Archives For Dr. Alan Shewmon

Controversies in brain death

Dr. Paul Byrne I had a great time at the brain death conference and met some really nice people, many doctors, nurses and pro-life advocates.

I’m not sure why Dr. Byrne wasn’t asked to speak as every speaker there mentioned him and all the research he has done as well as being a voice on the issue for many years.

“Brain death” (BD)1 is generally regarded as one of the few relatively settled issues of contemporary bioethics (Bernat, 1994, p. 115).

Such consensus, however, remains at the level of statutory law and clinical praxis, while the conceptual basis for equating a dead brain with a dead human individual remains as confused and controversial today as ever (Evers & Byrne, 1990; Halevy & Brody, 1993; Shewmon, 1992, 1997, 1998a, 1998b, 1999; Stapen­horst, 1996; Taylor, 1997; Tomlinson, 1990; Truog, 1997; Veatch, 1993; Youngner, 1994; Youngner et al., 1989).

The Conference

Dr. Hargroder a former transplant surgeon spoke on how he came to the decision to stop doing transplant surgery. “Something in my gut didn’t feel right as a transplant surgeon, and all the conflicting data made me question if a person was really dead.” When he first became a transplant surgeon, he said no one really questioned this new way of saving people’s lives. But as time went on he began to see that the issue was far from resolved.

He studied the human soul, and at that point knew he could no longer participate in the killing of one person to save another person.

I’ve read so much on brain death the last few years that I really felt like I wouldn’t learn anything new. But I did and will continue to look at those area’s where I heard new things. One thing I am trying to understand from a theological point of view is about St Aquinas soul which is far more than I imagined it to be.

The soul Thomas Aquinas Father Joseph Howard, from LSU also mentioned Thomas Aquinas study of the soul in his Summa Theologica, question 78.

The SOUL contain’s the body not the body containing the soul. The organs of the body are able to function because of the Rational Soul.

(This is what I am looking at and trying to get a clearer understand of) I don’t want to get too much into it because when Jamie was pronounced “brain dead” and on the ventilator all I really understood was that man was two parts, body and soul. I was thinking they were pretty much 1/2 and 1/2 and I didn’t understand the dynamic’s of an integrated human. More later… when I can explain it in lay language.

Dr. Alan Shewmon also a former transplant surgeon from UCLA,  studied extensively the  “somatic integrative unity” or “integrated function­ing of the organism as a whole” and the empirical evidence for its purported dependence on the coordinating activity of the brain.

  • “integrative unity” is either present or absent
  • it must not conflate mere disability or illness with death itself
  • consciousness is not a necessary condition for somatic integrative unity

Shewmon compiled 150 documented cases of brain-dead patients whose hearts continued to beat, and whose bodies did not disintegrate, past one week’s time. In one remarkable case, the patient survived 20 years after brain death before succumbing to cardiac arrest.

Some of integrative processes that brain-dead patients continue to exhibit include:

• Cellular wastes continue to be eliminated, detoxified, and recycled.

• Body temperature is maintained, though at a lower-than-normal temperature and with the help of blankets.

• Wounds heal.

• Infections are fought by the body.

• Infections produce fever.

• Organs and tissues continue to function.

• Brain-dead pregnant women can deliver a baby

 Brain-related criteria are flawed not only in scientific theory but also in application.

In order to fulfill the current “brain death” criteria, the entire brainstem must not be functioning. In fact and in practice, however, often only some brainstem reflexes. . . are evaluated …. Although there are other functions of the brainstem, including maintaining a normal body temperature, producing hormones via the hypothalamic-pituitary axis, neurogenic control of heart rate and maintenance of normal blood pressure, either these brain functions are not considered at all or they are said to be inapplicable or insignificant for determining death.

When a human is severely injured and in a comatose state their brain is injured. But, their other organs are still functioning. The soul is supporting those organs and there is an integrative unity of the body.

We humans and animals are both body and soul. A unified composite of matter, form, body, soul.

Jesus said to His twelve disciples in Matthew 10:28,  “And do not fear those who kill the body but cannot kill the soul. Rather fear him who can destroy both soul and body in hell.”

According to Dr. Paul Byrne, one of the primary authors of Life, Life Support, and Death, the term coma, or even irreversible coma, “is a term for someone who’s alive, not someone who’s dead.” Indeed, a key objection for the acceptance of brain death is the argument that the practice confuses prognosis with diagnosis. The word “irreversible” is frequently invoked in discussions of brain death. Yet the simple fact that the patient is irreversibly comatose, and will in all likelihood be dead shortly, does not justify the conclusion that he is dead.

Father Joseph Howard said, “Whenever there is no organism as a whole, death has occurred.”

Jamie’s body and soul

As we were gathered around my son’s bed, and ALL the tubes were out, Jamie fought for 14 minutes to live.  Only when my daughter, Christa leaned over and said, “Jamie, we are all here, the people who love you most in the world. Jamie we are going to be fine, you go ahead and be with Jesus”. At that very minute he took his last breath. His soul left his body, we saw it. His body right before our very eyes changed.

As sad as I was at that moment, we could literally see the physical evidence that Jamie’s soul was gone. No one could kill his soul, Jamie is more alive today than ever before and experiencing those things that we only long to see.

A day is coming when Jamies body will rise from the grave and re-integrate with his soul and we will all live together on the New Earth.

This resurrection of the dead will come to everyone who has died before Jesus comes back, some will rise to eternal life and others to eternal damnation.

For the Christian, death is not a tragedy but a glorious promotion—not the sad end, but the glorious beginning.

For to me, to live is Christ, and to die is gain. ~Philippians 1:21

Uniform Determination of Death Act (UDDA)

George Bush was the current President of the United States when he commissioned the  study of defining a uniform law on death.

At the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research they recommended and concluded that, in light of the ever-increasing powers of biomedical science and practice, a statue is needed to provide a clear and socially accepted basis for making determinations of death.

The commission, composed of ten men recommend the adoption of such a statute by the Congress for areas coming under federal jurisdiction and by all states as a means of achieving uniform law on defining death throughout the Nation.

The Uniform Determination of Death Act says, An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.

Surgery No person authorized by law to determine death, who makes such a determination in accordance with the Act, should, or will be, liable for damages in any civil action or subject to prosecution in any criminal proceeding for his acts or the acts of others based on that determination. 

Note: “This act is silent on acceptable diagnostic tests and medical procedures.… The medical profession remains free to formulate acceptable medical practices and to use new biomedical knowledge, diagnostic tests and equipment.”

Different Medical Standards

Each state has passed the UDDA and it is left to each doctor or hospital to determine the “acceptable medical standards”. One hospital could require one test, another hospital two doctors, some hospitals a nurse (Michigan). Some require an Apnea test, others two Apnea tests.

Depending on where you end up in a Trauma Center or hospital your “legal death” could be determined by different standards.

Life Processes in those pronounced “Brain Dead”

Regardless of the UDDA which defined death in the United States Dr. Alan D Shewmon has compiled a list of life processes that brain-dead patients continues to exhibit: 

  • Cellular wastes continue to be eliminated, detoxified, and recycled.
  • Body temperature is maintained, though at a lower than normal temperature and with the help of blankets.
  • Wounds heal.
  • Infections are fought by the body.
  • Infections produce fever.
  • Organs and tissues continue to function.
  • Brain-dead pregnant women can gestate a fetus.
  • Brain-dead children mature sexually and grow proportionately.

The other valid argument for Dr. Shewmon’s 150 cases is that in science, all you need is one case to falsify a theory.  Teresi, Dick (2012-03-13). The Undead: Organ Harvesting, the Ice-Water Test, Beating Heart Cadavers–How Medicine Is Blurring the Line Between Life and Death

If brain death is true death, then even one case (Dr. Shewmon has 150) destroys that theory.

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