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The neurological criteria for the determination of death remain
controversial within secular and Catholic circles, even though they
are widely accepted within the medical community. In Determining
Death by Neurological Criteria, Matthew Hanley offers both a
practical and a philosophical defense. Hanley shows that the
criteria are often misapplied in clinical settings, leading to
cases where persons declared dead apparently spontaneously revive.
These instances are often connected to a rushed decision to
retrieve donated organs, thus undermining the trust of the public
in organ donation. Hanley calls on health care institutions to take
seriously their obligation to establish strict protocols for the
determination of death, including who may conduct the examinations.
From a broader perspective, Hanley considers how the criteria rely
on a philosophical conception of the person as a living organism
whose unity disintegrates at death. This view, he notes,
corresponds to the Catholic conviction that the soul is the
life-principle of the body, which departs at death, bringing about
the destruction of the body-soul composite. The Vatican,
recognizing that death is a medical judgment, has generally given
its approval to the criteria. Hanley also reviews the many and
various objections offered by detractors, including against the use
of the apnea test, which is faulted as a practice that sometimes
hastens death. The problem of the continued presence of certain
vital functions within the deceased body of the brain dead is
explored in detail, with reference to particular cases and to
solutions proposed by leading physicians and bioethicists. Hanley
likewise addresses the dilemma of having two separate standards for
death, one neurological and the other cardiopulmonary. Given the
possibility of resuscitation following loss of the
cardio-circulatory system, he concludes that the neurological
criteria must be the true standard. Stoppage of the heart leads
swiftly to the final necrosis of the brain.
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