To the Editor.—
In the article entitled "The Use of Anencephalic Infants as Organ Sources: A Critique," Shewmon et al1 lament a perceived lack of respect for current definitions of death. The authors cite a history of laxity regarding determination of death in anencephalics prior to kidney procurement operations, they criticize certain medical centers for entering uncharted water in declaring particular anencephalics dead, and they invoke the "slippery slope" argument in pointing to other humans who have no greater prospects for life than anencephalics.However, toward the end of their long and heavily referenced article, the authors make a telling admission: "Inaccuracies in the declaration of brain death make no difference whatsoever from the point of view of dying, comatose patients themselves. The importance lies rather with the larger impact on society of establishing a tolerance toward sloppiness in either the conceptualization or implementation of standards for determining death."
Walters JW. Anencephalic Infants as Sources for Organs: Gravity and the Steepness and Slipperiness of Slopes. JAMA. 1989;262(15):2093. doi:10.1001/jama.1989.03430150053023
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