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Stanford ethicist discusses brain death

What exactly is "brain death?" And how does it differ from what you and I think of as death? That question and others are answered in this Q&A with David Magnus, PhD, director of the Stanford Center for Bioethics, who co-wrote a perspective piece on the topic that appears today in the New England Journal of Medicine. In that piece, he and his co-authors explained why the laws and ethics governing brain death should not be changed.

When asked by my colleague why he believes families (such as that of this young California girl) shouldn't be able to determine when a loved one is dead, Magnus had this to say:

The line between life and death is legally, ethically and medically important. It determines when someone has full constitutional protections under the law, when someone’s will takes effect, whether someone is still married and when physicians are obligated to provide life-sustaining medical treatments. It also determines the line where it is allowable to procure organs. Without brain death, there would be little to no cadaveric organ procurement in the United States, leading to thousands of deaths every year.

It is important that these lines be drawn in ways that are medically and philosophically defensible. Imagine if we decided that parents could decide when their children are mature enough to be allowed the status of adulthood. Some 40-year-olds would never get to vote or make decisions, while some 10-year-olds would. Instead, we draw a clear boundary at age 18. If a religious minority decides that patients are adults at age 13, it does not follow that the law should be different for them. Similarly, there needs to be a bright line drawn by professionals who can reliably and accurately distinguish between life and death, as we distinguish between child and adult...

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