Clarifying the Discussion on Brain Death

Definitions of death are based on subjective standards, priorities, and social conventions rather than on objective facts about the state of human physiology. It is the meaning assigned to the facts that determines whensomeone may be deemed to have died, not the facts themselves. Even though subjective standards for the diagnosis of death show remarkable consistency across communities, they are extrinsic. They are driven, implicitly or explicitly, by ideas about what benefits the community rather than what benefits the indidvidual. The differences that do exist across communities generally reduce to questions about legitimacy and not fact. The questions at the core of the debate about brain death are better framed by asking: ‘‘Whom ought we deem to be dead?’ ’ rather than: ‘‘Who is dead.’ ’ The rationale for equating brain death with death, therefore, extends well beyond somatic and biological concepts of death. Key words: brain death, deeming, definitions of death, Shewmon I