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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
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Determination of death: Metaphysical and biomedical discourse

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Department of Social Sciences and Humanities, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Department of Nursing and Care, Faculty of Nursing, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Institute of Physiology and Pharmacology, Faculty of Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2016, 52(4), 205-210; https://doi.org/10.1016/j.medici.2016.06.002
Received: 19 April 2016 / Revised: 8 June 2016 / Accepted: 19 June 2016 / Published: 30 June 2016
The prominence of biomedical criteria relying on brain death reduces the impact of metaphysical, anthropological, psychosocial, cultural, religious, and legal aspects disclosing the real value and essence of human life. The aim of this literature review is to discuss metaphysical and biomedical approaches toward death and their complimentary relationship in the determination of death. A critical appraisal of theoretical and scientific evidence and legal documents supported analytical discourse. In the metaphysical discourse of death, two main questions about what human death is and how to determine the fact of death clearly separate the ontological and epistemological aspects of death. During the 20th century, various understandings of human death distinguished two different approaches toward the human: the human is a subject of activities or a subject of the human being. Extinction of the difference between the entities and the being, emphasized as rational– logical instrumentation, is not sufficient to understand death thoroughly. Biological criteria of death are associated with biological features and irreversible loss of certain cognitive capabilities. Debating on the question ‘‘Does a brain death mean death of a human being?’’ two approaches are considering: the body-centrist and the mind-centrist. By bridging those two alternatives human death appears not only as biomedical, but also as metaphysical phenomenon. It was summarized that a predominance of clinical criteria for determination of death in practice leads to medicalization of death and limits the holistic perspective toward individual's death. Therefore, the balance of metaphysical and biomedical approaches toward death and its determination would decrease the medicalization of the concept of death.
Keywords: Brain death; Biomedical criteria; Determination of death; Medicalization Brain death; Biomedical criteria; Determination of death; Medicalization
MDPI and ACS Style

Jakušovaitė, I.; Luneckaitė, Ž.; Peičius, E.; Bagdonaitė, Ž.; Riklikienė, O.; Stankevičius, E. Determination of death: Metaphysical and biomedical discourse. Medicina 2016, 52, 205-210.

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