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Reasonable Doubt - Whitney G. Fatima Kura. She says if we apply these criteria to specific cases, we can distinguish between living human beings and dead bodies. Likewise, one who suffers complete spinal cord transection exhibits little or no autonomous bodily integration, and yet may be conscious. This is an infallible sign that the person is alive.
But when she applies the criteria to BD individuals, she finds no evidence of the persistence of living human beings.
Are Brain Dead Individuals Dead? Grounds for Reasonable Doubt
Because the brain is necessary to mental function, and BD individuals have lost all brain function, they do not and cannot exhibit any mental activity. Likewise, BD individuals do not and cannot exhibit persistence of somatic integration. She does not deny that complex cellular functions continue that may mimic the functions of a living human body. But she thinks that if the whole brain is dead, a body is nothing more than an aggregate of nonintegrated human cells carrying out behaviors that they as it were learned before the individual died: behaviors organized to a whole that no longer exists.
The answer is critical to the success of her argument. She says we know because each and every function that takes place in BD bodies is also observed in cells and tissues ex vivo.
Therefore, none of the functions expressed singly nor all of them together can be used as a reliable measure for determining whether or not a human being is alive: there is no evidence for biologic integration above that seen in human cells. To say there is no observable evidence for X does entail the conclusion non-X. The evidence may be elusive. Or the immediately exercisable capacity to exhibit functions that provide evidence for X may be blocked by pathology.
It would only be sound if X and Y were identical.
Month: January 2014
The fact that all the functions observed in BD individuals are also observed in isolated cells and tissue ex vivo, and that isolated cells and tissue are not living human beings, does not entail the conclusion that BD individuals are not living human beings.
For that to be true, the premise would also have to be true that BD individuals are identical to isolated cells and tissues ex vivo, which is not obviously true. A BD body may be a human organism whose capacities for higher-level operations are blocked by severe pathology.
BD individuals were once alive. Their bodies autonomously carried out vegetative functions that were undeniably an expression of this life. The same vegetative functions are observed after brain death, although the body in which they are observed may not possess the physiological stability it did before.
There is uninterrupted continuity of expression in those functions before and after brain death. A healthy human organism autonomously carries out functions at the vegetative, sensory, and rational levels.
We know that functioning at all three levels can be impaired, and functions even lost, without loss of the organism. If a body continues autonomously to express functioning at any of the three levels, including at the vegetative, we presume the organism persists. From all appearances, BD bodies continue to express vegetative function. The prima facie conclusion, therefore, is that the organism persists after brain death. But since we have certitude that all higher-level expressions of life sensory consciousness and rationality are lost, and for the sake of argument we conclude that all remaining somatic functions can be explained in terms of the functions of parts, certitude that the organism persists seems to be excluded.
But her argument does not yield certitude that they are dead. It does not rule out reasonable doubt that what remains is a very sick person. Chemical signals, for example, can elicit inherently restricted functions, even—given blood circulation—throughout the whole body. But because they are stimulated by localized signals, they do no more than elicit harmonious or common action between and among parts.
Integration, on the other hand, is a global response elicited by multiple sources of information drawn from the overall state of the body. It combines the information to respond in context to diverse bodily conditions for the sake of the well-being of the whole.
In other words, without the brain, all somatic activity is coordination: no modification, enhancement, or suppression of function in response to information derived from the whole body. Though coordinated processes persisting after brain death can be very complex, they are not functions of an integrated whole.
But we need more than a conceptual schema. Condic says that BD bodies exhibit no integrative functioning beyond the cellular level. But they appear in some cases to express true vegetative function.
What signs can we identify to distinguish between coordinated and integrated systems?
What evidentiary basis do we have for concluding that the one body expresses true integration and the other merely coordination? Without such criteria, how is the heuristic useful for more than formal classification?
For example, apart from consciousness, how is an end-stage ALS patient, who cannot move a muscle and cannot breathe, any more integrated than a chronic BD individual?
Reasonable Doubt: Volume 3
Or again, why are patients who lose neurologically based somatic integration, including cranial nerve reflexes e. Since rational functioning in an animal depends on the activity of the senses, to possess either the capacity for rational functioning or the potentiality for it, an individual must possess the capacity, or the potentiality for sentient functioning.
In mammals, a brain is necessary to exercise the capacity for sentient functioning.
Individuals who suffer total brain destruction possess neither a functional brain nor the capacity to develop a brain. Therefore, they are not animals and so a fortiori are not rational animals. Lee, and Grisez do not deny that BD bodies sometimes are—in a qualified sense—living, human, and organized. But what lives after total brain death is not the individual whose brain died or even any member of the human species Lee and Grisez, , The RCS argument focuses on sentience because it presumes the axiom of scholastic philosophy that the cognitive starting point for all ideas is sensible images.
The individual is no longer characterized by those operations, and so is no longer either rational or animal. Although integrated living operations may persist in a BD body, the individual who suffered brain death is dead.
On what basis do they say it is impossible to prove that a conscious person has irretrievably lost the power of rationality? They do not reply. And if one day this becomes a practical possibility, and we are presented with a conscious individual who has demonstrably lost the capacity for rationality, certainly there will be grounds for reasonable doubt that they are not living human beings. Further, it is not certain that there cannot be an individual who is rational, but has lost the capacity for sensation.
The individual would have lost the capacity for sentience, including the so-called internal senses of memory and imagination, as well as the capacity to develop those capacities. Should we consider the individual a living human being? If the answer is yes, then either the radical capacity for sentience is not dependent on the brain, or the status of a living human individual is not contingent on the radical capacity for sentience.
Since the argument provides no compelling reason for concluding that conscious individuals who are irrecoverably nonrational or nonsentient cannot actually exist, the RCS argument is unpersuasive. The head of a living individual John is surgically separated from the rest of the body.
Surgeons are able to avert fatal bleeding; oxygenated blood is provided to the head through a heart-lung machine; and the body is sustained on a ventilator. Both the head and the body continue to exhibit appropriate operations. Lack of interaction, however, may not be a decisive reason.
Shewmon, ; Condic argues they are living human beings, but not human organisms Condic, , figure 2 : they are alive, but the brain no longer integrates the rest of the body. Integration is not simply a survival-enhancing capacity that can be blocked. Without integration, there is no organismic life. The argument risks falling into anthropological dualism: mental function exists, so the entity is a living human being; but organismic function does not, so the human being is not a body.
If this is the case, then the headless segment is strictly speaking dead. Why then does it continue to look and function like an integrated body?
Condic might reply: the activity is merely coordination, not true integration. This may indeed be the case, but it does not overcome reasonable doubt that it is not true integration. Returning to the thought experiment, a critic might reply that if head and body can be separated and both continue to constitute proper parts of the same living human individual, then the argument proves too much.
So long as a part manifests some internal organization, it remains part of the whole. But no one would argue that an amputated leg or arm maintained ex vivo remains a constitutive part of the one from whom it is cut and consequently is due the respect due to a human being.
But for two reasons I do not think it follows that the body from the neck down is not John and hence not due the respect due to John. First, for defenders of the existence of a rational soul, the soul is that which organizes both head and body, but is reducible to neither. Why cannot this nonmaterial principle organize living parts of the same body that are separated?
Khushf replies that, at least for defenders of the biological definition of death, it is because this would imply the absurd conclusion that a biologically individuated organism can be divided into two Khushf, , But the SCI scenario has already challenged our ordinary ideas about individuality.
Pace Condic, it is not unreasonable to conclude that the head and body of the SCI patient belong—in both an organismal and metaphysical sense—to the same individual. If while separated the body segment ceased to express holistic integration and the head continued to exhibit consciousness, we would doubtlessly consider the SCI patient still alive.
Second, although individual limbs, even if expressive of some internal organization, should not be considered personal, it only follows that an entire living body severed from the head is impersonal if we conclude in advance that a functional brain is necessary for human life.
But this, of course, is what needs to be demonstrated. One might spin what I am saying into a reductio by asking how large a body segment must be before it moves from the category of mere part to that of constitutive part.
And I concede that, when swimming in these murky waters, finding a clear line is very difficult. But the persistent doubt that compromises my moral certainty arises not from the size of a body segment, but from the multiplicity and complexity of unified functions that a body expresses. When functions such as respiration, nutrition, homeostasis, temperature control, detoxification, febrile response, energy balance, and recovery from wounds, sepsis, and congestive heart failure, are all expressed by a body from the neck to the toes, I doubt that that body is a corpse.
Saying this only reemphasizes the importance of developing useful criteria for distinguishing between complex coordination in parts and holistic integration in a human whole, something that this paper does not provide, but that participants on all sides of the BD debate would greatly value.
This is a mistake. Results: Chi-square test was applied to find the distribution of malignant and benign tumors. The prevalence of salivary gland tumors in our study was 0. Conclusion: The present study was a single-institutional experience where the analysis of 32 SGTs was carried out. Malignant tumors were more compared to benign. Among benign tumors, pleomorphic adenoma was the most common type.
Among the malignant salivary gland tumors, mucoepidermoid carcinoma was the most common, followed by adenoid cystic carcinoma then ex-pleomorphic adenocarcinoma followed by low-grade polymorphous adenocarcinoma. Learning preferences among clinical dental students of coastal South India: A multi-centric study p. The 3rd and 4th years of Bachelor of Dental Surgery requires integration and application of clinical knowledge, skill, and attitude. However, to understand this integration, there is a paucity of literature on the dental students' learning preferences, especially in the Indian scenario.
Hence, the objective of the present study is to provide information about it. This multicentric study included students from four dental colleges in India. Likert scale 1—5 was used to know their perceptions of their VARK score.
Results: Majority of the students were multimodal with many students showing two preferences. Kinesthetic modality was the strongest single preference and visual was the weakest single preference.
Conclusion: Majority of the students are multimodal in their learning preferences with kinesthetic modality showing strong single preference. Teachers can help students to develop learning preferences based on their preferences of learning. Teaching methodology should involve all sensory modalities so that all kinds of students can actively participate in learning process.
Prevalence of detected soft tissue calcifications on digital panoramic radiographs p. The aim of the present study was to evaluate the prevalence of soft tissue calcifications observed on digital panoramic images and the relationship of the calcifications with age and gender. Materials and Methods: Four thousand two hundred and sixty-three digital dental panoramic radiographs of the individuals aged between 6 and 89 who had visited the faculty of dentistry for different oral and dental complaints were evaluated retrospectively and detected calcifications were recorded with the age and gender information.
Data were analyzed by means of descriptive statistics, Pearson Chi-squared, and independent samples t-test. Results: Two hundred and seventy calcifications 6. Observed calcification types were tonsillolith 2. Conclusions: The prevalence of calcifications seen on the dental panoramic images is relatively rare, but the detection during routine dental examinations is important in terms of the need for more detailed evaluation of the patients.Therefore, they are not animals and so a fortiori are not rational animals.
This is a mistake.
We are employing the GDS project phases of discovery, aplha, beta to live. After a tour of their setup we talked about opportunities to work together in the near future. ImperialCollege ofScience, Technology and Medicine. Nor is holding a proposition as probable certitude, but rather an opinion.
Moreover, as per the Indian Council of Medical Research data, it ranks the fifth in overall mortality rate among different cancers prevalent in India. Condic argues they are living human beings, but not human organisms Condic, , figure 2 : they are alive, but the brain no longer integrates the rest of the body.
Author information Copyright and License information Disclaimer St. The distinction in terms is meant to indicate a difference in effects.
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