Issn Print: 1533-7006

Publication Date: 2005/07/01


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HISTORICAL CONCEPT OF BRAIN DEATH STILL MAKES WAVES TODAY

Mark Moran

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Excerpt

For more than 30 years, the concept of “brain death” has been an operable – if still controversial – paradigm for defining death by neurological criteria, a concept first given institutional blessing by the Ad Hoc Committee of the Harvard Medical School in its 1968 report, “A Definition of Irreversible Coma” (JAMA 1968;205:337–340).
But an illuminating new historical analysis of the concept published in Neurology last month reveals that the Harvard committee was actually predated by reports in the literature as early as 1959 that described “death of the nervous system” and “coma depasse” (beyond coma), and by the pioneering work of one Belgian surgeon who introduced a set of brain death criteria for use in carrying out transplantation in 1963.
The “Historical Neurology” report by neurologist Calixto Machado, MD, PhD, demonstrates how once morally difficult notions may become the norm as a result of the influences of technology and evolving opinion – and how the canonization of those norms by respected societal institutions is often predated by the pioneering work of individuals who dare to “push the envelope” of what is acceptable.
For his report, Dr. Machado received AAN's prestigious Lawrence C. McHenry Award for History of Neurology at this year's AAN Annual Meeting in Miami Beach. The award recognizes excellence in research in the history of neurology.

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