Based on the article, Inventing a new death and making it believable - by Margret Lock

Cartesian Mind Body Dualism distinguishes between substances that are physical (i.e. body and brain) and substances that are more mental (e.g. mind, consciousness, self, intentionality etc. )

This division allowed medical science to function on a physical plane, separate from things that were viewed as purview of religion (i.e. whatever it is that makes us human)

The ICU is a conceptual space mostly produced by medical knowledge and practice. It is also informed by relevant discourse in other fields (e.g. the media, law, religious bodies and popular culture) Not everyone w/i this conceptual space agrees, but once something becomes common practice everyone is complicit. Medical practitioners must resolve doubt internally and individually.

Once you are no longer in possession of whatever gives you "human status" with all the dignities and rights associated, it is not murder to remove your organs. Because of dead donor rule it was determined that the body exists only to support the brain, which is where the "individual is"

Death was medicalised with the invention of technology that could better determine time of death, and consequently allow estimation of when patient was untreatable.

Japan - doctors taking organs from not dead enough patients, giving organs to those not in need.

Texas - Doctor was accused by family member of murdering the organ donor. It was decided that the murder was committed by the bludgeoning assailant not the surgeon.

There are also the organ procurement agencies which pressure and incentivise practitioners in the ICU to produce a maximal number of organ donors

- Regardless of medical opinion, the general society needed legal framework w/i which to operate. Ethical issues of justice, beneficence and non-maleficence.

-the majority of the 32 intensivists and 8 nurses interviewed in the 1990s had not read official guidelines (North America)

- there was consensus that clinical diagnosis of brain death is straightforward

- also that brain death is the first step to eventual irreversible brain death

- but there is still some doubt. One physician expressed doubts about how 'dead' an organ donor really is. Treatment largely continues as if they are alive, though focus is on organs not patient. Nurses still speak to and care for the body (because of the family, the patient's soul is still near or respect for the dead)

- some must view patient as a vessel for self-protection

- in the end they all approve of organ donation with proper consent

Case Studies

- Transplant of 'dead' heart

http://www.bbc.co.uk/news/health-29751880


- Organ donation from newborn with anencephaly


http://www.bbc.co.uk/programmes/b04b1zlk