Conversation With a Bioethicist

The Ethics of Brain Death Diagnoses

Abdallah Al Alfy
2 min readNov 25, 2021
Photo by David Matos on Unsplash

“Brain death is final. It’s irreversible.”

“What about people who say brain dead folks recovered before?”

“Can’t happen by definition. Brain death is irreversible. If brain activity commences after a period of inactivity, then clearly it wasn’t brain death.”

“So it’s a misdiagnosis?”


“Even though doctors fulfilled all the diagnostic criteria?”

“It can happen.”

“That means the diagnostic criteria is deficient. So doctors aren’t currently equipped to diagnose brain death?”

“Statistically they are. Statistically, the criteria is not deficient.”

“Ok, let me ask a different question. So doctors aren’t currently equipped to ‘absolutely’ diagnose brain death, for most cases currently diagnosed under the acceptable legal standards?”

“Not absolutely, no. Sometimes nothing we have can detect activity in the brain.”

“But what are the chances, right?”
“I know what you’re doing.”

“Do you?”

“You’re trying to make our non-religious ethics look like a joke. Because you’re religious.”

“Who does ‘our’ refer to?”

“Supporters of science.”

“The scientific method yields raw data. No more no less. Your extrapolation of ethics from scientifically gathered data is not the data itself.”

“I misspoke. I meant supporters of taking decisions solely based on science.”


“Oh come on. I said I know where you’re going with this! No, I don’t advocate stealing from sources of abundance or any other corner you want to drive me into. So not solely. Supporters of taking decisions mostly based on science.”

“Well, science says we’re misdiagnosing brain death sometimes despite fulfilling all the diagnostic criteria. That’s the raw data. So solely based on science, or “mostly” based on science, I would posit that brain death diagnoses and declarations are ethically wrong, at least at this stage.”

“The raw data says that rarely ever happens though. So statistically, it’s not wrong.”

“Well then I posit that you’re supporters of taking all decisions mostly based on statistics not on science in general.”

“Fair enough.”

“So we should cut people we’re not absolutely sure are dead because you think statistics say so?”

“It seems harsh when you put it like that but yes. What’re less than a thousand cases in every billion or so? Even less than that!”

“Your calculation is off.”

“I was just giving an example.”

“No, I know. But your calculation is off at its root. The statistics don’t say only 1 in a million, or 10 million, or 100 million revive after a requirement-fulfilling brain death diagnosis. They say that only such a number survive in the time before we cut them up or take them off the machines. If they had more time, the percentage of revivals after diagnoses could increase over time. So even the statistics that inform your ethics are wrong.”

“This is not a fruitful conversation.”




Abdallah Al Alfy

Writer, Commentator, Pharmacist, Some-time poet. Love me. I command it.