Article Review: “Is Brain Death the Death of a Human Person?”
Review for a university assessment: Robert Spaemann, “Is Brain Death the Death of a Human Person?” Communio 38 (Summer 2011): 326–340
Assessor’s comments: Your analysis of Spaemann’s paper shows a solid understanding of his thesis, which concentration on its major themes. You show evidence of skill in critical analysis, applying philosophical concepts learnt elsewhere to the text. Your personal reflection is honest and frank, drawing insights from the paper and applying them to other aspects of life. It is admirable.
Prior to my bioethics studies, I probably would have assumed that brain death is the death of the human person, especially prior to my philosophy and theology studies, when I did not have a full Catholic appreciation for the term ‘human person’. Spaemann’s essay starts with a reminder of the times we live in: “Death and life are not primarily objects of science”. It can be assumed that his reference to science here is that of modern science based on the scientific method. Indeed, we now live in a world that is heavily dependent on science, perhaps obsessed with science. This essay epitomised why it is not all about science — to understand the death of the human person is to understand it phenomenologically. After all, from an Aristotelian perspective, if life is about being alive, and the soul, the substantial form of the body, is what makes the body alive, then it is the death of the soul, not brain death, that constitutes the death of the human person. Therefore, the concept of ‘brain death’ is limited in understanding of the human condition.
This philosophical perspective may not appear scientifically certain, but the certainty this perspective provides is that the living organism is alive so long as it is internally united, that is, there is a body-soul composite in existence. The implication of this is that death disintegrates the composite. Whilst there are means of attempting to halt decomposition, such as chemical mummification, it would only hold the corpse together — the soul has already separated. This, of course, is different to life support for an alive human person in a ‘vegetative’ state, and since a person cannot be simultaneously dead and alive, Pope Pius XII clarified that human life continues even when vital bodily functions require artificial help. Even so, life and death cannot be clearly defined because being and non-being cannot be defined, according to Spaemann. In light of this, one can only rely on physical signs for discerning life and death.
Prior to the introduction of modern science, tradition provided alternative explanation for death of the person. For example, Holy Scripture points out that breathing is the vital foundation of life, and therefore breath is life itself. The cessation of breathing, beating of the heart, and other phenomena, have indicated since the beginning of time for human persons, that these are physical signs of death. In Europe, it was tradition to consult a physician for a second opinion on observations of death phenomena. The reason for this precaution would include that a physician may still be able to discern abnormally soft breathing, for example. In fact, due to the margin of error involved in declaring someone dead, it was also customary to allow a certain period elapse between declaration of death and funeral service. However, Harvard Medical School in 1968 challenged the reliability of death phenomenology in favour of medical science.
According to the School, science no longer presupposes life and death phenomenology. It is worth noting that according to Hurserlian phenomenology, phenomenology is a science proper that is the foundation of all the sciences, that is, medical science is not proper science unless its foundation is scientifically phenomenological. The implication of the School taking the contrary position is that human persons can be declared dead in accordance with science, even though they appear to be alive. This absurdity is not new — in the 17th century, Cartesian science denied the human phenomenology of animals feeling pain, thereby giving a social licence to unethical experiments on animals. The justification was that animal expressions of pain were merely mechanical reactions — whilst this is no longer a mainstream argument, the Harvard Medical School position appears to be another example of a famous quote by philosopher George Santayana: “Those who cannot remember the past are condemned to repeat it”.
It appears that the introduction of a scientific definition of death, such as that of ‘brain death’, at the expense of traditional death phenomenology, could be open to abuse in order to make a death declaration sooner. This logic has broader application — human pain could be scientifically (neurologically) defined, leading to people feeling pain being diagnosed as pain-free if the neurological diagnosis is inconclusive. Inadvertently, Spaemann has raised to me a fundamental problem with a particular aspect of the general transgender discourse. As a trans woman, I have argued in the past that because there is an emerging neuroscience behind the transgender phenomenon, this validates the experience of trans people such as myself. It is now apparent that the problem with this approach is that if there was a neuroscientific test for the transgender brain, and for whatever reason I failed said test, as far as I am concerned, my phenomenology is still valid. Therefore, what I have argued in the past deserves a review on my part.
Like the question of if the ‘transgender brain’ is what meant by the trans experience, Spaemann questions the equating of ‘brain death’ with the human understanding of death. It appears that the proverb of “the road to Hell is paved with good intentions” applies. This is because the Harvard Commission of 1968, in providing a new definition of death, was not interested in avoiding premature death declarations. They were more interested in guaranteeing legal immunity for discontinuing life-prolonging measures that are considered burdensome, and collecting vital organs for other human persons requiring transplants. Again, this is anti-phenomenological because the approach objectifies the subjective human person in question. Also the interest in transplantation appears contradictory, a contradiction between demand for live organs for life-prolonging measures, and risk of increasing premature death declarations so that collection of said organs cannot be considered killing. Herein lies a slippery slope.
The introduction of the nominal definition is neutral in a utilitarian way. Worse still, transplantation physicians were involved in the Harvard Commission’s efforts, which was a conflict of interest. Unsurprisingly, since 1968, there have been increasing contention surrounding the ‘brain death’ definition, as opposed to cardiac death, involving philosophers, jurists and medical scientists. But proponents of the definition have assumed that there is no debate to be had, based on appeal to authority. They equate human life to discernible mental activity, and the subject is objectifiable once such activity organically ceases. It is worth noting that near total loss of all brain functions could be undiscernible, such as that experienced by humans persons in a ‘vegetative’ state.