by Paul A. Byrne, M.D.

A recent Forum contributor pointed out that "...even when there is a heart beat, brain dead is dead."

If brain death and death were identical and equivalent, there would not be a need for both terms. So what is the difference and how does it apply?

"Brain death" is a diagnosis made after something has occurred that puts a patient in an intensive care unit on a ventilator. When a light is shined into the eye, no pupil response is seen. When ice water is put into the ear, no response is seen. There is no cough or gag reflex. The heart is still beating at normal rate. The blood pressure is normal. The patient is warm and pink. Isn't that different from cold, blue, and stiff?

While it is "legal" to pronounce brain death and then excise organs for transplant, it would not be just to charge someone with murder when the victim is still alive. After death, the heart cannot be used for transplant. It is indeed unfortunate that the desires of human beings cause them to cast aside principles to which they might otherwise adhere.

Brain death and death are not identical and equivalent. It does make a great difference to the one having the case for brain death imposed upon him, to the one about to be charged with a crime, and it should make a great difference to everyone involved in organ transplant and indeed to everyone because any one of us or someone we love could be involved in a similar way at any time.

In this case, if the victim is not dead, and thus a charge of murder cannot be made against another, how can the still beating heart be excised for transplant? Is the victim really dead? Are the donors really dead?