BRAIN-DEATH AS A METHOD OF
The death penalty has been imposed using a wide
variety of methods:
hanging, shooting, electrocution, gassing, & (more recently) lethal
The main focus of the executing authority has been
that the prisoner is really
and completely dead at the end of the procedure.
And in the more advanced countries of the planet Earth,
there has been increasing concern for the comfort of the condemned.
Many jurisdictions are abandoning
capital punishment entirely.
But wherever the death-penalty is still used,
the most peaceful and painless methods of achieving death are being
In light of the new possibility of allowing some
prisoners on death-row
to donate their organs and tissues after execution,
we can consider even more humane methods of execution:
How can we guarantee that the prisoner is completely and permanently dead?
And at the same time, how
can we best preserve
the organs and tissues of the
so that they will be healthy enough to transplant
into patients who will otherwise die without them?
1. BRAIN-DEATH HAS WIDE PUBLIC ACCEPTANCE IN ADVANCED COUNTRIES.
2. CHOOSING BRAIN-DEATH AS A METHOD OF VOLUNTARY EXECUTION.
THE PROPER SEQUENCE OF EVENTS:
THE DECLARATION DEATH,
HANDING OVER THE BODY TO THE
HARVESTING THE DONATED ORGANS.
A. THE EXECUTION.
B. THE OFFICIAL DECLARATION OF DEATH BY A
C. HANDING OVER THE BODY TO THE
D. HARVESTING THE DONATED ORGANS.
IF THERE ARE PROBLEMS WITH THESE PROCEDURES,
USEFUL CHANGES CAN BE SUGGESTED AND
1. BRAIN-DEATH HAS WIDE
ACCEPTANCE IN ADVANCED COUNTRIES.
One reason for considering brain-death as an
acceptable method of execution
is that public awareness in the advanced countries of the Earth
has now moved into greater acceptance of brain-death as a definition of
There will always be some people who cannot accept this new concept.
But the medical profession, the legal profession, and most of the
now acknowledge that when a
human brain has ceased to function,
that whole person is dead
if the body is maintained by 'life-support'
Most commonly, brain-death happens because of some
injury to the head.
Motorcycles and automobiles are responsible for the largest number of
When the human brain has been deprived of blood for a few minutes,
it begins to die because of lack of oxygen,
starting with the higher centers of consciousness
and finally causing the cessation of the automatic functions
of the body such as heart-beat and breathing.
When the human brain dies in a hospital,
there are mechanical and chemical methods of keeping the heart and
The patient whose brain has died will be declared dead
after sufficient time has passed to permit various neurological tests
to confirm that the
functions of the brain will never return.
When the specific cause of the brain-death is not
known with certainty
as with possible freezing, drowning, or drug-overdose—
body will be restored to its normal condition as quickly as possible,
with the hope that the brain will also recover from whatever happened
And sometimes such victims of accidental drowning or freezing
are completely restored to life.
But frequently, there is no way to save the victim.
In such cases, only repeated testing will confirm
that this brain has now completely and permanently died.
2. CHOOSING BRAIN-DEATH
METHOD OF VOLUNTARY EXECUTION.
However, when the exact medical conditions
of the body and brain are well known in advance
would be the case in any application of the death-penalty—
repeated neurological testing will not be necessary,
since there will be no
mystery about the cause of this brain-death.
The exact methods of achieving brain-death in the
prisoner being executed
will have to be tested and improved until the best methods are
First, it must be beyond doubt that the executed prisoner is really dead.
A state of suspended animation would not be acceptable.
science fiction will imagine various methods of faking the execution
so that the prisoner can be rescued and resuscitated by other
The official determination of death by a licensed physician must be
And this should not be too difficult to achieve,
since the physician who will be called upon to complete the
will know the precise means by which the execution was achieved.
As when using lethal injection to carry out the
doctor rightly should not be involved in the direct administration of
the lethal chemicals.
That is the role and duty of the executioners,
who are employed by the prison system to administer capital punishment.
The death-penalty has been duly authorized
by the legal system of that place on the Earth.
All legal appeals have been exhausted or abandoned.
Without a shadow of doubt, this execution will proceed as planned.
However, even tho doctors will not use their own
hands to cause death,
doctors have been deeply involved in the planning for this
In the case of execution by lethal injection,
doctors have decided just which chemicals to use—and
exactly how to administer them.
They have made sure that the executioners
know how to insert the tubes that will deliver the lethal chemicals.
When the purpose is to achieve brain-death as a
means of execution,
doctors will have to recommend and describe the precise means
by which the executioners will cause brain-death in the prisoner.
These doctors will know of the plans for donating organs after
And they will do everything
possible to preserve the organs in good
so that the donated organs will function well in the recipients'
There should be no contradiction in doctors being advisors for execution
while at the same time hoping
to maintain the organs in good shape.
The death-sentence has been duly authorized by the state.
Doctors who philosophically reject the death-penalty
will decide to have nothing to do with any executions.
But other doctors will recognize that the coming execution
has the possibility of saving
several lives that will otherwise
These doctors will agree to cooperate because of the greater good
that will be achieved as the result of this execution followed by organ
Doctors who cooperate in keeping the bodies of
long enough to harvest organs might also feel some ambivalence:
If possible, they will first attempt to save the person
who has been injured in a plane-crash.
But if and when it is clearly impossible to save that patient,
they can turn their attention to saving other patients
who are dying because their own organs are failing.
The unavoidable death of one
person (the accident victim)
can grant the gift of
continued life to several other people.
Likewise, the death of the condemned prisoner is unavoidable:
The legal procedures have all run their course.
Perhaps the prisoner has chosen a voluntary execution.
The execution will take place.
But even if the doctors regret
this loss of life,
they can achieve miraculous
resurrections of other people
who were doomed to die because of organ-failure.
And when the prisoner has voluntarily agreed to
this should encourage the doctors to be even more accepting of the
3. THE PROPER
THE DECLARATION DEATH,
HANDING OVER THE BODY TO THE
HARVESTING THE DONATED ORGANS.
Because we in the West live in societies governed by
the rule of law,
we will continue to observe meaningful procedures
concerning death by execution, followed by whatever happens to the
We will not allow living
bodies to be dissected.
We will strictly observe the dead-donor rule:
Organs may only be harvested from donors who have been officially
Since laws usually provide that executions must take
place inside prison walls,
this part of our orderly procedures can continue to be observed.
Following all of the protocols for execution,
the warden of the prison where the execution will take place
will make sure that all proper procedures are followed.
There might be some slight modifications of procedure
in light of the fact that the prisoner has volunteered
to donate his or her organs after execution.
But all such slight modifications will be approved in advance
by any officials and/or committees that must approve such minor changes
First, the execution will proceed as planned.
All of the witnesses will be present.
Representatives of the media will be scheduled.
At the appointed hour, the execution will proceed,
using whatever methods are best intended to achieve brain-death in
The process of execution can be as elaborate or simple as seems right
for all involved.
OFFICIAL DECLARATION OF DEATH BY A PHYSICIAN.
Second, a doctor who is familiar with the planned
method of execution
will be on hand to declare death when the procedure has been
In order to preserve all appearance of good procedures
conflicts of interest—
doctor who will declare the prisoner to be dead
should not be
involved in the transplant procedures that will follow.
The role of this doctor is only to determine that death has taken
to complete and sign the death-certificate,
which will say that the
prisoner died as a result of execution,
duly authorized by the state or country where the execution took place.
OVER THE BODY TO THE TRANSPLANT-TEAM.
Third, representatives of the transplant-team from
the medical institution
that has agreed to accept donated organs after execution
will then take over the brain-dead body of the donor.
This hand-over will necessarily take place within the prison walls.
But this is the way all bodies of the executed are handled:
After execution, the disposition of the remains proceeds as planned in
Perhaps a funeral director will transport the remains
for burial or cremation at some other location.
A funeral or memorial service might be held,
as planned by the family
and friends of the executed prisoner.
However, in the case of organ-donation after
'life-support' systems will be attached to the body,
which has now been officially
declared and certified to be a dead body.
Since the transplant-team does not want to operate
inside the prison,
they will send only those necessary members of the medical team
who will be required to keep the organs viable
inside the body of the dead donor.
Attached to whatever medical technology is needed,
the body of the donor will be transported to the transplant center,
which has been prepared to receive the donated organs.
HARVESTING THE DONATED ORGANS.
Fourth, thoughtful preparation and advance planning
will have identified the best recipients of the donated organs.
And their planned surgeries will be scheduled in advance,
since it will be known well ahead of time
exactly when these organs will become available for transplant.
This will create a much more
orderly procedure at the transplant center
than happens when the organs of accident-victims must be harvested
after often-traumatic (and unplanned) injuries to the donors.
But with respect to all other procedures at the
the arrival of the dead-donor will be the same:
An ambulance will roll up to the receiving door.
Inside the dead donor is attached to various forms of 'life-support'.
The dead donor will be taken to the scheduled operating room,
where all of the re-usable organs will be harvested
and immediately transplanted into the bodies of patients
waiting in other operating rooms nearby.
The organ-procurement team will have its work
will be no desperate search for the next of kin,
who can authorized the organ-donation.
will be no grieving relatives saying that their deceased has "suffered
All of these organ-procurement steps will be achieved
well in advance of this death by execution.
With respect to the emotional responses of the
those who resist the idea of organs donated by executed prisoners
will be assigned to other duties for that day or two.
Only those who whole-heartedly believe in these life-saving procedures
will be involved in transplanting organs from the brain-dead executed
As usual, they will never know the donor as a living, conscious person.
all of the others—comes
into the transplant center
only after death has been declared at some other location
by some other doctors.
The transplant team is well trained to harvest the
organs as quickly as possible,
so that they have the best chance of resuming their functions
in the bodies of the recipients.
There will be no time here to philosophize about organs from the
Such deep thinking will have
taken place months before.
And only those who approve such transplants will participate.
And because of the advance preparations made
possible by this method of donation,
the resulting transplants
will probably have a much higher rate of
Good tissue-matching will be achieved.
The prior condition of the organs will be known in advance.
(For example, it will be known that the donor had no diseases,
which is hard to determine when the donor was a victim of a motorcycle
Very few medical complications will result
for those patients who will receive
the donated organs.
4. IF THERE ARE PROBLEMS
USEFUL CHANGES CAN BE SUGGESTED
Because this whole process of harvesting organs from
is so new both for the prison authorities and for the transplant-team,
there might be some meaningful changes suggested for the above
And even after the first organ donations have been achieved,
those early experiences might suggest needed changes in procedure.
Legal and medical history will be made by the first people who agree to
And they might have some changes to suggest.
Reasonable people can agree to change past rules and procedures
when there are obvious good reasons for making such changes.
James Leonard Park is an existential philosopher and
He has written a few other essays on closely related themes,
which are linked below.
Much more about him is available on his website:
An Existential Philosopher's Museum:
See especially the section devoted to medical ethics.
See some related on-line essays also by James Park:
Protocol for Voluntary Execution followed by Organ Donation
Better than Capital Punishment?
Execution Followed by Organ Donation
How Dead Do You Have to Be?
EXCEPTIONS TO THE RULES:
Should Prisoners Be Permitted to Donate their Organs After Execution?
An Open Letter to Wardens, Governors, & Organ-Procurement Doctors
Choosing Your Date of Death:
How to Achieve a Timely Death
—Not too Soon,
Not too Late
Your Own Pathway towards Death .
April 14, 2010; Revised 4-16-2010; 4-22-2010; 4-28-2010; 8-27-2010;
2-4-2011; 4-14-2011; 12-10-2011; 4-21-2012; 10-12-2012