Life Support Issues/Medically Dead?


It happens that brain dead isn't dead enough for me based on my own real life experience with a loved one whose death was determined using neurologic criteria.   Whereas I do not subscribe to "brain dead = dead"    I do understand that "BRAIN DEAD = LEGALLY DEAD."

Recently mainstream media has been reporting on two very different cases involving patients who have been declared brain dead.   The pro-transplantation people have added something to the definition:  "BRAIN DEAD = LEGALLY DEAD and MEDICALLY DEAD."

Have you noticed the additional term "MEDICALLY DEAD" and can you explain what it means in this exact context?

Thank you!


"Medical" or "Clinical" Death is defined as "There is no pulse, no respiratory movement and no corneal reflex."  "Legal Death" is defined by each state, however, the Harvard Criteria is utilized by a majority of states and is defined as: 1) Unreceptivity and unresponsivity—the patient is completely unaware of externally applied stimuli and inner need. He/she does not respond even to intensely painful stimuli; 2) No movements or breathing—the patient shows no sign of spontaneous movements and spontaneous respiration and does not respond to pain, touch, sound, or light; 3) No reflexes—the pupils of the eyes are fixed and dilated. The patient shows no eye movements even when the ear is flushed with ice water or the head is turned. He/she does not react to harmful stimuli and exhibits no tendon reflexes; and 4) Flat electroencephalogram (EEG)—this shows lack of electrical activity in the cerebral cortex.  The Harvard Criteria was based on a committee finding in 1968 and was reported in JAMA.  That criteria has changed in some states due to the advancement of medicine and the need for medical transplantation of organs.

I hope this answers your very interesting questions.

Paul D. Friedman, M.A., Ph.D., J.D.

Life Support Issues

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Paul D. Friedman, M.A., Ph.D., J.D.


I have a master's degree in bioethics which inlcudes medical and research ethics. In addition to a law degree, I have a doctorate of philosophy in comparative ethics involving medicine, law and business. I also am an Adjunct Professor at a medical school.

I can answer questions related to the ethics of withholding, instituting or withdrawal of life support.

For more information, you may visit my website at WWW.EXPERTETHICS.COM


Experience in the area
I have been a practicing trial attorney since 1989 plus I have a master's degree in bioethics and a doctorate of philosophy regarding comparative ethics. I am also an Adjunct Professor at a medical school where I teach current providers and students medical ethics.

State Bar of Arizona
State Bar of Colorado (inactive)
District of Columbia Bar (inactive)
Federal Bar
Licensed in Arizona District Court
Licensed in Ninth Circuit Court of Appeals
Licensed in the United States Supreme Court
American Bar Association
National Board of Trial Advocacy
American Association for Justice
Arizona Trial Lawyers Association
American Society for Bioethics and Humanities
Kennedy Institute of Ethics
National Association of Realtors

Bachelor of Arts 1985
Juris Doctorate 1989
Master of Arts in Bioethics 2004
Doctorate of Philosphy 2006

Awards and Honors
Phi Beta Kappa
Multiple Who's Who

A list of my copyrighted publications and presentations is contained at WWW.EXPERTETHICS.COM

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