The 50-Year Legacy of the Harvard Report on Brain Death
JAMA. Published online June 7, 2018. doi:10.1001/jama.2018.6990
Posted: 25 Jun 2018
Date Written: June 7, 2018
This Viewpoint discusses the the ethical challenge of defining death in persons with irreversible coma, legalization of the definition of brain death in the 1981 Uniform Determination of Death Act, and current implications of the definition for decisions about life support, organ transplantation, and newer genetic technologies.
On August 5, 1968, an ad hoc committee at Harvard Medical School published a landmark report that laid the groundwork for a new definition of death, based on neurological criteria.The authors, under the leadership of anesthesiologist Henry Beecher, stated that their primary purpose was to “define irreversible coma as a new criterion for death.” The concept of brain death has guided clinical practice for 50 years even though vigorous debate about its legitimacy has never ceased.
History is full of ironies, and the 50-year legacy of the Harvard report is no exception. From one perspective, the report laid the foundation for laws that have both saved and improved the lives of hundreds of thousands of patients through organ and tissue donation. Conversely, decades of attempts to find a conceptual justification for linking this diagnosis to the death of the patient remain incomplete.
Keywords: brain death, death, UDDA, organ transplantation
JEL Classification: I18, K32
Suggested Citation: Suggested Citation