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Access Type
WSU Access
Date of Award
January 2023
Degree Type
Dissertation
Degree Name
Ph.D.
Department
Anthropology
First Advisor
Stephen Chrisomalis
Abstract
The category of brain death occupies a unique position in the continuum of life and death. Unlike persistent vegetative state patients, brain dead patients in the United States are considered legally dead despite their comatose appearance. This ambiguity has resulted in controversy and has ignited a number of debates around the conceptual coherence of brain death, the religious acceptance of death by neurological criteria, the ethics of organ donation from brain dead donors and how to standardize, document and talk about brain death. Drawing on 18 months of ethnographic fieldwork in a major Midwest hospital, my dissertation takes the case of brain death, a contested cultural model of death, to explore the ethical and religious quandaries of end-of-life decision-making that doctors, nurses, religious practitioners and families face as they navigate the uncertainty of brain death. Using a cognitive-linguistic approach, I analyze how decision-making in a clinical context highlights why brain death is such a contentious concept to begin with. I show how physicians’ cultural models of brain death exhibit tensions between biomedical standards and their practical applications, talking about brain death as a process rather than a moment in time even when they insist that brain death is the equivalent of cardiopulmonary death. I show how hospital practices and protocols work to structure the brain death event sequence to resolve uncertainties about ethical commitments and allow for the reconfiguration of potential from an individual future denied to other lives restored. I also argue that religious objections regarding the acceptability of brain death criteria or the permissibility of organ donation cannot be reduced to the utterances of religious fatalism but instead are the outcome of deeply held moral intuitions, cultural and cognitive constraints, and a constellation of diverse, distinctly organized and integrated ideas and beliefs. I show that by understanding how humans grapple with the contingencies and stakes of life as well as the implications of their decisions on the lives of others, we can see brain death and organ donation not only as institutionalized biomedical practices, but ones whose ethical stakes are embedded in everyday cognition and conversation.
Recommended Citation
Saad, Summar, "A Cognitive Ethnography Of The Brain Death Debates" (2023). Wayne State University Dissertations. 3807.
https://digitalcommons.wayne.edu/oa_dissertations/3807