Introduction: Medical and Philosophical Issues in Determining Death
Keywords:心肺死, 腦死, 全腦死亡, 上腦死亡, 昏迷, 持續性植物狀態, 死亡之定義, 死亡之判準, 死亡之測試, 遇物之靈, 人的本質, 形神關係
LANGUAGE NOTE | Document text in Chinese; abstract also in English.
This essays begins by noting the brief history of "updating" death since the Harvard Medical School Report in 1968. The deficiencies of this report are noted and the background of the President's Commission's Report on "Defining Death" are briefly explained. The author then discusses and endorses the three-fold distinction in the determination of death as suggested by other scholars, viz., the definition of, the criterion of, and the tests for death. While the test for death is basically a medical issue, and that the definition of death is basically a philosophical issue, the criterion of death is both medical and philosophical.
Since the People's Republic of China does not have any brain death legislation, and since some recent Chinese biomedical ethics textbooks have an inaccurate understanding of brain death, the present author summarizes the major theses of "Defining Death" by the President's Commission of 1981. It is pointed out that the idea of "brain death" does not indicate a new definition of death; it only advocates a new criterion of death, and a new way of testing death (neurological) in addition to the conventional way of testing death (cardiac-pulmonary). Hence the precise idea of "brain death" is not as radical as some Chinese interpreters think it to be.
This essay also analyzes the criticism of brain death criterion both from the left and from the right. The Jewish position, as articulated by Hans Jonas and others, that brain death is not the sufficient condition of human death is explained. The present author points out that Jonas' idea that the argument for brain death is value-laden is vindicated by many Chinese writings on biomedical ethics. The position in the other extreme, viz., whole brain death is not even a necessary condition of the death of persons, is also explained. The arguments in its favor and against it are both critically analyzed. The serious mistake of many Chinese writings of equating the condition of persistent vegetative state with whole brain death is criticized. The author also notes that according to Buddhist views, pvs patients still possess some degree of consciousness and hence should not be deemed dead.
The philosophical issue of "what is death?" necessarily leads to another issue, viz., what is the nature of human life? The ancient Chinese discussions of the nature of the soul (shen) and the body-mind (xing-shen) problem are briefly discussed. The author points out the relevance of these discussions to the contemporary reflection on the nature of human death.
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Copyright (c) 1999 International Journal of Chinese & Comparative Philosophy of Medicine
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