Although it is commonly believed that the concept of brain death was developed to benefit organ transplants, it evolved independently. Transplantation owed its development to advances in surgery and immunosuppressive treatment; BD owed its origin to the development of intensive care. The first autotransplant was achieved in the early 1900s, when studies of increased intracranial pressure causing respiratory arrest with preserved heartbeat were reported. Between 1902 and 1950, the BD concept was supported by the discovery of EEG, Crile’s definition of (...) death, the use of EEG to demonstrate abolition of brain potentials after ischaemia, and Crafoord’s statement that death was due to cessation of blood flow. Transplantation saw the first xenotransplant in humans and the first unsuccessful kidney transplant from a cadaver. In the 1950s, circulatory arrest in coma was identified by angiography, and the death of the nervous system and coma dépassé were described. Murray performed the first successful kidney transplant. In the 1960s, the BD concept and organ transplants were instantly linked when the first kidney transplant using a brain-dead donor was performed; Schwab proposed to use EEG in BD; the Harvard Committee report and the Sydney Declaration appeared; the first successful kidney, lung and pancreas transplants using cadaveric donors were achieved; Barnard performed the first human heart transplant. This historical review demonstrates that the BD concept and organ transplantation arose separately and advanced in parallel, and only began to progress together in the late 1960s. Therefore, the BD concept did not evolve to benefit transplantation. (shrink)
J.S. Mill's plural voting proposal in Considerations on Representative Government presents political theorists with a puzzle: the elitist proposal that some individuals deserve a greater voice than others seems at odds with Mill's repeated arguments for the value of full participation in government. This essay looks at Mill's arguments for plural voting, arguing that, far from being motivated solely by elitism, Mill's account is actually driven by a commitment to both competence and participation. It goes on to argue that, for (...) Mill, much of the value of political participation lies in its unique ability to educate the participants. That ability to educate is not, however, a product of participation alone; rather, for Mill, the true educative benefits of participation obtain only when competence and participation work together in the political sphere. Plural voting, then, is a mechanism for allowing Mill to take advantage of the educative benefits that arise from the intersection of competence and participation. (shrink)