Minds, brains, and hearts: an empirical study on pluralism concerning death determination

Abstract

Several authors in bioethics literature have expressed the view that a whole brain conception of death is philosophically indefensible. If they are right, what are the alternatives? Some authors have suggested that we should go back to the old cardiopulmonary criterion of death and abandon the so-called Dead Donor Rule. Others argue for a pluralist solution. For example, Robert Veatch has defended a view that competent persons should be free to decide which criterion of death should be used to determine their death. However, there is very little data on people's preferences about death determination criteria. We conducted online vignette-based survey with Latvian participants (N = 1416). The data suggest that the pluralist solution fits best with the way our study participants think about death determination-widely differing preferences concerning death determination criteria were observed. Namely, most participants choose one of the three criteria discussed in the literature: whole brain, higher brain, and cardiopulmonary. Interestingly, our data also indicate that study participants tend to prefer less restrictive criteria for determination of their own deaths than for determination of deaths of their closest relatives. Finally, the preferences observed in our sample are largely in accord with the Dead Donor Rule for organ procurement for transplantation.

Public Understandings of the Definition and Determination of Death: A Scoping Review

“…Other studies have reported similar findings in that people believe that brain death does not mean a person is dead and that it is not the same as “natural death.” 17 , 24 , 27 , 29 , 30 , 43 , 48 Other studies showed that people believed that brain-dead patients were still alive or would recover. 25 , 43 , 48 In other countries like Japan, the cessation of brain function is not necessarily felt to be representative of the cessation of life while other organs such as the heart continue to function. 49 …”

“… 28 Similarly, in Denmark, after brain death was opened up for public examination, the result, surprisingly, was greater uncertainty and lower organ donation rates, despite the huge economic investment by the government to sponsor large public hearings, public debates, educational films, and programs on national television. 23 , 48 …”

“…From experiences of other countries such as in Denmark and Japan, a lesson learned is that in itself, increasing the involvement of the general public in the debates and legislation around death determination may not necessarily increase public acceptance and may perpetuate heated discourse not necessarily based on a strong conceptual foundation. 10 , 23 , 48 , 53 , 60 , 61 …”

Experimental philosophical bioethics and normative inference

“…Case study 5. Pluralism "Minds, brains, and hearts: an empirical study on pluralism concerning death determination" [69] Pluralism concerning death determination states that people should be allowed to choose-within reason-what criterion will be applied to determine their own deaths [70]. It assumes that death determinations take place under conditions of uncertainty in the presence of more than one medically reasonable option.…”

“…It assumes that death determinations take place under conditions of uncertainty in the presence of more than one medically reasonable option. Against this backdrop, Ivars Neiders and Vilius Dranseika presented study participants with a possible description of the process of dying that was divided into a number of stages, beginning with the onset of health deterioration and concluding with the onset of corpse decay [ 69 ]. They were asked at which of these stages they would prefer their own death to be declared.…”