Toward Defining Death: Mechanics of a Committee

It looks like the Harvard faculty committee's redefinition of death will soon become part of medical gospel. Yet this little committee which managed to over-throw a fundamental concept of human life is only one among hundreds of Harvard's intellectual kaffee klatches.

The committee itself hardly made any of the decision it passed down, it mostly just amended, discussed and gave the Harvard seal of approval and authority to problems and solutions which interested Dr. Henry Beecher, chairman of the committee and Professor of Research in Anesthesia at Harvard and the Massachusetts General Hospital.

Dr. Beecher asked Robert H. Ebert, dean of the Harvard Medical School, to sponsor the Ad Hoc Committee to Examine the Definition of Brain Death. Testifying before a Senate investigation into scientific research on humans increased Beecher's feeling that such a committee was necessary.

To insure divergent viewpoints, the committee drew on various branches of medical faculties. For good measure Ebert and Beecher got some non-medical types to join the crew; they felt that death was not simply a matter of medicine, but also one for other disciplines, especially religion and law. Everett I. Mendelsohn, associate professor of the History of Science at Harvard, joined up after Beecher saw him at a conference on the social implications of biology and chemistry, because he felt his historical background would broaden the group. Ralph Potter was pulled in from Divinity School because Ebert wanted a theologian on hand. The first man he asked recommended Potter.

But this report, which prescribes a method for pronouncing death based on the condition of the central nervous system, was mainly a Beecher baby.

Harvard faculty committees aren't much more successful or efficient than less star-studded one. Attendance at committee meetings was often sparse. Few members were persistent enough to probe all possible angles of the question. Instead of growing out of long dialogues, the committee's report came from Beecher's drafts.

Now the work is done. Until the AMA JOURNAL publishes reactions to the Report, medical acceptance of the new diagnosis is only probable, but not certain. Yet even medical and more important, legal acceptance of the redefinition isn't enough.

Committee theologian Ralph Potter felt that important issues were ommitted from the Beecher committee's re-evaluation of human death. They brought it to the public hoping to stimulate discussion, according to Mendelsohn, and Potter will be among the first to comment.

In early September Potter will discuss unsettled problems, like what to do about someone in irreversible coma, in The Villanova Law Review. He will say that the report shifts the definition of death from the intuitive to one of sharply calibrated expertise.

Further, he will ask how we decide between intensive care to the irreversibly ill and broad basic medical care to the many. Doctors are dedicated to the extension of human life by virtue of the binding Hippocratic oath. In the light of family feelings and the traditional Western regard for life, it is difficult to turn of the respirator, as the report recommends, just because a report redefinition of death is satisfied