In 1968, Harvard Medical School changed the definition of death. It no longer based on cardiac and circulatory arrest but on a flat electroencephalogram. Electroencephalography is useful but not essential in determining brain death. It amounted to a radical change in the conception of death. The Catholic Church has also implicitly accepted this definition of death but with many reservations.
The scientific justification lies in the definition of the nervous system that casts doubt precisely on the fact that the brain causes the disintegration of the body. Since then, the organ indicative of death is the brain, no longer the heart. Before the invention of life-support systems, brain death always led quickly to death of the body. With new technology patients who were dead could still have a heartbeat and gave the false impression that they were very much alive while kept on a ventilator, giving hope to grieving families that the person may suddenly wake up. This false hope sometimes prevents their families from donating their organs but it may also be prompted by a specific interest i.e. the need for organs transplants.
Hence, ethical considerations are crucial to defining criteria for brain death, which in most countries must be met before efforts to extend life may be ended. Such criteria include deep coma with a known cause, absence of any brainstem functions and the exclusion of hypothermia, drugs, and poison as causes. Organ donors must therefore be declared brain-dead before their organs may be removed for transplant. These considerations obviously give rise to new bioethical problems for the Catholic Church. An interesting question is when can life support be legally end and who will play God? Although this is one of life's most painful experiences, it also can be a rich time of expressions of love and gratitude.
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