Brain Death: Can It Be Resuscitated?

Asian Bioethics Review1117-2

The brain and somatic integration: Insights into the standard biological rationale for equating ` brain death'' with death.

ABSTRACT The mainstream rationale for equating``brain death'' (BD) with death is that the brain confers integrative unity upon the body, transforming it from a mere collection of organs and tissues to an``organism as a whole.'' In support of this conclusion, the impressive list of the brain's myriad integrative functions is often cited. Upon closer examination, and after operational de®nition of terms, however, one discovers that most integrative functions of the brain are actually not somatically integrating, and, conversely, most integrative functions of the body are not brain-mediated. With respect to organism-level vitality, the brain's role is more modulatory than constitutive, enhancing the quality and survival potential of a presupposedly living organism. Integrative unity of a complex organism is an inherently nonlocalizable, holistic feature involving the mutual interaction among all the parts, not a top-down coordination imposed by one part upon a passive multiplicity of other parts. Loss of somatic integrative unity is not a physiologically tenable rationale for equating BD with death of the organism as a whole