Monday, November 9, 2015

Why defining death leaves me cold

by John Banja, PhD

*Editor's note: In case you missed our annual Zombies and Zombethics (TM) Symposium entitled Really, Most Sincerely Dead. Zombies, Vampires and Ghosts. Oh my! you can watch our opening keynote by Dr. Paul Root Wolpe by clicking on the image below. We recommend starting at 9:54 min.

http://4.bp.blogspot.com/_1c6uKfrEfj0/S7-dg3QzSwI/AAAAAAAAE8M/RJRZVjlXnrI/s320/Meinhardt_Raabe.jpg

Two weeks ago, I attended a panel session on brain death at the annual conference of the American Society for Bioethics and Humanities. Forgive the bad pun, but the experience left me cold and …lifeless(?). The panel consisted of three scholars revisiting the more than a decade old conversation on defining death. Despite a standing room only crowd, there was utterly nothing new. Rather, we heard a recitation of the very familiar categories that have historically figured in the “What does it mean to be dead?” debate, e.g., the irreversible cessation of cardio-respiratory activity, the Harvard Brain Death criteria, the somatic integration account, the 2008 Presidential Commission’s “loss of the drive to breathe,” and so on. I walked out thinking that we could come back next year, and the year after that, and the year after that and get no closer to resolving what it means to be dead.

Dr. Banja in his natural habitat.
I’d suggest that the reason for this failure is the stubborn persistence of scholars to mistake a social practice, i.e., defining death, for a metaphysical event. Philosophers who insist on keeping the “defining death” conversation alive are invariably moral realists: They mistakenly believe that death is an objectively discernible, universally distributed, a priori, naturally occurring phenomenon that philosophical reasoning and analysis can divine. Now, the irreversible cessation of cardio-respiratory functioning or the cessation of all brain functioning certainly are actual biophysiological events. But determining death requires a social decision because its primary purpose consists in triggering various social practices like terminating medical care or preparing a body for organ recovery; commencing rituals of grieving or mourning; disposing the body in a way that protects the public’s health; securing life insurance or inheritance benefits, and so on. Understood this way, it’s up to a community of language users to decide when these activities should commence rather than look to a bunch of academic philosophers to give us the “correct” answer. After all, what are philosophers going to do? They can only argue their moral intuitions, but they must ultimately admit that there is no source of confirmation that proves which of their intuitions is the “correct” one.

Death contains a social component, as depicted in The Court of Death by Rembrandt Peale
The problem with the various death defining criteria is that, at least to me, they all have a ring of plausibility. (Otherwise, they wouldn’t be seriously discussed.) This especially includes Robert Veatch’s position that we should leave the nature of death determination up to the individual.* According to Veatch, if I believe that I’m as good as dead if I enter a state of permanent unconsciousness, then I should be treated as such: discontinue all life prolonging care; prepare to dispose of my bodily remains in a respectable way; and if my beating heart disturbs anyone, inject it with curare or a reasonable substitute to stop it.

The idea that death is a “natural occurrence” is only loosely and metaphorically true. In fact, death is largely a socio-cultural happening that derives from social needs or pressures—like the Harvard Brain Death criteria deriving from the need for a dead organ donor or to assist the courts in their prosecution of murderers. The idea that philosophers can discern the “real and true” essence of death—because we mistakenly think the answer sits out there in the biosphere waiting to be discovered—seems an intellectual conceit. We don’t need philosophers to tell us how our social practices should work. It’s up to the rest of us to experiment with them and retain the ones that work best. And that’s what will happen if there are further chapters in the social narrative around defining death: Future generations will meet that challenge according to the survival pressures that living and dying present to them. Philosophical definitions of death might be interesting and even illuminating. But contemporary, western societies will most likely decide when death occurs according to pragmatically reasonable criteria than philosophically subtle ones.

*Veatch RM. The death of whole-brain death: the plague of the disaggregators, somaticists, and mentalists. Journal of Medicine and Philosophy 2005;30:353–378.

Want to cite this post?

Banja, J. (2015). Why defining death leaves me cold. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/11/why-defining-death-leaves-me-cold_3.html

No comments: