In my opinion, this subject might deserve a separate discussion: Brain Death and Buddhism.
Definition of brain death: the irreversible loss of function of both the encephalon (responsible for cognition and experience) and the brainstem (responsible for vital functions such as breathing, heart rate, blood pressure, and tissue perfusion). Without ventilatory and hemodynamic support, clinical death inevitably follows.
According to current medical knowledge, individuals in this condition do not have any kind of experience—pleasant or painful. Nevertheless, spinal cord reflexes and autonomic responses can still occur. Moreover, the role of the heart in relation to consciousness is understood merely as supplying the brain with the substrates it needs to function. In principle, a brain could maintain some level of activity if its perfusion were sustained by mechanisms other than the heart.
Questions for reflection:
Without a functioning brain, what could sustain a stream of consciousness in a body unable to generate experiences or respond to mental states—whether in the present moment or at some later stage?
Concerning the idea that consciousness resides in the heart: would this still hold true in a brain-dead individual? If the brain is no longer viable, could consciousness still “take footing” in the heart?
From a Buddhist perspective, does rebirth occur at the point of brain death, or only after the complete cessation of vital functions?
Since a person in such a condition requires constant intervention to be kept alive, would the withdrawal of vital support (which would invariably result in death) be considered an intentional act of killing—or simply the cessation of a futile intervention?
Can questions of this depth be resolved through textual analysis of the Abhidhamma and related scriptures alone, or would they require supernormal knowledge (abhiññā)?
Organ transplantation is a significant advancement in Medicine. If brain-dead individuals are already “karmically” dead—meaning they have already been reborn in other bodies—then ending the life of brain-dead bodies would have no karmic consequences, and their organs could be used without moral concern to save other people’s lives. However, if this is not the case, what would be the karmic impact for those involved?
If the person is living then he has not finished his kamma.
I think we are confusing two subjects:
Although brain dead seems to not have any cases of someone living on their own without support, it can be misdiagnosed as “brain dead” (GPT said this). As I mentioned in the original post, doctors are sometimes quick to give a brain dead diagnosis to harvest organs.
Body Heat Is The Sign Of Life
Since we all believe in Abhidhamma, the answer is straightforward.
The heart is where the mind resides. It is difficult to determine life status when mixing Western science and Buddhism.
How to tell?
If the body is digesting food and generating heat from that, then kammaja oja (jivita as 9th) kalapas are still present.
They are kammaja oja kalapas. It is impossible to be Buddhist-dead and have karmic digestion that keeps the body warm.
Consciousness stays in all body. Consciousness works in whole body. In eyes, ear, nose, tongue, body, heart. Mind becomes in all those places. This is clearly stated in “Milinda Panha” book.
In the book “Milinda Panha,” Bhante Nagasena states that the mind door becomes in the all body, not only in the heart. We can understand that when performing a bypass surgery on the heart, consciousness remains still in the same body even after the surgery. When meditating mind consciousness element comes in between eyebrows. So nimitta (the meditation sign) becomes visible in between eyebrows.
Dear friend. I am sorry because it is a long work. I have to read the book again to find the place this was written. Right now I am unable to do that. But it was clearly mentioned in the book that the mind door becomes everywhere in the body.
Unfortunately, back in the time of the Buddha and his most accomplished disciples, there was no way to talk directly about brain death. If someone with abhiññā today had the chance to examine a brain-dead person and share their observations, I think it could really help clarify these questions. However, such individuals would most likely keep their insights to themselves, or, if they chose to speak, would be met with skepticism.
I find the scientific evidence regarding the brain’s role in sentience too compelling to dismiss entirely. At the same time, the scriptural arguments suggesting that sentient life does not necessarily end with brain death, prior to clinical death, also appear to be well-supported.
In light of this, I take an intermediate stance:
I will not revoke my status as an organ donor; I consent to the use of my organs in the event of brain death, for the benefit of the recipients.
To prevent any potential kammic burden on my relatives, I will sign a document stating my wish to donate my organs upon confirmed brain death, and make it clear that my relatives should not be required to authorize the procedure. If their authorization becomes a necessary condition for donation, then the procedure should not go ahead. I understand that, under the current laws of my country, this may make organ harvesting unfeasible. But changes in the law may allow such donations without demanding the relatives’ consent.
I’ll refrain from criticizing — even inwardly — those who decide not to authorize organ donation for themselves or their relatives.
I remain open to new evidences concerning the continuity of sentient life during brain death.
I think either the translation you read had an error or there was a misunderstanding of the passage.
During a sense door process the cittas arise at the corresponding sense base. But only the brief moments of, for example, cakkhu vinnana ( seeing consciousness) are at the eyebase, the other moments in the series are at the heart base. And all mind door processes arise at the heartbase. It is all occurring so rapidly.
Another example: the body base:
When tangible object contacts the body-sense, the pañca-dvārāvajjana-citta (five-sense-door adverting consciousness) that arises has the hadaya-vatthu as its physical base, but the body-consciousness (kāya-viññāṇa) itself has the kāya-pasāda-rūpa as its base. All the succeeding cittas in that process, however, take the hadaya-vatthu as their base. Also all cittas in the mind-door process also have the hadaya-vatthu as their base. So there may be hardness experienced somewhere on the foot while walking. The kāya-viññāṇa arises there but the other cittas in the process are arising at the heart base. It is all so interesting to learn about and to begin to see this.
This link gives a clear explanation in more detail:
yes. honestly. even if you arent Buddhist, i think everyone should have a statement about what should happen to them if brain dead anyways. relieves a great deal of pressure from relatives if you just tell them beforehand what you want to happen rather than forcing them to make the decision themselves.
‘Consciousness is a condition for name and form’—that’s what I said. And this is a way to understand how this is so. If consciousness were not conceived in the mother’s womb, would name and form coagulate there?”
“No, sir.”
“If consciousness, after being conceived in the mother’s womb, were to be miscarried, would name and form be born into this place?”
“No, sir.”
“If the consciousness of a young boy or girl were to be cut off, would name and form achieve growth, increase, and maturity?”
“No, sir.”
“That’s why this is the cause, source, origin, and reason of name and form, namely consciousness.
Mendicants, when three things come together an embryo is conceived. In a case where the mother and father come together, but the mother is not in the fertile phase of her menstrual cycle, and the virile spirit (gandhabbha, accorring to Ven. Thanissaro a being whose kamma enables it to take birth on that occasion) is not ready, the embryo is not conceived. In a case where the mother and father come together, the mother is in the fertile phase of her menstrual cycle, but the virile spirit is not ready, the embryo is not conceived. But when these three things come together—the mother and father come together, the mother is in the fertile phase of her menstrual cycle, and the virile spirit is ready—an embryo is conceived.
The mother nurtures the embryo in her womb for nine or ten months at great risk to her heavy burden. When nine or ten months have passed, the mother gives birth at great risk to her heavy burden.
There are differences between an embryo and a brain-dead individual:
The Buddha clearly regarded an embryo as a human being from the beginning of its formation. A monk who takes part in an abortion is expelled from the Order. However, the notion of brain death did not exist at that time.
An embryo does not have a brain or even a heart in its initial stages, but it has the potential to fully develop those structures (and to manifest consciousness) over the course of its development. A brain-dead individual, on the other hand, cannot regain consciousness—at least not the type of consciousness that depends on brain activity.
According to DN15 Mahānidānasutta, an embryo develops only if consciousness becomes established in it. The sequence saṅkhāra (ommited in this sutta)→ viññāṇa → nāmarūpa → saḷāyatana (six-sense bases, also ommited in DN15) suggests that mental factors participate in the formation of bodily structures, including the brain. Perhaps this process works in both directions: the embryo must be suitable for the establishment of consciousness, and consciousness, in turn, supports the development of the embryo. An unsuitable embryo, without established consciousness, develops only up to a certain stage before being miscarried. It is also possible that a consciousness already established in the embryo may later be “miscarried,” thereby halting its development.
If consciousness can be miscarried from an unsuitable embryo, then perhaps it could also be “miscarried” from a body that is no longer suitable for brain-based consciousness, such as a brain-dead individual. Even if the texts define the mind-base as being located in the heart, it is possible that the mind-base is “miscarried” from the heart in the case of brain death.
However, such an argument is difficult to defend, since the available texts come from a time when clinical death and brain death could not be distinguished. There was no practical reason for the texts to describe this process in detail.
Yes, that is very interesting, since we Classical Buddhists believe in life at conception. If we do, then brain death is already present at conception (just a guess), until it is developed. The same is true with the physical heart. Nevertheless, the “heart base” (hadayavatthu) is still present at patisandhi. This confirms what has been discussed here. I’m quite sure this is often overlooked, yet very important to discuss.
In practice, brain death is not established with absolute certainty, but rather based on strict clinical criteria designed to minimize the possibility of error. These criteria are rooted in the current best available medical knowledge and diagnostic tools. So, you’re correct: brain death is, in effect, a practical and operational definition of death under current medical standards — not a metaphysical or philosophical absolute.
Why “irreversible” is still used in the definition:
The term irreversible refers to the absence of any reasonable possibility of recovery, given current medical capabilities. It’s meant to distinguish brain death from conditions like:
Coma, which can sometimes improve.
Locked-in syndrome, where the person is conscious but cannot move or speak.
Persistent vegetative state, where some brain activity remains.
In this context, “irreversible” doesn’t mean logically or metaphysically impossible to reverse, but that there is no known intervention capable of reversing the condition. It’s a clinical and legal threshold, not a statement of omniscience.