All living things die. This is not new and it has nothing to do with technology. What is new in our technological age, however, is an uncertainty about when death has come for some human beings. These human beings, as an unintended consequence of efforts to prevent death, are left suspended at its threshold. Observing them in this state of suspension, we, the living, have a very hard time knowing what to think: Is the living being still among us? Is there still a present for this person or has the long reign of the past tense begun: Is he or was he? The phenomenon is popularly known as “brain death,” but the name is misleading. Death accepts no modifiers. There is only one death. Has it occurred or not? Alive or dead? The President’s Council on Bioethics has taken up this question in a recently published report entitled Controversies in the Determination of Death. At stake in the report is the moral status of those human beings who are “suspended at the threshold.” These are human beings who have suffered the worst sort of injury to the brain, but who, with technological support, retain ambiguous signs of life. The brain injury leaves them in a state of incapacitation significantly more profound than that associated with the “persistent vegetative state” (PVS), the condition associated with the cases of Karen Ann Quinlan, Nancy Cruzan, and Terri Schiavo. The name given to their injury is “brain death,” or sometimes “whole brain death.” The President’s Council suggests a more neutral term, which this article will adopt as well: “total brain failure.” Calling the condition by this name does not pre-judge the question of whether the patient so diagnosed is alive or dead.
more from Alan Rubenstein at The New Atlantis here.