From Twelve to Six Hours: The Social Construction of Brain Death Criteria in Korea, 1969–1999

This paper historically traces how the concept of brain death was constructed in Korean society. It examines the social establishment process of the brain death concept by focusing on the confirmation time—a seemingly technical yet symbolic indicator. The prevailing account explains the establishment and diffusion of the brain death concept as a smooth history of institutionalization without resistance. However, this study includes the earlier period of the 1960s–1970s in its analysis, noting that the brain death concept actually faced numerous forms of resistance. The first Korean brain death criteria, presented by the Korean Medical Association’s Committee for the Definition of Death in 1983, set the confirmation time at 12 hours. This was a longer duration compared to other countries, representing a choice that prioritized alleviating social opposition over the efficiency of organ transplantation. However, as brain-dead patients resulting from state violence occurred repeatedly in the late 1980s and the first brain-dead liver transplant was performed, brain death gained new political and moral legitimacy. Based on this shift in atmosphere, the Korean Medical Association issued a second set of criteria in 1989, reducing the confirmation time to 6 hours. These criteria functioned as de facto legal norms during the legal vacuum period until their codification in 1999. This series of processes demonstrates that brain death criteria, including confirmation time, are not pure medical facts but rather constructs of negotiation and tension surrounding the meaning of death and the legitimacy of organ transplantation.