Twentieth Century Medical Technology, Brain Death, and Somatic Limits of the Self

Twentieth Century Medical Technology, Brain Death, and Somatic Limits of the Self

Luciana Kind

This project discussed medical technology achievements of the twentieth century, which enabled a scientific interdisciplinary debate to redefine death, and the consequences for the notion of “human being.” Noticeable rearrangements had to be done to enclose death in medical terms, among them, the argument of personal identity loss. Two adverse assumptions had to be vigorously defended: the precision of the moment of one’s death, despite the continuity of breath and heart functions with life support machinery, and the reduction of personal identity to one’s brain.

The offspring of such a nuanced debate is the so-called brain death. Somewhat controversial, this definition was officially presented to American public in a four-page report by the Ad Hoc Committee of Harvard Medical School to Examine the Definition of Brain Death. The report was entitled “A Definition of Irreversible Coma” and published in the Journal of American Medical Association, in August 1968. Before that publication, the definition for a new category of coma was described by French neurologists Mollaret and Goulon (1959) and Jouvet (1959). Named as coma dépassé, a situation beyond previous coma descriptions, it signalized unprecedented medical problems after the artificial respiration improvements in the 1950s.

Even though it produced a lively dialogue among scientists and in society in general, the endeavor of redefining death is an inheritance of earlier discussions raised by the ordinary use of extraordinary procedures in medical practice. The devices and techniques developed in the early twentieth century, for instance, artificial respirators, advances in anesthesiology, and intensive care units, were rapidly incorporated into medical practice. The subsequent developments, such as improvements in organ transplantation, also deserve some attention.

Therefore, the project examines early twentieth century medical technologies that preceded brain death definition, describe how those technologies helped to frame what is a “human being,” and determine the end of personhood. Hence, we intend to deal with the transformations of the very notion of “human being” that appeared in medicine-based literature from the 1920’s to the 1980’s. A shift can be observed in this period. Until the 1960’s, there was a concern with the “experimentation in human beings,” when the debate was oriented by the notion of “biological organism.” From the 1960’s to the 1980’s an enterprise to locate the human attributes in the brain took place. Then, there was an appraisal of “Lockean personal identity” concept in medical literature.

One first hypothesis to be discussed was that, since the first publications analyzed, the efforts to redefine death were grounded in a “somatic selfhood.” But, the conception of “human being” oscillated from an image of a whole individual to a commodified body. An apex of this discussion is the location of one’s humanity into the head, precisely, in one’s brain. Specialists from different fields of study accepted this idea, renaming “brain-dead” those novel sort of patients, “plugged in” life-supporting technology. To analyze this debate, the idea of cerebral subject, “anthropological figure” presented by Fernando Vidal (2005), was employed. By proposing to widen the discussion with medical publications from the 1920’s to the 1980’s, the project group intended to problematize some allegations historically related to the definition of brain death.

Funding Institutions

CAPES—Brazilian Agency for the Advanced Training of University Personnel