accurate enough. This is no longer the case when modern resuscitative and supportive measures are involved. These improved activities can now restore "life" as judged by the ancient standards of persistent respiration and continuing heart beat. This can be the case even when there is not the remotest possibility of an individual recovering consciousness following massive brain damage...
...discussion following, it was proposed that the moment of death be defined as the moment when spontaneous heart beat cannot be restored. Others (Louisell, 1966) raise the question of whether the moment of death might not best be defined as "the moment at which ireversible destruction of brain matter, with no possibility of regaining consciousness, is conclusively determined...
...must be recognized that this situation when the patient is in full possession of his mental faculties is not comparable to turning off the respirator of an unconscious patient with irretrievable brain damage. The patient who has the possibility of rejecting hemodialysis must weigh not only the financial and emotional cost to his family but also the cost to the society to which he belongs. Medical resources in this field are limited: utilization by one deprives another...
...unconscious patient with overwhelming brain damage can be maintained only by extraordinary means. When it becomes evident that the brain is dead, there is an obligation to discontinue extraordinary supports. But one must remember that the termination of extraordinary care even for just reasons, with death to ensue, can have a shocking effect on observers...