Introduction

In the management of the brain-dead child discussed by Drs. Frankel and Randle we encounter descriptive anomalies and problems that are intimately connected with our moral posture toward brain death. I will discuss these anomalies and problems, and then consider whether brain death should continue to serve as the criterion of death, and whether the brain-dead individual should simply be called dead.

Descriptive problems

Let us consider some descriptive problems connected with this case. Notice that in describing this situation, the phrases, “prolonged medical support,” “medical interventions,” “attending physician,” and “life support” were employed. Indeed, it was difficult to do without them, since they are part of the conventional terminology.

Is the brain-dead child dead? Most physicians would say yes. (It is less clear whether an ordinary person would agree.) A human being, particularly in the early period of death, is also called a corpse (Pallis 1982, Annas 1996). If so, do we then believe that it is sensible to speak of ventilatory support of the brain-dead child as ventilating a corpse? If not, can we consider such support a form of treatment?

One response might be to point out that physicians treat organs, as well as people. But it is normally the treatment of the organs of the living, rather than those of the dead, patient. If we extend the use of the term “treatment” to the organs of the brain-dead, we may be giving credence to the view that the brain-dead individual is, in some sense, alive.