ON THE ISSUES
Two essays look at ethical issues arising from new neuroimaging research suggesting that a small minority of patients with severe brain injury might be able to communicate.
Title: Severe Brain Injury and the Subjective Life
Authors: J. Andrew Billings, Larry R. Churchill, and Richard Payne
Summary: Does brain activity necessarily equate to consciousness or a meaningful existence? The authors contend that "modern neuroscience provides many findings about the complexity of brain function that should discourage us from jumping from evidence of local brain reactivity to conclusions about consciousness." They conclude , "Given the extreme likelihood of unacceptably poor outcomes, most of these patients [in a persistent vegetative state]as judged by their advanced directives or through substituted judgmentshould have life support discontinued."
Title: In the Blink of the Mind's Eye
Authors: Joseph J. Fins and Nicholas D. Schiff
Summary: Can a signal on an MRI scan help guide end-of-life decisions? The authors conclude, "Certainly, this is not yet the case, nor will it be anytime soon." While neuroimaging holds promise for helping reclassify some conscious patients thought to vegetative, it "should never become a routine arbiter of whether life-sustaining therapy should be withdrawn."
Title: Are DCD [Donation after Cardiac Death] Donors Dead?
Author: Don Marquis
Summary: Donation after cardiac death protocols are subject to two constraints. The first is that organ removal must occur as soon as possible after cardiac arrest. The second is that it must not occur so soon that the donor is not yet dead. Can both be satisfied at once? If hearts can be transplanted successfully, then is their loss of circulatory function reversible? DCD protocols are widely accepted, so arguments for them have apparently been persuasive. But this does not mean they are soun
|Contact: Michael Turton|
The Hastings Center