A Sound Anthropology? Neuroendocrine Functions and Death by Neurological Criteria
Samuel Berendes, Saint Louis University
Death by neurological criteria (DNC), often referred to as ‘brain death,’ has been a source of significant controversy in the past decades. Particular concern has been raised regarding the ways in which brain death has been conceptually understood and how such understandings cohere with clinical practice. The legal definition of brain death focuses on the irreversible loss of all brain function, including the brain stem, leading to an understanding of whole-brain death. The response to this has ranged from that of a complete rejection of brain death as a diagnosis to calls for higher-brain death in which the loss of conscious capacity is all that is required. Of particular importance for the brain death debate, the American Academy of Neurology has recently asserted that the loss of neuroendocrine function is not necessary for brain death determination. Concern has been raised regarding this understanding of brain death by some within the Catholic and Thomistic traditions.
The question becomes whether it is consistent with a sound anthropology to accept brain death despite continuing neuroendocrine function. I argue that it is as the integrative unity required for continued life depends on the brain as a whole. This will be shown through engaging with the writings of Thomas Aquinas, especially as they relate to a hylomorphic understanding of the human person. Additionally, I will engage with understandings of brain death as the loss of the integrative unity of the human organism, particularly with Maureen Condic’s distinction between integration and coordination. Through this, I will argue that brain death determinations are valid if there is an irreversible loss of the capacity for consciousness, the capacity for spontaneous breath, and brainstem reflexes regardless of continuing neuroendocrine functions. This is to say that neuroendocrine functions alone are not sufficient to demonstrate continued integrative unity, and thus life, as such unity relies on an understanding of the brain as a whole.
The question becomes whether it is consistent with a sound anthropology to accept brain death despite continuing neuroendocrine function. I argue that it is as the integrative unity required for continued life depends on the brain as a whole. This will be shown through engaging with the writings of Thomas Aquinas, especially as they relate to a hylomorphic understanding of the human person. Additionally, I will engage with understandings of brain death as the loss of the integrative unity of the human organism, particularly with Maureen Condic’s distinction between integration and coordination. Through this, I will argue that brain death determinations are valid if there is an irreversible loss of the capacity for consciousness, the capacity for spontaneous breath, and brainstem reflexes regardless of continuing neuroendocrine functions. This is to say that neuroendocrine functions alone are not sufficient to demonstrate continued integrative unity, and thus life, as such unity relies on an understanding of the brain as a whole.