The Brain as a Whole? Neuroendocrine Functions and Death by Neurological Criteria

Death by neurological criteria, often referred to as “brain death,” has been the source of significant controversy in the past decades. The legal definition of brain death focuses on the irreversible loss of all brain function, including the brain stem, leading to an understanding of whole-brain death. Of particular importance for the brain death debate, the American Academy of Neurology has recently asserted that the loss of neuroendocrine function is not necessary for brain death determination. The question becomes whether it is consistent with a sound anthropology to accept brain death despite continuing neuroendocrine function. I argue that it is, as neuroendocrine function depends on the brain as a whole. This will be shown through engaging with the writings of Thomas Aquinas, especially as they relate to a hylomorphic understanding of the human person. Additionally, I will engage with understandings of brain death as the loss of the integrative unity of the human organism, particularly with Maureen Condic's distinction between integration and coordination. Through this, I will demonstrate that arguments that neuroendocrine functions do not in themselves constitute a vital function but, rather, depend on the brain as a whole.