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Brain Death - Beyond the Slogan

by Paul A. Bryne, M.D.

Brain death is not about a definition of death, although it is often stated as a matter of definition. Rather, brain death vs. death is about the facts of death. If brain death and death were identical and equivalent, there would have been no need to coin "brain death."

One ought to begin with the known. Death is a fact. The concept of death can be defined, often from a theological or philosophical viewpoint. Medicine can have knowledge of the theological or philosophical concept, but the physician must make his determination of death based on the science (biology, biochemistry, etc.) that he knows.

The law should be for all. The purpose of the law should be for the protection of citizens. In the case of death the law should protect a citizen from being determined or pronounced dead before death, the fact, has occurred. This is not occurring in brain death.

These are facts of life. Anatomically and physiologically during life there is an interdependence of organs and systems maintaining the unity (oneness) of the body. In an organism as complicated as a human being, no one should be pronounced dead unless and until there is destruction of at least the major vital systems of the body, i.e., the circulatory and respiratory systems, and the entire brain.

Because of the desires of man to transplant vital organs, absence of brain functioning, functions or function was proposed and has been accepted by those who follow the leaders. Others have studied and realized that absence of brain functioning, functions or function is not identical and equivalent biologically or medically to death.

Furthermore, even though the Uniform Determination of Death Act calls for ". . . irreversible cessation of all functions of the entire brain, including the brain stem," this is not what is occurring in practice. The Annals of the New York Academy of Science (ANYAS 9, 315, pg. 65, 1978) reported that only 4 percent of the patients in the Collaborative Study would have met the criteria of a dying brain stem. To say it another way, when the criteria based on the Collaborative Study became the practice and a standard for determining brain death, 96% of the patients did not and do not have a dying brain stem. While this is only one set of criteria, whether it or any other set of criteria based on the Collaborative Study is used, 96 percent of the so-called "brain-dead" patients still have a functioning brain. When the beating heart is then excised, the patient becomes dead, i.e., the patient is killed.

The acceptance of brain death is a major link in the euthanasia movement. Many of the difficult issues of euthanasia have been evaded by the acceptance of brain death (Willard Gaylin). "Brain death" is not death. Brain death is not based on data that would be considered valid for any other scientific purpose.

Brain death is not the truth, but someday the truth will have to be told.

Dr. Paul Byrne is the president of the Catholic Medical Association and an uncompromising defender of the sanctity of innocent life. The above remarks were presented in Rome on October 4, 1995 at a CURE workshop at the Third International Congress of the Movement for Life convened by the Pontifical Council for the Family.