Table 1.

Physiological evidence of somatic integration in brain-dead individuals

Homeostasis of a countless variety of mutually interacting chemicals, macromolecules and physiological parameters, through the functions especially of liver, kidneys, cardiovascular and endocrine systems, but also of other organs and tissues (e.g., intestines, bone and skin in calcium metabolism; cardiac atrial natriuretic factor affecting the renal secretion of renin, which regulates blood pressure by acting on vascular smooth muscle; etc.) Elimination, detoxification and recycling of cellular wastes throughout the body Energy balance, involving interactions among liver, endocrine systems, muscle and fat Maintenance of body temperature (albeit at a lower than normal level and with the help of blankets) Wound healing, capacity for which is diffuse throughout the body and which involves organism-level, teleological interaction among blood cells, capillary endothelium, soft tissues, bone marrow, vasoactive peptides, clotting and clot lysing factors (maintained by the liver, vascular endothelium and circulating leucocytes in a delicate balance of synthesis and degradation), etc. Fighting of infections and foreign bodies through interactions among the immune system, lymphatics, bone marrow, and microvasculature Development of a febrile response to infection Cardiovascular and hormonal stress responses to unanesthetized incision for organ retrieval Successful gestation of a fetus in a [brain dead] pregnant woman Sexual maturation of a [brain dead] child Proportional growth of a [brain dead] child

Table is reproduced from The White Paper by The President’s Council on Bioethics on “Controversies in the determination of death” (The President’s Council on Bioethics 2008) and source (Shewmon 2001). Materials produced by the President’s Council on Bioethics are government documents and in the public domain. Please note the source as http://bioethics.georgetown.edu/pcbe/