I. O’ Rourke’s Objection
A. His definition of "futile":
Does not enable the patient to pursue the purpose of life—spiritual
B. Reply: Implicit Dualism /
II. PVS Patients and ANH
A. PVS and ventilators, amputation, etc.—often extraordinary care
B. not a bad "quality of life judgment"
C. life + other goods vs. life only—makes a difference /
III. Euthanasia and the Law
A. purpose of law
B. Results of legalizing assisted suicide:
1. pressure
2. nonvoluntary euthanasia (equal opportunity)
3. general message: life a mere instrumental good/
IV. DNR
A. Resuscitation—always ordinary?
B. Involves more than what’s seen on TV
C. Dying vs. not dying—important, not necessarily decisive/
V. Organ Donation
A. Inter Vivo
B. not principle of totality
C. side effect
D. non-vital organs—otherwise direct mutilation/
VI. Definition of Death as Whole Brain Death
A. Problem—three systems
B. Law = Whole Brain Death
C. Rationale: = total cessation of integrative function of the organism (no unitary organism any more) /
VII. UDDA
Either (a.) irreversible cessation of function of he circulatory and respiratory systems
Or: (b.) total and irreversible cessation of function of the entire brain, including the brain stem /
VIII. Rationale
A. Death = loss of integrative function of organism
B. no longer a single organism
C. Brain = primary organizer /
IX. Challenge to Brain Death
A. Alan Shewmon
B. counter-examples (178 cases)
C. No need for primary material organizer
D. Brain = modulator of pre-existing unity /
X. Who’s Right?
A. objection to Shewmon: misdiagnoses?
B. unity could be artificial?
C. Most Neurologists not convinced
D. Pontifical Academy of Life, and Pope (says the brain death criterion can be used –not absolutely committed/
X. Implications for Transplants
A. Non-Heart Beating Donor
B. Removal of heart—does not involve intending death, nor even causing or hastening death
C. Pittsburgh Protocol (asystole, 2 minutes, extraction) /