How to Deal With the Brain “Death” Issue

By Reason McLucus

The controversy over Terri Schiavo demonstrates the need for a better law to determine the fate of those with brain damage whose hearts still function without artificial support. The matter should not be left to the discretion of judges who lack the training to understand medical conditions. The decision certainly should not depend upon hearsay testimony from anyone, particularly a spouse, about the patient’s wishes. In general, spouses(including former spouses) are one of the biggest category of murderers. Any decision should consider the latest in medical knowledge, including rehabilitation therapies. The termination of all life functions in such cases should be done using the most humane method possible rather than by starving the person to death

In the absence of a signed and witnessed document stating the patient’s wishes, complete agreement should be required of all the patient’s closely related adults: parents, spouse and adult children. Agreement by parents and children is more important than agreement by a spouse. The spouse is more likely to have a vested interest in the death such as by inheritance and the possibility of the spouse having abused(note: women are also capable of abusing a spouse) the patient. Those who have been abused often keep that knowledge secret even from parents and children. Adult children may also be in a position to benefit from the death through inheritance. Parents are the least likely to benefit from the death. The mother who produced the “patient” is one most likely to care about what is best for the patient, although this is not always the case.

A common misconception is that providing a feeding tube is a form of artificial life support. Artificial stimulation of the heart is life support because the heart’s continuous function is essential for continued life. The body can survive without food and water for significant periods. Providing nutrients and fluids affects the quality of life rather than life itself in the short run. Many medical conditions, including paralysis, may require assistance through use of feeding tubes or IV’s.

Scientists are discovering that the brain is more complex than previously thought. The brain was once believed to be relatively fixed at an early age with no significant new cell growth thereafter. Recent research indicates the body can replace damaged brain cells under certain conditions. Research also indicates that brain functions may not be as rigidly situated in specific areas of the brain as previously though. Other areas may be able to take over functions of damaged areas. The extent of this process is still unknown with further research needed. Any decision to end the life of someone with brain damage should thus be made using the most recent knowledge available.

The court or other body making the decision to end the life of someone with brain damage should consult those doing the latest research. No action should be taken to terminate a life until all established and experimental therapies have been attempted. A determination of brain death should include evaluation of the patient’s brain using all known means of studying brain activity, including checking for brain waves – the accepted measurement for determining brain death. X-rays of brain damage are insufficient to indicate brain activity. Complete agreement that the patient’s brain is not functional and will not respond to known treatment should be required for a decision to end all biological life..

Scientists cannot be absolutely certain of what goes on in the brain. The fact that the patient may not be able to communicate doesn’t mean he or she is unaware of what is going on in the external world or cannot feel pain. In the event the patient may still feel pain, the action to end a life should minimize the possibility the patient will suffer. Withholding nutrients and fluids is inhumane and should never be used so long as the patient can process them. Some medical conditions may preclude providing nutrients or fluids because the patient can no longer process them. 

Withholding nutrients and fluids isn’t “letting someone die”. It is killing whatever parts of that body is still alive. The action should be quick and painless rather than drawn out. If serial killers deserve a humane means of ending their lives, then the same should apply to people with incapacitating conditions.