The Ethics of a Donated Brain: An Abuse of Autonomy

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COMMENTARY

Forcing someone to donate their brain for research—especially as part of a legal settlement—strikes at the ethical principles we hold dear and the very heart of our humanity. While we all grapple with the pain and horror of Nikolas Cruz’s actions, who perpetrated the Parkland high school shooting, where he shot and killed 17 individuals and wounded 17 others on February 14, 2018, using his brain as a tool for justice raises profound moral concerns that we cannot afford to ignore.

In the civil case of Emely Delfin et al vs Nikolas Jacob Cruz, the defendant, now serving 34 consecutive life sentences, agreed to donate his brain for medical research after his death as part of the settlement. The plaintiff’s representative, Mr Arreaza, asked the haunting question: "What turns a person into Nikolas Cruz? Was it something that we can learn by studying his brain?"

This question reflects a deep, human desire to understand and prevent such tragedies in the future. Yet, influencing Cruz to donate his brain, even after death, crosses a line that we must be careful not to blur. The Belmont Report and the Universal Declaration on Bioethics and Human Rights both emphasize that participation in medical research must be voluntary, informed, and free from coercion. The Nuremberg Code, born out of the darkest chapter in medical history, insists that voluntary consent is the bedrock of ethical research. At trial, it was established that Nikolas Cruz is a severely traumatized individual. He is officially vilified by the courts, politicians, and media, and is vulnerable to seek atonement by extreme means.

Abusing the concept of autonomy by manipulating Cruz—or anyone—even in the name of justice, threatens to erode the very principles that safeguard our humanity. We must resist the urge to let our anger cloud our judgment, for in doing so, we risk compromising the integrity of medical research and the ethical standards that protect us all. This is not just about 1 man’s brain; it is about the values we choose to uphold in the face of our darkest impulses.

Dr Choudhury is psychiatry resident physician at the University of Florida. Dr Thornton is a clinical associate professor of psychiatry at the University of Florida. He is the founding director for the UF-VA UNESCO Bioethics Unit and works clinically in the general adult division both inpatient and outpatient services.