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2 110 brain death criteria whole-brain criteria brainstem criteria The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death (Washington, DC: Government Printing Office, 1981), Jahi McMath Aden Hailu 2015 Robert M. Veatch and Lainie F. Ross, Defi ning Death: The Case for Choice (Washington, DC: Georgetown University Press, 2016), 10.

3 the Ad Hoc Committee of the Harvard Medical School 3 The Uniform Determination of Death Act, UDDA the cardiopulmonary criteria 4 (1) (2) irreversible cessation of all functions 3 4 The Ad Hoc Committee of the Harvard Medical School, A Definition of Irreversible Coma: Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death, Journal of the American Medical Association 205, no. 6 (August 1968): Tom Beauchamp and Seymour Perlin, eds., Ethical Issues in Death and Dying (Englewood Cliffs, N.J.: Prentice-Hall, 1978), 14.

4 112 of the entire brain, including the brain stem 5 UDDA American Bar Association ABA American Medical Association AMA irreversible loss of the capacity for consciousness combined with the irreversible loss of all brain stem functions, including the capacity to breathe the locus of homeostatic control, cranial nerve reflexes, and control of respiration the brain as a whole The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death, 2. David DeGrazia, Human Identity and Bioethics (New York: Cambridge University Press, 2005), 117. Conference of Royal Colleges and Faculties of the United Kingdom, Memorandum on the Diagnosis of Death, in The Removal of Cadaveric Organs for Transplantation: A Code of Practice, ed. Working Party of the United Kingdom Health Departments (London: Department of Health & Social Security, 1979), The Canadian Forum 2006 Sam D. Shemie et al., Severe Brain Injury to Neurological Determination of Death: Canadian Forum Recommendations, CMAJ 174, no. 6 (March 2006): S1-S12. The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death,

5 The President s Commission 11 James Bernat Charles Culver Bernard Gert the permanent cessation of functioning of the organism as a whole LawClass/LawAll.aspx?PCode=L The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death, James Bernat, Charles Culver, and Bernard Gert, On the Definition and Criterion of Death, Annals of Internal Medicine 94, no. 3 (March 1981): death definition criterion

6 / Bernat the death of the whole body the death of the body as a whole 14 the irreversible loss of consciousness persistent vegetative state, PVS Damien Keown, Buddhism, Brain Death, and Organ Transplantation, Journal of Buddhist Ethics 17 (2010): 12, accessed May 15, 2016, dickinson.edu/buddhistethics/2010/01/15/buddhism-brain-death-and-organtransplantation-2/.

7 115 primary organ integrated functions 15 Shewmon Chronic Brain Death : Meta-Analysis and Conceptual Consequences 16 bodily disintegration Shewmon 2001 somatic integration The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death, 31. D. A. Shewmon, Chronic Brain Death : Meta-Analysis and Conceptual Consequences, Neurology 51, no. 6 (December 1998): D. A. Shewmon, The Brain and Somatic Integration: Insights into the Standard Biological Rationale for Equating Brain Death with Death, Journal of Medicine and Philosophy 26, no. 5 (October 2001):

8 Controversies in the Determination of Death: A White Paper 19 integrator the loss of somatic integration the organism as a whole organism whose parts are working together in an integrated way the fundamental vital work of a living organism President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper (Washington, DC: Government Printing Office, 2008), President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper, President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper, 60. President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper, 61.

9 openness to the world receptivity to stimuli and signals from the surrounding environment 2. the ability to act upon the world to obtain selectively what it needs 3. the basic felt need that drives the organism to act as it must, to obtain what it needs and what its openness reveals to be available consciousness felt awareness commerce spontaneous breathing President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper, 62.

10 118 complete loss of integrated somatic functioning 23 David DeGrazia President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper, 64. David DeGrazia, The Definition of Death, in The Stanford Encyclopedia of Philosophy, Fall 2011 Edition, ed. Edward N. Zalta, accessed May 15, 2016,

11 119 Shewmon DeGrazia Shewmon 25 Shewmon drive DeGrazia Shewmon breathing inflation and deflation of a bellows diffusion at the alveoli cellular respiration D. A. Shewmon, The Brain and Somatic Integration: Insights into the Standard Biological Rationale for Equating Brain Death with Death, David DeGrazia, The Definition of Death, in The Stanford Encyclopedia of Philosophy, Fall 2011 Edition, ed. Edward N. Zalta, accessed May 15, 2016,

12 the corresponding standard to permanent cessation of the critical functions of the whole brain 29 a higher-brain criterion electroencephalographic activity isolated nests of living neurons Robert M. Veatch, The Impending Collapse of the Whole-Brain Definition of Death, in Defi ning the Beginning and End of Life: Readings on Personal Identity and Bioethics, ed. John P. Lizza (Baltimore, Md: Johns Hopkins University Press, 2009), 485. The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death, James Bernat, A Defense of the Whole-Brain Concept of Death, Hastings Center Report 28, no. 2 (March-April 1998): 17.

13 121 President s Council on Bioethics infarction swelling endpoint cerebral blood flow testing or electroencephalography a prognostic approach diagnostic President s Council on Bioethics (U.S.), Controversies in the Determination of Death: A White Paper, 64. David A. Jones, An Unfounded Diagnosis: Revisiting the Medical and Metaphysical Justifications of Brain Death, in Defining the Beginning and End of Life: Readings on Personal Identity and Bioethics, ed. John P. Lizza (Baltimore, Md: Johns Hopkins University Press, 2009), 449.

14 āyu/ vitality usmā/ heat vijñāna/ consciousness 34 Damien Keown 1995 Buddhism and Bioethics 35 life-faculty Pāli, prana/ vital breath the autonomic system The President s Commission, Defi ning Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death, Damien Keown, Buddhism and Bioethics (Basingstoke: Palgrave, 2001),

15 Keown 37 Keown Keown Keown 2010 Buddhism, Brain Death, and Organ Transplantation Damien Keown, Buddhism and Bioethics, 149. Damien Keown, Buddhism and Bioethics, 158. Damien Keown, Buddhism, Brain Death, and Organ Transplantation, 2. live organ donation cadaveric organ donation Dead Donor Rule Franklin G. Miller and Robert D. Truog, Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life (Oxford: Oxford University Press, 2012), 114.

16 124 loss of the body s organic integrity nirodha-samāpatti/ attainment of the cessation Keown 40 Keown Karma Lekshe Tsomo Tsomo Damien Keown, Buddhism, Brain Death, and Organ Transplantation, 25. Karma Lekshe Tsomo, Into the Jaws of Yama, Lord of Death: Buddhism, Bioethics and Death (Albany: State University of New York Press, 2006), 187.

19 127 Skt. pratītya-samutpāda/ dependent co-arising 48 Skt. skandh/ aggregate 49 Skt. nāma-rūpa/ name-and-form S Bhikkhu Bodhi, trans., The Connected Discourses of the Buddha: A New

20 Translation of the Saṃyutta Nikāya (Boston: Wisdom, 2000), Skt. rūpa/ form Skt. vedanā/ feeling Skt. saṃjñā/ conception, conceptualization Skt. saṃskāra/ mental formations Skt. vijñāna/ consciousness S Bhikkhu Bodhi, trans., The Connected Discourses of the Buddha: A New Translation of the Saṃyutta Nikāya,

21 Skt. avidyā/ ignorance Skt. saṃskāra/ compounded formations Skt. vijñāna/ consciousness Skt. nāma-rūpa/ name-and-form Skt. aḍ-āyatana/ six sense passways Skt. sparśa/ contact Skt. vedanā/ feeling Skt. tṛṣṇā/ craving Skt. upādāna/ clinging Skt. bhava/ existence S.12.2 The passing

22 130 Skt. maraṇa Skt. atthaṅgama; antaradhāna Skt. cavanatā Skt. kaḷevarassa nikkhepo Skt. jīvitakkhaya Skt. jīvitindriyassupaccheda Skt. khandhānaṃ bhedo Skt. kāla-kiriyā away of the various beings from the various orders of beings, their perishing, breakup, disappearance, mortality, death, completion of time, the breakup of the aggregates, the laying down of the carcass: this is called death. S Bhikkhu Bodhi, trans., The Connected Discourses of the Buddha: A New Translation of the Saṃyutta Nikāya,

25 133 saṃskāra 568

26 Pāli, vitakketvā/ thought Pāli, vicāretvā/ examination S Bhikkhu Bodhi, trans., The Connected Discourses of the Buddha: A New Translation of the Saṃyutta Nikāya, kayasȧ khā ra cittasȧ khara vacı saṅ khā ra S Bhikkhu Bodhi, trans., The Connected Discourses of the Buddha: A New Translation of the Saṃyutta Nikāya, in-breathing and out-breathing are bodily, these are states bound up with the body; that is why in-breathing and outbreathing are the bodily formation. First one applies thought (Pāli, vitakketvā) and sustains thought (Pāli, vicāretvā), and subsequently one breaks out into speech; that is why applied thought and sustained thought are the verbal formation. Perception and feeling are mental, these are states bound up with the mind; that is why perception and feeling are the mental formation.

27 135 Pāli, sañña/ perception vedanā/ feeling Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya (Boston: Wisdom, 1995), 399. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, when this body is bereft of three states vitality, heat, and consciousness it is then discarded and forsaken, left lying senseless like a log. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, 1296.

28 136 jīvitindriya, vital formation 65 impulse

29 faculties Pāli, saññāvedayitanirodha/ the cessation of perception and feeling in the case of one who is dead, who has completed his time, his bodily formations have ceased and subsided, his verbal formations have ceased and subsided, his mental formations have ceased and subsided, his vitality is exhausted, his heat has been dissipated, and his faculties are fully broken up. In the case of a bhikkhu who has entered upon the cessation of perception and feeling, his bodily formations have ceased and subsided, his verbal formations have ceased and subsided, his mental formations have ceased

30 138 Vital formations, friend, are not things that can be felt. If vital formations were things that can be felt, then a bhikkhu who has entered upon the cessation of perception and feeling would not be seen to emerge from it. Because vital formations are one thing and things that can be felt another, a bhikkhu who has entered upon the cessation of perception and feeling can be seen to emerge from it. 71 vital formation and subsided, but his vitality is not exhausted, his heat has not been dissipated, and his faculties become exceptionally clear. This is the difference between one who is dead, who has completed his time, and a bhikkhu who has entered upon the cessation of perception and feeling. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, 392. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, 392. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, 1239.

31 Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, Keown metabolic process Damien Keown, Buddhism, Brain Death, and Organ Transplantation,

32 Now these five faculties, each having a separate field, a separate domain, not experiencing each other s field and domain, have mind as their resort, and mind experiences their fields and domains. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, as to these five faculties that is, the eye faculty, the ear faculty, the nose faculty, the

33 [ ] tongue faculty, and the body faculty these five faculties stand in dependence on vitality. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, Just as when an oillamp is burning, its radiance is seen in dependence on its flame and its flame is seen in dependence on its radiance; so too, vitality stands in dependence on heat and heat stands in dependence on vitality, Majjhima Nikāya, no. 43, i 296. Bhikkhu Ñāṇamoli and Bhikkhu Bodhi, trans., The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya, 392.

34 142 Keown disintegration integrity disintegrate

35 Keown 81 materially reductionistic Damien Keown, Buddhism, Brain Death, and Organ Transplantation, Damien Keown, Buddhism, Brain Death, and Organ Transplantation, John P. Lizza biological paradigm materially reductionistic John P. Lizza, On the Definition of Death, in Defi ning the Beginning and End of Life: Readings on Personal Identity and Bioethics, ed. John P. Lizza (Baltimore, Md: Johns Hopkins University Press, 2009),

36 144 nāma-rūpa/ name-and-form

39 147 prognosis diagnosis

41 Bodhi, Bhikkhu, trans. The Connected Discourses of the Buddha: A New Translation of the Saṃyutta Nikāya. Boston: Wisdom, Bodhi, Bhikkhu, and Bhikkhu Ñāṇamoli, trans. The Middle Length Discourses of the Buddha: A Translation of the Majjhima Nikāya. Boston: Wisdom, 1995.

42 Beauchamp, Tom, and Seymour Perlin, eds. Ethical Issues in Death and Dying. Englewood Cliffs, N.J.: Prentice-Hal, DeGrazia, David. Human Identity and Bioethics. New York: Cambridge University Press, Keown, Damien. Buddhism and Bioethics. Basingstoke: Palgrave, Miller, Franklin G., and Robert D. Truog. Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life. Oxford: Oxford University Press, President s Council on Bioethics (U.S.). Controversies in the Determination of Death: A White Paper. Washington, DC: Government Printing Office, The President s Commission. Defining Death: A Report on the Medical, Legal, and Ethical Issues in the Determination of Death. Washington, DC: Government Printing Office, Tsomo, Karma Lekshe. Into the Jaws of Yama, Lord of Death: Buddhism, Bioethics and Death. Albany: State University of

43 151 New York Press, Veatch, Robert M., and Lainie F. Ross. Defi ning Death: The Case for Choice. Washington, DC: Georgetown University Press, Conference of Royal Colleges and Faculties of the United Kingdom. Memorandum on the Diagnosis of Death. In The Removal of Cadaveric Organs for Transplantation: A Code of Practice, edited by Working Party of the United Kingdom Health Departments, London: Department of Health & Social Security, Jones, David A. An Unfounded Diagnosis: Revisiting the Medical and Metaphysical Justifications of Brain Death. In Defi ning the Beginning and End of Life: Readings on Personal Identity and Bioethics, edited by John P. Lizza, Baltimore, Md: Johns Hopkins University Press, Lizza, John P. On the Definition of Death. In Defining the Beginning and End of Life: Readings on Personal Identity and Bioethics, edited by John P. Lizza, Baltimore, Md: Johns Hopkins University Press, Veatch, Robert M. The Impending Collapse of the Whole-Brain Definition of Death. In Defining the Beginning and End of Life: Readings on Personal Identity and Bioethics, edited by John P. Lizza, Baltimore, Md: Johns Hopkins University Press, 2009.

44 152 Bernat, James. A Defense of the Whole-Brain Concept of Death. Hastings Center Report 28, no. 2 (March-April 1998): Bernat, James, Charles Culver, and Bernard Gert. On the Definition and Criterion of Death. Annals of Internal Medicine 94, no. 3 (March 1981): Keown, Damien. Buddhism, Brain Death, and Organ Transplantation. Journal of Buddhist Ethics 17 (2010): Accessed May 15, buddhistethics/2010/01/15/buddhism-brain-death-and-organtransplantation-2/. Shemie, Sam D. et al. Severe Brain Injury to Neurological Determination of Death: Canadian Forum Recommendations. CMAJ 174, no. 6 (March 2006): S1-S12. Shewmon, D. A. Chronic Brain Death : Meta-Analysis and Conceptual Consequences. Neurology 51, no. 6 (December 1998): The Brain and Somatic Integration: Insights into the Standard Biological Rationale for Equating Brain Death with Death. Journal of Medicine and Philosophy 26, no. 5 (October 2001): The Ad Hoc Committee of the Harvard Medical School, A Definition of Irreversible Coma: Report of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death. Journal of the American Medical Association 205, no. 6 (August 1968):

45 L DeGrazia, David. The Definition of Death. In The Stanford Encyclopedia of Philosophy. Fall 2011 Edition. Edited by Edward N. Zalta. Accessed May 15, edu/archives/fall2011/entries/death-definition/.

46 154 Research on the Issue of Brain Death Criteria from the Buddhist View of Death Tu, Chun-Han Abstract This paper will discuss the definition of death and how one s death is determined from the Buddhist view of death, particularly focusing on the critique of brain death criteria in modern neurology. Firstly, this paper introduces the theoretical background and clinical critique on brain death criteria. Secondly, the author elaborates the Buddhist definition and criteria of death. Finally, this paper scrutinizes the brain death criteria and the related definitions of death in modern neurology form the Buddhist perspective. From the Buddhist view of life, the living body of a sentient being is composed of many properties, which can be classified into two categories: mind (nāma) and form (rūpa). One s death are part of an incessant process caused by one s physical and mental changes of correlated properties. In Buddhism, determination of one s death is based on three properties: vitality, heat and consciousness; when one s consciousness is no longer attached to the physical body meaning the body displays no signs of breathing, temperature and mental activities the person can then be ultimately declared dead. In comparison, modern neurology classifies one s death based on cease of * Postdoctoral Researcher, Ghent Centre for Buddhist Studies, Ghent University, Belgium.

47 155 activity in the whole-brain or the brainstem which merely establishes the determination of one s death on the activity, or lack of, in their physical brain, so as to allow one s death to be declared as soon as possible. Keywords: Buddhist view of death, brain death, death criteria, whole-brain criteria, brainstem criteria.

48 156

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<4D6963726F736F667420576F7264202D2030352DB7ECA6F7A6E6ACA3AABAA5CDA952C65B2DB3AFA3B8BCD02D393730383136> 瑜伽行派的生命觀 113 瑜伽行派的生命觀陳一標摘要阿賴耶識是瑜伽行派中極為重要的概念, 乃一切雜染與清淨法的所依, 具有一切種子執受所依異熟所攝的三種特質因為阿賴耶識含藏一切精神與物質的種子, 所以是我們的精神活動