ABSTRACT
This chapter examines proposals that death should be redefined with criteria for the determination of death based on ontological grounds; that is, in terms of the loss of personhood or personal identity so determined in terms of the loss of structures associated with consciousness and cognition. Exponents of ontological definitions contrast them with biological definitions, such as brainstem definition, which defined as ‘the irreversible loss of function of organism as a whole’. Criteria for personal identity have been extensively discussed by philosophers, theologians, and lay persons, and vary from culture to culture. Arguments supporting ontological or higher brain formulations of death are concerned with criteria seeking to describe the minimum necessary qualities for personhood, defined in terms of psychological abilities. Personal identity concepts of death run into difficulties with borderline cases, such as anencephaly or profound dementia. There are much closer similarities between the persistent vegetative state and profound dementia than between loss of brainstem function and persistent vegetative state.
