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578Challenges for Bioethics from Asia

Teaching About Brain Death

- Li Kuang, M.Sc. .

Biology Department, Beijing Normal University Attached Middle School, Beijing, CHINA  

Email: kuangli@sohu.com

Bioethics education is carried out primarily in medical universities and hospitals in China at present.  However, it should not only be for professionals or academics, but it should also be understood and accepted by ordinary citizens since it greatly affects people’s lives. Thus bioethics education is necessary and appropriate for high school students to reflect upon society’s ethical maturity. For those high school students, whose life values are beginning to be developed, discussion about bioethics issues can help them learn how to look at life with respect and to understand the diversity of choices from different views and cultures. At the same time, it is also does good to teachers themselves.

Outline of the class structure: 1 students` play (13min); 2 what is death?(2min); 3 what is brain death?(20min) the anatomy of brain and the criterion of brain death; 4 discussion “support or not ”(30min); 5 summarize different views(5min); 6 brief introduce brain death in China and in other countries  (10min). Student's performed and modified a play based on the plays made by Alireza Bagheri in the teaching materials for brain death and organ transplantation.

The international medical criteria for brain death from a 1968 Geneva conference were introduced (a  lose all reactions to environment;  b  lose physiological reflex and muscles rigidity completely; c  no autonomous respiration; d  arterial pulse drops swiftly if  the life maintain machines canceled; f  brain wave keeps no fluctuation).

The first brain death case from 1963 in Britain (Potter) was introduced. Potter`s brain was hurt seriously in a scuffle. With the agreement of his family the hospital excised one of his kidneys. However after Potter`s death, the hospital was prosecuted by the family for stopping the respiration machine and leading to the death of the patient. At last the hospital was declared   guilty of murder. The traditional concept of heart and breathing judgments for death was compared with the new concept of brain death. Support for the use of brain death included:

1Brain death is  not reversible, and there is no therapy replaceable .

2 Just because of the thinking activity of brain, human being become a kind of animal with intelligence. If a person lose his sensuousness forever, he is dead.

3 Much more organs are available for transplanting under brain death.  

4 The quality of life is very bad and there`s no chance to recovered even though the heart beating and breathing of patient is kept by modern machine.

5 It denies the traditional criterion itself to recover the heart beating and respiration with modern machines.

6 Those people drowned, poisoned or frozen  could be regarded as dead and miss the time for rescue if by the traditional heart-lung criterion.

Objection included:

1 The concept of brain death is against the principle of humanitarianism, which was put forward on the consideration of organ transplant.

2 It can not be tolerated that a person whose heart is still beating is sentenced to be dead for it is the willing of living which sustained humankind struggling for surviving and developing for thousands of years.

3 Public can hardly understand and accept the criterion of brain death.

4 Being hard for identify and not open of its criterion, Brain death could easily be taken advantages by crimes.

5 How to identify a infant's death since it has no consciousness.

Brain death in other countries (France, USA, Britain, Finland, Norway, Sweden, Switzerland, Germany, and Japan was compared). The first brain death in China (10 April 2003,

. pp. 578-579 in Macer, DRJ., ed., "Challenges for Bioethics from Asia" (Eubios Ethics Institute, 2004).

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