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October 10, 1990

Road to Euthanasia or Right to Refuse Care?-Reply

Author Affiliations

Rush-Presbyterian—St Luke's Medical Center Chicago, Ill

Rush-Presbyterian—St Luke's Medical Center Chicago, Ill

JAMA. 1990;264(14):1810. doi:10.1001/jama.1990.03450140029020

In Reply.—  Dr Sananman correctly points out that the whole-brain criterion of death has been accepted widely in the United States among medical professionals and state governments. However, to say this is not to exhaust the concept of "death." There is a body of opinion that would define death as "the loss of those brain functions that support awareness and cognition."1,2 As a step in the direction of acceptance of this definition we note a growing tendency to withdraw life support from persons in the persistent vegetative state.3 In this sense the "range of those regarded as dead" has widened.The debate about the definition of death continues and will do so until in some way or another the technical criteria for determining death are derived from a broader philosophical concept of its meaning.1-3