The Metaphysics of Brain Death, Persistent Vegetative State, and Dementia

1985 ◽  
Vol 49 (1) ◽  
pp. 24-80 ◽  
Author(s):  
D. Alan Shewmon
Keyword(s):  
Brain Death ◽  
Vegetative State ◽  
Persistent Vegetative State

The Advance of Technoscience and the Problem of Death Determination

2020 ◽  
Vol 24 (3) ◽  
pp. 306-331
Author(s):  
Bas de Boer ◽  
Jonne Hoek ◽  
Keyword(s):  
Brain Death ◽  
Medical Literature ◽  
Life Support ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Life And Death ◽  
Brain Death Determination ◽  
Existential Choice ◽  
Medical Involvement ◽  
Death Determination

Death determination has long been a topic of intensive technoscientific and medical involvement. Due to advances in twentieth-century medical technology, the distinction between life and death has become less evident. Ambiguities appear when we start to use life-support technologies in order to save lives, bringing about “tragic artifacts” such as brain death and persistent vegetative state. In this paper we ask how this technoscientific and medical involvement shapes our understanding of death. We provide an overview of medical literature that has appeared on (brain) death determination, highlighting thereby the role that technologies played in its establishment. Subsequently, we develop three philosophical interpretations of technological death determination: With Agamben and Marcuse as the installation of political power; with Don Ihde as an existential choice for the inevitable; and with Jacques Derrida as an encounter with the ineradicable mystery of death. To conclude, we argue that technological death determination reveals an intrinsic, paradoxical connection between human’s technicity and its ignorance of death.

Persistent vegetative state and brain death

The Lancet ◽  
1993 ◽  
Vol 341 (8846) ◽  
pp. 696-697 ◽  
Author(s):  
D.J. Hill ◽  
D.W. Evans ◽  
LaurensP. White
Keyword(s):  
Brain Death ◽  
Vegetative State ◽  
Persistent Vegetative State

Determination of cerebral perfusion by means of planar brain scintigraphy and99mTc-HMPAO in brain death, persistent vegetative state and severe coma

1992 ◽  
Vol 18 (2) ◽  
pp. 76-81 ◽  
Author(s):  
H. -P. Schlake ◽  
I. G. Böttger ◽  
K. -H. Grotemeyer ◽  
I. W. Husstedt ◽  
W. Brandau ◽  
...  
Keyword(s):  
Brain Death ◽  
Cerebral Perfusion ◽  
Vegetative State ◽  
Persistent Vegetative State

scholarly journals Brain Death and the Persistent Vegetative State: Similarities and Contrasts

1989 ◽  
Vol 16 (4) ◽  
pp. 388-393 ◽  
Author(s):  
Bryan Young ◽  
Warren Blume ◽  
Abbyann Lynch
Keyword(s):  
Cerebral Cortex ◽  
Brain Death ◽  
Neuronal Death ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Neuronal Function ◽  
Medical Support ◽  
Specific Test ◽  
Brainstem Death ◽  
The Brain

ABSTRACT:Brain death and the persistent vegetative state (PVS) share the following features: 1.) There is death of neurons in the brain; 2.) Both require an etiology which is capable of causing neuronal death. 3.) The potential for cognition is totally and permanently lost; 4.) Intensive medical support is usually withdrawn. In contrast, the diagnosis of brain death depends on death of the brainstem, while PVS implies permanent and total loss of forebrain function. While brainstem death can be diagnosed clinically, accurate prognosis in PVS requires additional investigation. Thus far, the EEG is the most specific test of neuronal function in the cerebral cortex. Brain death is equivalent to death, while PVS is not; management of the latter is more complex because of medical, social, ethical and legal factors.

Diminished vasomotor component of systemic arterial pressure signals and baroreflex in brain death

1997 ◽  
Vol 273 (3) ◽  
pp. H1291-H1298 ◽  
Author(s):  
T. B. Kuo ◽  
H. W. Yien ◽  
S. S. Hseu ◽  
C. C. Yang ◽  
Y. Y. Lin ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Brain Death ◽  
Healthy Subjects ◽  
Vegetative State ◽  
Linear Regression Analysis ◽  
Persistent Vegetative State ◽  
Low Frequency ◽  
Systemic Arterial Pressure ◽  
Highly Correlated ◽  
Spontaneous Baroreflex

We compared the cardiovascular autonomic regulatory mechanisms between patients with brain death or under a persistent vegetative state and healthy volunteers, based on auto- and cross-spectral analysis of systolic blood pressure (SBP) and interpulse interval (PPI) signals. Brain-dead patients exhibited a significant reduction in the absolute and relative power of the low-frequency (LF; 0.04-0.15 Hz) component in both SBP and PPI spectra, along with appreciable decrease in the very low frequency (VLF; 0.004-0.04 Hz), LF, and high-frequency (HF; 0.15-0.4 Hz) power of the PPI signals. Patients in a persistent vegetative state exhibited a power of the VLF and LF component in the SBP spectrum that was comparable to that in healthy subjects, although a discernible reduction in the VLF, LF, and HF power of the PPI spectrum was manifested by the former group. Assessments with the magnitude of SBP-PPI transfer function and linear regression analysis of beat-to-beat fluctuations in SBP and PPI revealed a progressive decline in spontaneous baroreflex sensitivity from healthy subjects to patients in a persistent vegetative state or with brain death. We conclude that the vasomotor component of systemic arterial pressure signals and spontaneous baroreflex are highly correlated with the functional integrity of the brain stem.

Brain Death and Persistent Vegetative State

2017 ◽  
Author(s):  
Karl E. Misulis ◽  
E. Lee Murray
Keyword(s):  
Brain Death ◽  
Vegetative State ◽  
Persistent Vegetative State

Neurologists are often asked to consult for determination of brain death or to advise families about prognosis and other aspects of the persistent vegetative state. Criteria for these conditions are discussed along with challenges in discussing them with families.

Mental Status Change

2017 ◽  
Author(s):  
Karl E. Misulis ◽  
E. Lee Murray
Keyword(s):  
Brain Death ◽  
Mental Status ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Status Change ◽  
Confusional State ◽  
Mental Status Change ◽  
Reason For Admission

Disorders of mental status are among the most common reasons for neurologic consultation, second only to stroke in most institutions. Mental status change may be the reason for admission, or it may develop during hospitalization. Among the mental status changes defined and described here are confusional state, dementia, delirium, encephalopathy, amnesia, lethargy, persistent vegetative state, coma, and brain death.

scholarly journals Guidelines for supporting a pregnant patient with brain death: A case discussion and literature review

2017 ◽  
Vol 7 (8) ◽  
pp. 86 ◽  
Author(s):  
Lisa Rose Erlinger
Keyword(s):  
Brain Death ◽  
Healthcare Professionals ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Pregnant Patient ◽  
Unborn Child ◽  
Case Discussion ◽  
Brainstem Function ◽  
Brain Dead ◽  
Guidelines And Recommendations

Brain death implies irreversible cessation of the brainstem function. While it is generally considered unethical and futile to continue to support vital organs once a diagnosis of brain death has been made, patients who are both pregnant and brain dead complicate this issue because the appropriateness of continuing maternal somatic support to prolong gestation to delivery is still debated. This article will review the literature, and open up dialogue, about the need for guidelines and recommendations in anesthesia care, including the ethics, legality, and cost of supporting the mother’s life to save an unborn child, when somatically supporting pregnant patients who are brain dead, are in a persistent vegetative state (PVS), or are in a coma due to irreversible brain injury. Making a case for or against supporting such patients is outside the scope of this paper. This review finds that the need for guidelines to assist healthcare professionals in providing care to somatically supported mother is necessary.

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