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Brain Death and Spontaneous Breathing

When is a person dead? Or more precisely: what criterion should be used to determine when someone is declared dead? The answer may have great practical importance, for perhaps it should determine when medical efforts whose aim is to sustain a patient’s life may be discontinued or when a patient’s organs may be removed for transplant to others. If the wrong criterion is used—if someone is not already dead when these things are done—then in doing some of them we may kill him, and this, many will say, is wrong. The contemporary debate about this issue focuses on at least four different positions. One is the traditional cardiopulmonary criterion (CPC): a person is dead when his heart permanently stops beating and he permanently does not inhale and exhale air. The possibility of attaching people to respirators that artificially induce respiration has, in the minds of some, created problems for the CPC, because, they argue, someone can be dead even though a machine is mechanically producing respiration. Among those who raise this problem for the CPC are the proponents of a second criterion for death, the death of the whole brain (WBC). More accurately, they claim that a person is dead when