Adams, Raymond, 5, 8, 168, 170, 192–94, 203 n36
After Virtue (MacIntyre), 227
Akinetic mutism, 147, 153, 192
Alexander, Leo, 33
American Society of Electroencephalography, 164
Ayd, Frank J., 17
Baker, Jeffrey C., 113
Bard, Philip, 144–45, 147, 186
Barger, Clifford, 5
Barnard, Christiaan, 6
Becker, Lawrence, 215
Beecher, Henry K.
analgesia studies, 56–57, 87 n12
death criteria views of, 63–74, 84–85,
on EEG as confirmatory test, 193–94
Eliasburg Manuscript, 51–55, 53f
ends justify means argument, 61–64, 66–69, 83–84, 222
“Ethics and Clinical Research,” 60
on ethics and science relationship, 61–63
experimentation and ethics, 55–64, 87 n12, 88 n23, 88 n25, 89 n36 (see also experimentation)
Experimentation in Man, 87 n12
informed consent, 46 n73, 57–62, 88 n25, 221
pragmatism, xvii–xviii, 63–64, 72–74, 89 n36, 200, 222, 225, 235
Research and the Individual, 58, 61, 62, 66, 80, 85, 87 n12
Belmont Report, 233
Bioethics
autonomy, xxvii, 54, 219-, 235
conceptual turn xxv, 212–19, 246 n38
ends justify means argument, 63–64, 90 n47, 222
healthcare ethics consultation (HCEC), 206–7, 233
naturalism in, 226
problems of wicked complexity, 239–43
reasoning by analogy, 217–19, 246 n38
as simulacra of morality, 227–29
The Birth of Bioethics (Jonsen), 8, 90 n47
Black, Peter McL., 210
Black’s Law definition of death, 70–71, 93, 96–97, 103–4, 117–18
Brain death
American Neurological Association, 210, 211, 245 n17, 245 n18
autopsy evidence, 150–51, 161 n75
biological integration functions, 214–18
brainstem vs. whole brain emphasis, 182–83, 188–90, 192–93, 195, 210–11
“Collaborative Study of Cerebral Death,” 209–10
“conceptual turn”, accounts of brain death 212–220
cortical activity in determination of, 188–97, 204 n46
EEG/physical examination findings, 11–13 43 n26, 71–72, 208–12
human experimentation connection to, 55
irreversible loss of activity detection, 124–29, 155 n2
Minnesota criteria, 209
President’s Commission on Ethical Problems in Medicine and Biomedical and Biobehavioral, Research, xv, xxviii n3, 213, 245 n24
President’s Council on Bioethics, xv, xxviii n3, 219, 246 n42
triad (see Schwab)
Brainstem/consciousness relationship, 188–97, 204 n46
Bremer, Frederic, 130, 132, 136, 148
Brickley, William, 124–26, 154, 155 n2
Bronowski, Jacob, 63
Calculus of suffering, 15–16, 20–23, 43 n36, 69, 170
Callahan, Daniel, 65, 70, 77–78, 226
Cancer patients
truth-telling (disclosure), 25–32, 45 n66, 68
withdrawal of treatment, 21–23
Cobb, Stanley, 138, 139–41, 144
Coma
coma dépassé, 149–51, 160 n70, 187, 196
criteria, standardization of, 198–200
The Diagnosis of Stupor and Coma (Plum/Posner), 184–88, 203 n36
EEG vs. physical findings in death determination, 151–53, 162 n84, 162 n88, 188–96
neurologic status in limitations of care, 177–88, 203 n36
patients, neurological examination of, 173–74, 180–88, 203 n25
persistent vegetative state, 192–93, 218–19
Culver, Charles, 215
Curran, William J.
Curran’s notes, 42 n21, 94–100, 120nn5, 222
on experimentation, 38
Dana Foundation, 241
Death. see also brain death
Black’s Law definition, 70–71, 93, 96–97, 103–4, 117, 118
concepts of, xiv–xv, 1–3, xxviii n2, 212–220
as continuous event, 84–85, 224
Decerebrate preparation, 127–28, 146–47, 186
The Diagnosis of Stupor and Coma (Plum/Posner), 184–88, 203 n36
Ebert, Robert H., 4–6, 41 n16, 62
Economo, Constantin von, 134
EEG
alpha EEG rhythm, 142
ambiguity of interpretations, 151–152, 179–81, 190
brain death, cortical activity in determination of, 188–97
cardiac arrest case studies, 148–49, 160 n68
centrencephalon, 147
coma, EEG vs. physical findings in death determination, 151–53, 162 n84, 162 n88, 188–96, 208–212
as confirmatory test, 178–79, 193–95, 208–9
EEG, EKG tracing comparison, 123–27, 155 n2
James-Lange theory of emotion, 135
EEG and Clinical Neurophysiology, 164
Eliasburg Manuscript, 51–55, 53f, 167
Emerson, Jack, 14
Encephalitis lethargica, 134
“Ethical Absolutism and the Ideal Observer,” 75
“Ethics and Clinical Research” (Beecher), 60
Ethics in Medical Progress, 109
Experimentation
Beecher’s ethics, 55–64, 87 n12, 88 n23, 88 n25, 89 n36
informed consent, xxii, 10, 32–40, 47 n93, 48nn94–94, 49 n97
medical knowledge vs. medical ethics, 36–40
pragmatism, 63–64, 73–74, 89 n36, 222, 225
quality and accountability, 39–40, 60–62, 69–70, 232–35
randomized clinical trial, 37, 88 n23
therapeutic/nontherapeutic distinction, 34–36, 37, 57–60
“usual doctor–patient relationship,” 58–59
Experimentation in Man (Beecher), 87 n12
Feinstein, Alvan, 231
Fessard, Alfred, 140, 147, 159 n43
Finesinger, Jacob, 27
Firth, Roderick, 75–76, 90 n67
Fischer, C. Miller, 94, 182–84, 203 n25
Fisher, C. Miller, 174
Fletcher, George P., 114
Fletcher, Joseph, xvi, 5, 62–63, 66, 73, 80, 82–84, 223–24
Gaylin, Willard, 65
Gervais, Karen 216
Good, Byron, 235
Gregg, Alan, 139
Gregory, John, 28
Hamlin, Hannibal, 171–72, 189, 202 n19
Harding, Vanessa, 2
Healthcare ethics consultation (HCEC), 206–7, 233
Heidegger, Martin, 85
Henderson, Scott, 42 n21, 221–22
Herrick, C. Judson, 135
Hess, Walter Rudolph, 133, 135, 136, 157 n24
Informed consent
clinical equipoise, 59–60, 88 n25
“Ethics and Clinical Research” (Beecher), 60
experimentation, xxii, 10, 32–40, 47 n93, 48nn94–95, 49 n97, 56–61, 87 n12 (see also experimentation)
physician’s care, acceptance of, 56–58, 87 n12
quality and accountability, 39–40, 60–62, 69–70, 232–35
transplantation, 221
truth-telling, 25–32, 45 n68, 46 n73, 59–60
“usual doctor–patient relationship,” 58–59
Institute for Healthcare Improvement, 233
Institute of Medicine, 233
Intermittent positive pressure breathing machines (IPPBs), 14–15, 43 n30
Ivy, Andrew C., 33
Jackson, Hughlings, 136
Jasper, Herbert, 133, 134, 136, 138–39, 144, 148, 164
Jewson, Norman, 237
Jonas, Hans, 67–70, 77, 85–86, 89 n42, 143–44, 219
Jonsen, Albert, 8, 35, 89 n42, 90 n47
Justification
calculus of suffering narrative, 15–16, 20–21, 170
consciousness and function, 71–74
ends justify means argument, 61–64, 66–69, 83–84, 222
fallacy of the generalization of expertise, 76–77
human experimentation (see experimentation)
moment of death ambiguity, 1–3, 20–21, 44 n44, 64–69, 223–225
pragmatism, xxvii–xxviii, 63–64, 73–74, 89 n36, 222, 225, 235
quality and accountability, 39–40, 60–62, 69–70, 232–35
“the right to be let alone,” 51–55, 53f
Katz, Jay, 30
Kennedy Institute of Ethics, 65, 77
Kuriyama, Shigehisa, 242
background consensus, 96–99, 103–6
Black’s Law definition of death, 70–71, 93, 96–97, 103–4, 117, 118
Curran’s notes, 94–100, 106, 120nn5–5, 222
EEG assessment of brain activity, 113, 118, 122 n48
omission of treatment, 114–15, 122 n50
Pettigrew v. Pettigrew, 108
Pierce v. Swan Point Cemetery, 108–9, 121 n37
Schmitt vs Pierce, 102–5, 121 n26
Smith v. Smith, 92, 95–96, 100–102, 120 n5
timing of death, 94, 95, 100–106, 115–118, 120 n5
Uniform Anatomical Gift Act, 106–7, 110–11
Uniform Simultaneous Death Act, 100–105, 118
willed disposal of corpses, 108–9
Lindsley, Donald, 133, 137, 138, 142, 185
Luria, A. L., 163
Magoun, Horace W., 123, 132–34, 136, 138–39, 145–48, 182, 185, 186
Massachusetts General Hospital (MGH), xiv, 3. see also specific individuals
coma, care of, 170–184, 188–200
intensive care technology, 171–73, 202 n15, 202 n19, 202 n21, 202 n23
medical records, 174–177, 43 n26
respirator use historically, 14, 170–71
Mead, Margaret, 137
Medical knowledge
clinical equipoise, 59–60, 88 n25
evidence-based medicine, 232
fallacy of the generalization of expertise, 76–77
medical facts vs. ethical values, xvi–xvii, xxii–xxiii, 7–8, 38–39, 74–87, 90 n67, 90 n69, 143–44, 205–7, 224–35, 243 n1
patient-centered care, 234
physician privilege vs. patient prerogative, 21–23, 25–32, 45 n66, 45 n68, 46 n73, 223–24
pragmatism (see pragmatism)
problems of wicked complexity, 239–43
quality and accountability, 39–40, 60–62, 69–70, 232–35
“usual doctor–patient relationship,” 58–59
Merleau-Ponty, M., 123
Mill, John Stuart, 75
Minnesota criteria, brain death, 209
Morals and Medicine (Fletcher), 62, 67, 82
Moruzzi, Guiseppi, 132–33, 136, 138, 146–48, 158 n36, 182, 185, 187
Murray, Joseph, 4, 5, 151, 161 n75, 169
National Academy of Sciences, 89 n36
National Institute of Neurological Diseases and Stroke, 209
Negovsky, Vladimir A. xxx, 202 n21
Niebuhr, Reinhold, 83
Non–Heart Beating Donation (NHBD), 219–22, 224
Oken, Donald, 26
Omission of treatment, 114–15, 122 n50
The Patient as Person (Ramsey), 80
Penfield, Wilder, 133, 136–37, 144, 145
Pernick, Martin, 2, 15–16, 42 n21
Persistent vegetative state, 192–93, 218–19. see also coma
Pittsburgh protocol, 220
Pius XII (Pope), 21
Plum, Fred, 94, 120 n6, 150, 173, 174, 184–88, 203 n36
Posner, Jerome, 184–88, 203 n36
Principia Ethica (Moore), 63
Quality and accountability, 39–40, 60–62, 69–70, 231–35 238–239
Quasi property rights, 108–9, 121 n37
Quinlan, Karen Ann, 17
Racine, Eric, 226
Ramsey, Paul, 62–63, 67, 70–71, 80–81, 223–24
Reese, Michael, 26
Reichardt, Martin, 134
Research and the Individual (Beecher), 58, 61, 62, 66, 80, 85, 87 n12
Rethinking Life and Death (Singer), 8
Reticular activating system (RAS)
active control center hypothesis, 132–34, 156 n21, 157 n24
persistent vegetative state, 192–93, 218–19
RAS-consciousness connections research, 132–34, 138–46, 153–54, 159 n43
RAS cybernetics, 136–38, 158 n36
Riesman, David, 5
Rockefeller Foundation, 139, 144
Rose, Nikolas, 236, 239–40, 248 n74
Rosoff, Sidney, 12, 172–73, 202 n21
Rothman, David, 60
Russell, Bertrand, 63
Rynearson, Edward, 22
Safire, William, 241
Sanger, Margaret, 84
Schwab, Robert
coma, care of, 123–27, 163–64, 170–84, 188–200
death criteria views of, 71, 102, 113, 122 n48, 194–97
Harvard Committee, 8–9, 165–169
triad, 1–2, 12, 165–169, 191–92, 202 n21
Sherrington, Charles, 128
Shewmon, Alan, 211–12, 215, 218, 219, 246 n38
Shils, Edward A., 54
Singer, Peter, 8
Situation Ethics (Fletcher), 62
situation ethics, 62–63, 73, 83–84
Sutherland, Arthur, 27
Sweet, William, 5, 41 n16, 172, 193, 204 n46, 208
The Techno-Human Condition (Allenby/Sarewitz), 240
Theory of Justice (Rawls), 76
Truth-telling, 25–32, 45 n66, 45 n68, 46 n73, 59–60, 88 n25
Uniform Anatomical Gift Act, 106–7, 110–11
Uniform Simultaneous Death Act, 100–105, 118
Updating Life and Death (Callahan), 78
Value Freedom in Science and Technology (Veatch), 74–76, 78–79
Veatch, Robert
death criteria views of, 71–73, 213
Value Freedom in Science and Technology, 74–76, 78–79