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Comment & Response
October 9, 2018

Biological, Legal, and Moral Definitions of Brain Death

Author Affiliations
  • 1Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, Ontario, Canada
JAMA. 2018;320(14):1494. doi:10.1001/jama.2018.10980

To the Editor Brain death, as Dr Truog argued in a Viewpoint, is a concept that blends both medical and legal information.1 He pointed out that while the law often requires drawing bright-line distinctions between categories—guilty and innocent, dead and alive—biological domains tend to be more continuous and less discrete. We would like to suggest that there is a relevant moral component as well, in that different communities and cultures may have views of personhood that diverge from those contained in legal statutes or medical guidelines. Without the necessary moral assumptions, there is no direct inference from brain death to person death: in other words, stakeholders need to agree a priori that brain death equates to person death for it to carry the medical and legal meanings implied in the Uniform Declaration of Death Act (UDDA). As shown in the unfortunate case of Jahi McMath, this is not always a given.