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Medicine and Public Policy |

Human Death and High Technology: The Failure of the Whole-Brain Formulations

STUART J. YOUNGNER, M.D.; and EDWARD T. BARTLETT, Ph.D.
[+] Article and Author Information

Grant support: in part by a grant from The Cleveland Foundation.

▸Requests for reprints should be addressed to Stuart Youngner, M.D.; University Hospitals, 2040 Abington Road; Cleveland, OH 44106.


Cleveland, Ohio


© 1983 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1983;99(2):252-258. doi:10.7326/0003-4819-99-2-252
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Modern technology has raised questions about the definition of death, and various factors that influence public policy about declaring people dead. The widely accepted "whole-brain" definition of death is inadequate and should be replaced by a definition of "irreversible loss of consciousness and cognition." Any definition that identifies the innate ability of the organism to "integrate" itself or function "as a whole" should be rejected. The proponents of such definitions fail to provide a standard for the selection of essential sub-systems. The innate integration of vegetative functions cannot be used as the necessary and sufficient condition for life. A person without innate integration can still be alive; a dead person retaining just this function can survive as a living, mindless organism. Only cognitive functions have a spontaneity that is, in principle, irreplaceable.

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