“Brain Death” is not Death

Brain death has been used to decide whether to keep sustained care and treatment. It can facilitate tissue, organ, and body donation for several purposes, such as transplantation and medical education and research. In Japan, brain death has strict diagnostic criteria and family consent is crucial, but it has been a challenging concept for the public since its introduction, including knowledge and communication issues. We analyzed data across YouTube and Twitter in Japan to uncover actors and assess the quality of brain death communication, providing recommendations to communicate new medical technologies. Using the keyword "" (brain death), we collected recent data from YouTube and Twitter, classifying the data into 5 dimensions: time, individuality (type of users), place, activity, and relations (hyperlinks). We employed a scale to evaluate brain death information quality. We divided YouTube videos into 3 groups and assessed their differences through statistical analysis. We also provided a text-based analysis of brain death-related narratives. Most videos (20/61, 33%) were uploaded in 2019, while 10,892 tweets peaked between July 3 and 9, 2023, and June 12 and 18, 2023. Videos about brain death were mostly uploaded by citizens (18/61, 27%), followed by media (13/61, 20%) and unknown actors (10/61, 15%). On the other hand, most identified users in a random sample of 100 tweets were citizens (73/100, 73%), and the top 10 retweeted and liked tweets were also mostly authored by citizens (75/100, 75%). No specific information on location was uncovered. Information videos contained guides for accreditation of the National Nursing Exam and religious points of view, while misinformation videos mostly contained promotions by spirituality actors and webtoon artists. Some tweets involved heart transplantation and patient narratives. Most hyperlinks pointed to YouTube and Twitter. Brain death has become a common topic in everyday life, with some actors disseminating high-quality information, others disseminating no medical information, and others disseminating misinformation. Recommendations include partnering with interested actors, discussing medical information in detail, and teaching people to recognize pseudoscience.

Traditionally, death has been determined by observing the cessation of respiration and circulation. Technological developments in the middle of the twentieth century led to a new conception of death based on neurological criteria: the cessation of the functioning of the entire brain. This development greatly facilitated the emerging life-saving technology of organ transplantation. In this chapter, drawing on scientific research, we challenge the established view that "brain death" constitutes death. Not only do patients who meet the diagnostic criteria for "brain death" retain some brain-mediated functions, they also continue to maintain a broad array of biological functions with the aid of mechanical ventilation. We conclude that "brain death" is inconsistent with the biological definition of death that underlies medical practice in determining death. A recent effort by the President's Council on Bioethics to uphold "total brain failure" as compatible with a biological conception of death fails to withstand critical scrutiny.

50 years after its introduction, brain death remains controversial among scholars. The debates focus on one question: is brain death a good criterion for determining death? This question has been answered from various perspectives: medical, metaphysical, ethical, and legal or political. Most authors either defend the criterion as it is, propose some minor or major revisions, or advocate abandoning it and finding better solutions to the problems that brain death was intended to solve when it was introduced. Here I plead for a different approach that has been overlooked in the literature: the philosophy of science approach. Some scholars claim that human death is a matter of fact, a biological phenomenon whose occurrence can be determined empirically, based on science. We should take this claim seriously, whether we agree with it or not. The question is: how do we know that human death is a scientific matter of fact? Taking the philosophy of science approach means, among other things, examining how the determination of human death became an object of scientific inquiry, exploring the nature of the brain death criterion itself, and analysing the meaning of its core concepts such as “irreversibility” and “functions”.

PART I of this article established the scientific validity of current clinical and laboratory criteria for determining complete destruction of the brain or brain death. It also showed that total destruction of the brain constitutes a determinant of death, which is in accord with secular philosophy and the three major Western religions. In part II, legal issues that arise from use of brain-related criteria to pronounce death are considered. <h3>NEED FOR STATUTORY RECOGNITION OF BRAIN DEATH</h3> The fact that physicians can recognize total and irreversible destruction of the brain on the basis of clinical and laboratory criteria is accepted and commonly utilized in many areas of the world. The need to make such pronouncements is based primarily on the requirement of society to respond appropriately to two recent advances in medical technology. The first is the hardware that can artificially maintain lung and heart action in the absence of spontaneous

While both living donation and donation after circulatory death provide alternative opportunities for organ transplantation, donation after donor brain death (BD) still represents the major source for solid transplants. Unfortunately, the irreversible loss of brain function is known to induce multiple pathophysiological changes, including hemodynamic as well as hormonal modifications, finally leading to a systemic inflammatory response. Models that allow a systematic investigation of these effects in vivo are scarce. We present a murine model of BD induction, which could aid investigations into the devastating effects of BD on allograft quality. After implementing intra-arterial blood pressure measurement via the common carotid artery and reliable ventilation via a tracheostomy, BD is induced by steadily increasing intracranial pressure using a balloon catheter. Four hours after BD induction, organs may be harvested for analysis or for further transplantation procedures. Our strategy enables the comprehensive analysis of donor BD in a murine model, therefore allowing an in-depth understanding of BD-related effects in solid organ transplantation and potentially paving the way to optimized organ preconditioning.

Advances in medical technology have led to both clinical and philosophical challenges in defining death. Highly publicized cases have occurred when families or communities challenge a determination of death by the irreversible cessation of neurologic function (brain death). Parallels can be drawn in cases where an irreversible cessation of cardiopulmonary function exists, in which cases patients are supported by extracorporeal cardiopulmonary support, such as extracorporeal membrane oxygenation (ECMO). Two cases and an ethical analysis are presented which compare and contrast contested neurologic determinations of death and refusal to accept the irreversibility of an imminent death by cardiopulmonary standards. Ambiguities in the Uniform Determination of Death Act are highlighted, as it can be clear, when supported by ECMO, that a patient could have suffered the irreversible cessation of cardiopulmonary function yet still be alive (e.g., responsive and interactive). Parallel challenges with communication with families around the limits of medical technology are discussed. Cases that lead to conflict around the removal of technology considered not clinically beneficial are likely to increase. Reframing our goals when death is inevitable is important for both families and the medical team. Building relationships and trust between all parties will help families and teams navigate these situations. All parties may require support for moral distress. Suggested approaches are discussed.

The concepts of hope and the medical miracle are ubiquitous in modern medical practice and can often become central aspects of a critically ill patient’s or his family’s hospital experience.1–3 Cases where these beliefs are especially strong even make their way into mainstream media, as in the 2013 case of the California teen who became brain dead after a complication from a tonsillectomy. In this case, her family fought a widely publicized court battle to be able to keep her on mechanical support and move her out of state to another facility. They believed that, despite what was explained to them regarding the diagnosis of brain death, their daughter would one day recover.4 A high prevalence of spirituality within the American population serves as a foundation for expectations in miracles5 and pediatricians may frequently encounter similar ideas in conversations with families. Despite all of the limitations in contemporary practice, physicians are acutely aware of the popular confidence in medical technology and the tendency for families to hope for outcomes that are medically unattainable. The unprecedented explosion of rapid medical advancement through the 20th century has helped to perpetuate the belief that technology has the ability to repair any affliction. With the advent of the mechanical ventilator and proliferation in its use from the 1960s to 1970s, it was suddenly possible to even prevent death. The new technology mandated the medical community to outline technical definitions of cardiac death and brain death, which is a debate that continues … Address correspondence to Bonnie H. Arzuaga, MD, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Rose-3, Boston, MA 02215. E-mail: barzuaga{at}bidmc.harvard.edu

Pregnancy is a biological process that usually takes forty weeks. The more advanced pregnancy is in terms of gestational age, the higher the chances that the fetus would survive in case of a premature and unnatural delivery. Hence, when a pregnant woman is struck by brain death, the fetus’ chances of survival are seriously and immediately threatened. Until recently, there were two choices in such a situation: letting the mother (and the fetus) naturally die without further intervention or delivering the fetus through a cesarean section when the death of the fetus was a tragic but likely result.Recent advances in medical technology, however, have provided physicians with an ability to control over the time and manner of death in ways that were never previously considered by their patients.

Background: With the trend of international integration, many universities in Vietnam have incorporated English proficiency into the criteria for evaluating students’ achievement of competency standards, reflecting the institutions’ recognition of the importance of English in education and training. Enhancing English skills enables students in general, and particularly those in the health sciences, to access a wide range of academic resources from various educational organizations, thereby acquiring new knowledge that supports more effective learning and research. Among the four fundamental language skills, speaking is considered the most critical, as it plays a central role in foreign language acquisition. The success of learning a foreign language is often measured by the learner’s ability to communicate effectively in that language. Objectives: To describe the difficulties in practicing English speaking skills among undergraduate students at the Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy. Materials and methods: A cross-sectional descriptive study with total population sampling method was conducted on 729 students of the Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy. Data were collected by using the questionnaire which was established by Pham Minh Thu. The questionnaire assessed the difficulties in practicing English speaking skills with 4 fields including: linguistics, psychology, learning environment, and teaching methods. Results: The average scores for difficulties related to linguistics, psychology, learning environment, and teaching methods were 3.92±0.54, 3.99±0.54, 3.72±0.67, and 3.01±1.00, respectively. Conclusion: The study indicates that students from the Faculty of Nursing and Medical Technology face numerous difficulties in practicing English-speaking skills, which are related to linguistic factors, psychological aspects, and the learning environment. Therefore, organizing seminars or English clubs and create opportunities for students to engage in interactions with international students to improve their English-speaking skills are truly necessary.

What Does the Korean Medical Association Need to Talk About?

Using the example of 'sperm tales', borne out of the biomedical technologies that went hand in hand with the establishment of the 'science of man' (andrology), the article engages with the epistemic evolution of interrelated biomedical theories and concepts of what constitutes a 'healthy' reproductive male body. The article asks: how has the normative ideal male body been either perpetuated or interrogated through these tales of male reproduction at the interface between scientific and medical technologies? And how were changes to the normalization of male bodies central to clinical practices and cultural understandings of health and illness? With many aspects of the medical history of male reproduction in the 20th century still unexplored, this article will focus on the growing intervention of biomedicine to 'treat' male infertility by way of the classification, standardization and normalization of male corporeality, focusing in particular on the representation and construction of men and the male body, as reflected in medical science and practice from the second half of the 20th century onwards in Germany. The article analyses the rise in importance of sperm in biomedical investigation, including a consideration of the construction of infertility as the defining force behind concepts of 'healthy men', and examines the related conceptualization of male reproductive bodies at the crossroad between 'healthy' and 'normal'. It is argued that the ideal of male reproduction as being inherently healthy has lost ground. By the late 20th century, male bodies have become vulnerable, at least as represented in medical science and technology.

The International Congress on Health Sciences and Medical Technologies is a periodical congress. It held three times regrouping several researchers and organization active in technology and medical research. With the contribution of universities, research centers, companies and publishers the congress was established at Algerian cities (Tlemcen, Algiers). This report describes the congress achievement through these three past years and announces its’ new edition.

Scientific reasoning is the ability to think about the characteristics of formal development to master concepts and solve physics problems. Physical problem solving requires a high level of thinking that is a combination of reasoning namely conceptual and general mathematical equations. The student’s thinking ability that is inconsistent with their formal developmental stage is the cause of the student’s scientific reasoning lack. The purpose of this study is to analyze the common false made by students during their scientific reasoning process. This research is a qualitative descriptive with the aim at describing common error of scientific reasoning with the physics problem. Scientific reasoning tests were given to 108 students who had studied physics using mixed methods of lectures and assignments. Results showed the false of each component of the student’s scientific reasoning. Student’s scientific reasoning was dominated by competence level. The quality of claims, arguments, and levels of student’s confidence in giving answers was still low. Students experienced false scientific reasoning and weak concepts when confronted with physics problems. The important recommendation of this study is that the learning process needs an innovation to overcome false and inconfident feeling in the process of scientific reasoning and mastery of student concepts.

The objective of this study was to investigate students in Grade 9 on scientific reasoning skills by combining basic learning about advertising. The s amples were 30 students in Grade 9 at Khon Kaen Demonstration Secondary School, Khon Kaen Province. In this study, interpretative paradigm was used to analyze teaching and learning activities aiming at enhancing students’ scientific reasoning skills through advertising as literature. Data were collected from class observation and assignment that reflect students’ scientific reasoning process based on the Four-Phased Approach of Reasoning proposed by Wu [1] that consists of 4 phases: (1) Issues identification as to identify key issues, (2) Clarification as to clarify personal views or attitudes toward issues, (3) Discussion and Defense as to logically present viewpoints and discuss them, and (4) Synthesis and Conclusion. Students were challenged to express their arguments regarding adverting they have exposed to and seek appropriate solutions to the problems. Students’ scientific reasoning process to analyse advertising as knowledge literacy also reflects their problem-solving skills. The results showed that students could express their opinions in logical thinking process by starting from 1) identifying issues, 2) clarifying viewpoints on adverting, 3) discussing and defensing, and 4) synthesizing and concluding. Therefore, using advertising as literature to induce students can significantly develop their scientific reasoning skills . This study also presents practical implications to enhance students’ scientific reasoning through learning activities of literary advertising.

This paper examines the relationship between medical technology and liminal states of "undeath" as presented in "The Facts in the Case of M. Valdemar" and the real-life case of Jahi McMath, who was maintained on life support for over four years following a diagnosis of brain death. Through this juxtaposition, "Valdemar" comes to function as a modern fable, an uneasy herald of medical technology's potential to create liminal states between life and death. The ability to transgress these boundaries bears a cost, however: both Valdemar and Jahi McMath lose the autonomy to direct their respective narratives. Yet, their utterances "from beyond the grave" highlight the precarious nature of their position and the ethical concerns therein. Poe's literary performance of "undeath" thereforeserves to caution real-life cases in which life support is used to sustain an individual reported to be brain-dead. Such application of life-sustaining technology complicates the fundamental binary of life/death, allowing its subjects to resist textual closure. Even as Poe's work represents an imaginative interrogation of the scientific enterprise, this nineteenth-century story holds a mirror to contemporary medical practice, inviting a reconsideration of the ethics, language, and power relations surrounding the fraught relationship between death and medical technology.