Features of gait are determined at multiple levels, from the selection of the gait itself (e.g. walk or run) through the specific parameters utilized (stride length, frequency, etc.) to the pattern of muscular excitation. The ultimate choices are neurally determined, but what is involved with that decision process? Human locomotion appears stereotyped not so much because the pattern is predetermined, but because these movement patterns are good solutions for providing movement utilizing the machinery available to the individual (the legs and (...) their requisite components). Under different circumstances the appropriate solution may differ broadly (different gait) or subtly (different parameters). Interpretation of the neural decision making process would benefit from understanding the influences that determine the selection of the appropriate solution in any set of circumstances, including that of normal conditions. In this review we survey an array of studies that point to energetic cost as a key input to the gait coordination system, and not just an outcome of the gait pattern implemented. We then use that information to rigorously define the construct proposed by Sparrow and Newell (1998) where the effects of environment, organism and task act as constraints determining the solution set available, and the coordination pattern is then implemented under a pressure for energetic economy. Environment is defined in terms of affordances based on the ecological psychology definition of the concept and organism is defined as classic morphology and physiology based capabilities. We rely on a novel conceptualization of task that recognizes that the task goal needs to be separated from the mechanisms that achieve the goal if the motivation behind the selection of the mechanism strategy is to be exposed and understood. This reformulation of the Sparrow and Newell construct is then linked to the proposed pressure for economy by considering it as an optimization problem, where the most readily selected gait strategy will be that which achieves the task goal at (or near) the energetic minimum. (shrink)

We share with Anderson & Lebiere (A&L) (and with Newell before them) the goal of developing a domain-general framework for modeling cognition, and we take seriously the issue of evaluation criteria. We advocate a more focused approach than the one reflected in Newell's criteria, based on analysis of failures as well as successes of models brought into close contact with experimental data. A&L attribute the shortcomings of our parallel-distributed processing framework to a failure to acknowledge a symbolic level (...) of thought. Our framework does acknowledge a symbolic level, contrary to their claim. What we deny is that the symbolic level is the level at which the principles of cognitive processing should be formulated. Models cast at a symbolic level are sometimes useful as high-level approximations of the underlying mechanisms of thought. The adequacy of this approximation will continue to increase as symbolic modelers continue to incorporate principles of parallel distributed processing. (shrink)

The dominant paradigm of experiments in the social and behavioral sciences views an experiment as a test of a theory, where the theory is assumed to generalize beyond the experiment's specific conditions. According to this view, which Alan Newell once characterized as “playing twenty questions with nature,” theory is advanced one experiment at a time, and the integration of disparate findings is assumed to happen via the scientific publishing process. In this article, we argue that the process of integration (...) is at best inefficient, and at worst it does not, in fact, occur. We further show that the challenge of integration cannot be adequately addressed by recently proposed reforms that focus on the reliability and replicability of individual findings, nor simply by conducting more or larger experiments. Rather, the problem arises from the imprecise nature of social and behavioral theories and, consequently, a lack of commensurability across experiments conducted under different conditions. Therefore, researchers must fundamentally rethink how they design experiments and how the experiments relate to theory. We specifically describe an alternative framework, integrative experiment design, which intrinsically promotes commensurability and continuous integration of knowledge. In this paradigm, researchers explicitly map the design space of possible experiments associated with a given research question, embracing many potentially relevant theories rather than focusing on just one. Researchers then iteratively generate theories and test them with experiments explicitly sampled from the design space, allowing results to be integrated across experiments. Given recent methodological and technological developments, we conclude that this approach is feasible and would generate more-reliable, more-cumulative empirical and theoretical knowledge than the current paradigm – and with far greater efficiency. (shrink)

Scepticism about ought simpliciter is the view that there is no such thing as what one ought simpliciter to do. Instead, practical deliberation is governed by a plurality of normative standpoints, each authoritative from their own perspective but none authoritative simpliciter. This paper aims to resist such scepticism. After setting out the challenge in general terms, I argue that scepticism can be resisted by rejecting a key assumption in the sceptic’s argument. This is the assumption that standpoint-relative ought judgments bring (...) with them a commitment to act in accordance with those judgments. Instead, I propose an alternative account of our normative concepts according to which only ought simpliciter judgments commit one to acting in accordance with those judgments. In addition to answering the sceptical challenge, the proposal offers an independently motivated account of what makes a concept normatively authoritative. (shrink)

In a seminal 1977 article, Rumelhart argued that perception required the simultaneous use of multiple sources of information, allowing perceivers to optimally interpret sensory information at many levels of representation in real time as information arrives. Building on Rumelhart's arguments, we present the Interactive Activation hypothesis—the idea that the mechanism used in perception and comprehension to achieve these feats exploits an interactive activation process implemented through the bidirectional propagation of activation among simple processing units. We then examine the interactive activation (...) model of letter and word perception and the TRACE model of speech perception, as early attempts to explore this hypothesis, and review the experimental evidence relevant to their assumptions and predictions. We consider how well these models address the computational challenge posed by the problem of perception, and we consider how consistent they are with evidence from behavioral experiments. We examine empirical and theoretical controversies surrounding the idea of interactive processing, including a controversy that swirls around the relationship between interactive computation and optimal Bayesian inference. Some of the implementation details of early versions of interactive activation models caused deviation from optimality and from aspects of human performance data. More recent versions of these models, however, overcome these deficiencies. Among these is a model called the multinomial interactive activation model, which explicitly links interactive activation and Bayesian computations. We also review evidence from neurophysiological and neuroimaging studies supporting the view that interactive processing is a characteristic of the perceptual processing machinery in the brain. In sum, we argue that a computational analysis, as well as behavioral and neuroscience evidence, all support the Interactive Activation hypothesis. The evidence suggests that contemporary versions of models based on the idea of interactive activation continue to provide a basis for efforts to achieve a fuller understanding of the process of perception. (shrink)

I consider the role of cognitive modeling in cognitive science. Modeling, and the computers that enable it, are central to the field, but the role of modeling is often misunderstood. Models are not intended to capture fully the processes they attempt to elucidate. Rather, they are explorations of ideas about the nature of cognitive processes. In these explorations, simplification is essential—through simplification, the implications of the central ideas become more transparent. This is not to say that simplification has no downsides; (...) it does, and these are discussed. I then consider several contemporary frameworks for cognitive modeling, stressing the idea that each framework is useful in its own particular ways. Increases in computer power (by a factor of about 4 million) since 1958 have enabled new modeling paradigms to emerge, but these also depend on new ways of thinking. Will new paradigms emerge again with the next 1,000‐fold increase? (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)

This paper examines the general prospects for conceptual role expressivism, expressivist theories that embrace conceptual role semantics. It has two main aims. The first aim is to provide a general characterisation of the view. The second aim is to raise a challenge for the general view. The challenge is to explain why normative concepts are not a species of defective concepts, where defective concepts are those that cannot meaningfully embed and participate in genuine inference. After rejecting existing attempts to answer (...) the challenge, I propose an alternative solution. However, the solution leaves conceptual role expressivism a far less distinctive and interesting position than its proponents claim. I conclude that we should be sceptical about how much expressivists gain by appealing to conceptual role semantics. (shrink)

The shape of a life hypothesis holds that the temporal sequence of good or bad times in a life can itself be a valuable feature of that life. This is generally thought to be incompatible with additivism about lifetime well-being, which holds that lifetime well-being is fully determined by momentary well-being. This discussion examines Dale Dorsey’s recent argument that these views are in fact compatible. I argue that accepting the conjunction of these views requires stronger commitments than Dorsey recognizes. After (...) arguing that these commitments are problematic, I conclude that we should reject the compatibility claim. (shrink)

The concept of whole‐brain death is under attack again. Scholars are arguing that the concept of brain death per se—regardless of the focus on “higher,” “stem” or “whole”—is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have pointed out that medical professionals and lay persons remain confused about its meaning. Yet whole‐brain death remains the standard for determining death in much of the Western world and its defenders (...) believe this concept best maps onto our everyday conception of death. (shrink)

The study of human intelligence was once dominated by symbolic approaches, but over the last 30 years an alternative approach has arisen. Symbols and processes that operate on them are often seen today as approximate characterizations of the emergent consequences of sub- or nonsymbolic processes, and a wide range of constructs in cognitive science can be understood as emergents. These include representational constructs (units, structures, rules), architectural constructs (central executive, declarative memory), and developmental processes and outcomes (stages, sensitive periods, neurocognitive (...) modules, developmental disorders). The greatest achievements of human cognition may be largely emergent phenomena. It remains a challenge for the future to learn more about how these greatest achievements arise and to emulate them in artificial systems. (shrink)

The concept of quantum transition is critically examined from the perspective of the modern quantum theory of measurement. Historically rooted in the famous quantum jump of the Old Quantum Theory, the transition idea survives today in experimental jargon due to (1) the notion of uncontrollable disturbance of a system by measurement operations and (2) the wave-packet reduction hypothesis in several forms. Explicit counterexamples to both (1) and (2) are presented in terms of quantum measurement theory. It is concluded that the (...) idea of transition, or quantum jump, can no longer be rationally comprehended within the framework of contemporary physical theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Contemplating the Beautiful: The Practical Importance of Theoretical Excellence in Aristotle’s EthicsJames L. Wood (bio)Aristotle, unlike plato, famously distinguishes φρόνησις from, practical from theoretical wisdom, in Book VI of the Nicomachean Ethics. He distinguishes them on the basis of both their objects and their psychic spheres: is the excellence or virtue (ἀρετή) of the scientific faculty, τὸ ἐπιστημονικόν, “by which we contemplate [θεωρου̑μεν] the sort of beings whose principles (...) [ἀρχαί] do not admit of being otherwise,” while φρόνησις is an excellence of the calculative faculty, τὸ λογιστικόν, by which we contemplate “the sort of beings that admit of being otherwise” (VI.1, 1139a6–8).1 Φρόνησις is skilled and experienced deliberation about human action and emotion, and in particular about “the sort of things that relate to (πρός) living well in general” (VI.5,1140a28); so φρόνησις guides right action, and as it turns out, directly entails excellence of character, ἠθική ἀρετή (VI.13, 1145a1–2)., on the other hand, while necessary for complete happiness (VI.12, 1144a1–6), “contemplates none of the things that make a human being happy” (VI.12, 1143b19–20), because it contemplates not changeable human affairs, circumstances, and actions, but eternal and unchanging realities (VI.6–7; X.7–8; cf. On the Soul, III.9, 432b26–433a1). Θεωρία, contemplation itself, is defined with reference to in Book X, where contemplation is made the basis of the highest human happiness as the excellent activity of intellect (νου̑ς) by which “beautiful and divine” realities are apprehended (X.7, 1177a15–18 and following). In contrast, the excellence of practical activity (both φρόνησις and ἠθική ἀρετή) is explicitly distinguished from the excellent theoretical activity of νου̑ς in θεωρία and relegated to a merely “secondary” importance (X.8, 1178a9 and following).2 [End Page 391]We might well conclude from this account that theoretical activity has nothing to do with practical activity, even if each is independently necessary for complete human happiness, and even if, as Aristotle says, practical excellence is somehow necessary to prepare the way for theoretical excellence (cf. VI.13, 1145a6–11). I wish to counter this impression, however, by showing that there is a theoretical dimension to excellent practical activity.3 More precisely, I will argue that theoretical activity contributes to practical excellence by furnishing the principles (ἀρχαί) of practical reasoning to the calculative faculty and the motivating end (τέλος) of action to the irrational-appetitive (τὸ; ἄλογον) part of the soul. The intellectual faculty that performs this theoretical activity is νου̑ς; the principles that νου̑ς apprehends are the first premises of ethical and political deliberation; and the τέλος that νου̑ς holds up to the appetitive soul as an orienting and motivating object is το καλόν.4 What distinguishes this activity from the theoretical activity that furnishes the principles of scientific reasoning (ἐπιστήμη) for the sake of knowledge is both the kinds of objects studied and the purpose of the study. One typically studies mathematics or astronomy in order to gain knowledge, not to act virtuously; however, one can certainly study the principles of human nature for the sake of virtuous action (as well as knowledge), as Aristotle himself does in the Ethics and other treatises (cf. II.2, 1103b27–29).5 Moreover, the theoretical study of the most “beautiful and divine” realities, described in Book X of the Ethics and Book XII of the Metaphysics, raises the possibility of a direct contribution of θεωρία at the highest levels to πρα̑ξις through the mediating activity of νου̑ς in the contemplation of the highest beauty and divinity.In what follows I will develop and defend these points through a close examination of Aristotle’s discussion of these concepts. My argument has three main parts. The first examines the role of thought in excellent action, the second brings out [End Page 392] the significance of το καλόν as the universal object of practical excellence, and the third argues in three subsections for the contribution in different ways of theoretical to practical excellence.1. The Dependence of Desire on Thought in Excellent ActionAs is clear from his concluding remarks in Book VI, where he declares that the possession of φρόνησις entails the possession of all the virtues of character (VI.13, 1145a1–2), Aristotle holds that the ἀρεταί of practical thought and character, φρόνησις and ἠθική ἀρετή, are interdependent and mutually implicating in virtuous choice and action. Thought needs desire in order to be practically effective... (shrink)

Over the past quarter century, organ donation after the circulatory determination of death (DCD) has grown in acceptance and prevalence throughout the world (Domínguez-Gil et al. 2021). Notwithstan...

The question whether epistemological concepts are closed under deduction is an important one since many skeptical arguments depend on closure. Such skepticism can be avoided if closure is not true of knowledge (or justification). This response to skepticism is rejected by Peter Klein and others. Klein argues that closure is true, and that far from providing the skeptic with a powerful weapon for undermining our knowledge, it provides a tool for attacking the skeptic directly. This paper examines various arguments in (...) favor of closure and Klein's attempted use of closure to refute skepticism. Such a refutation of skepticism is mistaken. But the closure principle is in any case false, so the skepticism that depends on it is undermined. The appeal of the closure principle derives from a failure to recognize an important feature of our epistemological concepts, namely, their context relativity. (shrink)

In this interview, James L. McClelland responds to questions regarding connectionist models of cognition, a theory inspired by information processing in the brain. McClelland explains the distinction between symbolic and non-symbolic processing for a better understanding of mental processes. He argues that connectionist models can perform the computations which we know the brain can perform. In addition, he responds to several general questions on the perspectives of computational models of cognition.

The locked-in syndrome is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple (...) medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS. (shrink)

Critical notice of Guy Fletcher's 'Dear Prudence: The Nature and Normativity of Prudential Discourse' and Dale Dorsey's 'A Theory of Prudence'.

The identification of a set of mutually exclusive and exhaustive propositions concerning the states of quantum systems is a corner stone of the information-theoretic foundations of quantum statistics; but the set which is conventionally adopted is in fact incomplete, and is customarily deduced from numerous misconceptions of basic quantum mechanical principles. This paper exposes and corrects these common misstatements. It then identifies a new set of quantum state propositions which is truly exhaustive and mutually exclusive, and which is compatible with (...) the foundations of quantum theory. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:LettersJames L. Walsh, Moira M. McQueen, Kevin O'Rourke, and Jean deBloisEarly Delivery of the Anencephalic InfantMadam:In the March 1994 issue of the Kennedy Institute of Ethics Journal, Kevin O'Rourke and Jean deBlois have replied to an article of ours (KIEJ, December 1993) on the early induction of the anencephalic fetus. They agree with our conclusion that such early delivery may be morally acceptable, but argue that our justification is (...) flawed. Exchanges on the subject probably could continue ad nauseam; here we simply state some of the elements of their article that leave us perplexed.1. The phrase "prolonging the life of" (p. 49) has one meaning in the case of artificial life supports, which may be unwarranted interventions, but it has a different meaning when it refers to not interfering with a person's enjoyment of necessary natural means of preserving his or her life. Inducing labor prior to viability, which denies the natural means of life support without a possible substitute, has more in common with smothering a dying patient than the nonemployment of or withdrawing of artificial means of life support. To refer to the death of the fetus here as an effect is rather like saying that I suffocated you and the effect of the suffocation is your death. This is quite different from induction after viability where the induction can have different effects.2. If the authors were correct that "the prohibition on inducing delivery before viability is predicated upon the assumption that the fetus in utero is a human being with the potential for further development" (p. 49) and the anencephalic has none, why is there need to employ the principle of double effect? They say that there is no moral obligation to prolong the life of the anencephalic fetus. Just as there is no need for the principle in cases of withdrawing unwarranted artificial life support, so there would be no need for it here. Because the authors seem to perceive a complete disjunction between direct and indirect killing (allowing to die being in the category of indirect killing), it seems that they are unable to let their argument rest here, but have to justify the death that occurs.3. The example concerning smothering and the nonemployment of aggressive interventions (p. 49) explains well the difference between killing and allowing to die. But allowing to die is not indirectly killing since it occurs as a result of the disease and not from the causality of the agent.4. How can we cause something and not intend it? There are instances in which we simply "permit" evil events, but where we are not the cause. For example, evil events may be attributable to the bad will of others. Legislators make just laws knowing that some people of bad will will break them for their own advantage. Here the legislators really do permit evil. Neither are we the cause of death when we allow a person to die by not imposing unwarranted means of life support; we permit his or her death. But can we so readily designate by "permit" [End Page 184] what we knowingly choose to bring about? O'Rourke and deBlois use interchangeably "indirectly intended" and "unintended" for what is caused by our actions; "indirectly intended" is a better designation than "unintended." The whole package, including all foreseen effects, is intended. Evil "happening" (p. 51) as a result of an action that I place can refer either to evil as caused by my action or to evil as arising from a cause apart from my action. Only in this latter sense do I permit evil and not intend it, either directly or indirectly.5. The fourth condition of the principle of double effect is given as follows: "There must be a proportionately grave reason for placing the act. The greater the evil, the more cogent the reason must be for performing the act" (p. 50). How the authors can abstract from balancing goods and evils here is beyond us.6. We cannot follow the authors' use of the term "morally good" with respect to the induced delivery (p. 50). The problem is concerned with the morally right... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:In Memoriam:Masao Abe (1915–2006)James FredericksProfessor Masao Abe, a pioneer in the international dialogue among Christians and Buddhists, died in Kyoto, Japan, on September 10, 2006. He was 91 years old. Professor Abe was given a quiet funeral service reserved to family and close friends, according to sources in Kyoto.After the death of his mentor D. T. Suzuki, Abe became a leading exponent of Zen in the West and (...) a driving force in the encounter between Buddhism and Christianity. Abe must be credited with much of the intellectual vitality of this dialogue, as well as its relevance to contemporary social problems.Abe was a tireless exponent of the Buddhist doctrine of emptiness as the standpoint for realizing the True Self, yet was also willing to place this basic Buddhist teaching in dialogue with Christianity. Rejecting the notion that Christianity and Buddhism were either fundamentally similar or completely different, Abe saw in interreligious dialogue an opportunity for the mutual transformation of dialogue partners and pursued dialogue to help Buddhists and Christians in confronting the threat of nihilism in the modern world.In the ruins of postwar Japan, Abe began his studies with Hajime Tanabe at the University of Kyoto, a prominent figure in the Kyoto school of contemporary Zen Buddhist philosophy in Japan. But it was his encounter with Shin'ichi Hisamatsu, another philosopher of Zen at the University of Kyoto, that would be decisive for Abe's turn to Zen. In a series of Zen retreats with Hisamatsu at Myoshinji Temple in western Kyoto, Abe was forced to confront the reality of nihilism within himself and eventually resolve this problem by entering the Zen standpoint of emptiness, wherein the enlightened self arises.At age 40, Abe left Kyoto for New York to study at Union Theological Seminary with two of the most prominent Christian theologians of his day, Paul Tillich and Reinhold Niebuhr. This encounter began a distinguished career of teaching, writing, and, above all, dialogue with leading Christian thinkers, including David Tracy, Langdon Gilkey, Rosemary Radford Ruether, Jurgen Moltmann, and Hans Kung. Abe served as visiting professor at the University of Chicago, Purdue University, Claremont College, Columbia University, Princeton University, the University of Hawai'i, and other schools. In Germany, [End Page 139] Abe taught at Heidelberg, Tubingen, and Munich. In addition to his many Japanese publications, Abe wrote extensively in English. These works include Zen and Western Thought, an award-winning collection of essays, and a ground-breaking reflection on Christian belief in Christ interpreted from a Buddhist perspective, "Kenotic God and Dynamic Sunyata." This essay appeared in conjunction with responses from several Christian and Jewish theologians, making the book itself a dialogue. Abe also engaged Jewish intellectuals with his Buddhist reflection on the Holocaust.In 1984, Abe and John Cobb convened a group of Buddhist and Christian intellectuals from Japan, North America, and Europe for dialogue in depth over a sustained period of time on a number of fundamental issues. He was also a guiding influence on the Society for Buddhist-Christian Studies, which continues his work of dialogue today.Masao Abe is survived by his wife Ikuko Abe, his constant companion in a life of sojourn and dialogue in the West. [End Page 140]James FredericksLoyola Marymount UniversityCopyright © 2007 The University of Hawai'i Press... (shrink)

This paper examines the integration and unification of the philosophy and psychology of well-being. For the most part, these disciplines investigate well-being without reference to each other. In recent years, however, with the maturing of each discipline, there have been a growing number of calls to integrate the two. While such calls are welcome, what it means to integrate well-being philosophy and psychology can vary greatly depending on one’s theoretical and practical ends. The aim of this paper is to provide (...) a novel conceptual framework for thinking about integrating well-being philosophy and psychology that systematically categorizes different kinds of integration projects. We divide existing attempts in the literature into three broad categories according to the perspective from which the integration takes place: (1) top-down meta-theoretical unification; (2) psychological integration within philosophy; and (3) philosophical integration within psychology. These categories are then broken down into various further subcategories. Our aim in providing this framework is both to facilitate the assessment and comparison of existing integration attempts and to provide a roadmap for future integration attempts. For each category, we discuss one or two representative examples of the approaches. By doing so, we hope to generate interest in the wide variety of existing integration projects, as well as to generate discussion concerning the benefits and pitfalls of different approaches. (shrink)

The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that (...) paralleled advances in intensive care unit treatment. The century‐old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death. (shrink)

Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that (...) must cease in circulatory death determination is that to the brain. Eliminating brain circulation from the donor ECMO organ perfusion circuit in thoracoabdominal NRP protocols satisfies the unified brain-based determination of death but only if the complete cessation of brain circulation can be proved. Despite its medical and physiologic rationale, the unified brain-based determination of death remains inconsistent with the Uniform Determination of Death Act. (shrink)