adress to the International Congress of the Transplantation Society
"Brain Death"- Enemy of Life and Truth - Pope John Paul II's August 29, 2000, address to the International Congress of the Transplantation Society has awakened renewed interest in the ongoing controversies surrounding "brain death" and organ transplantation. Inasmuch as these controversies quite literally involve matters of life and death physical and spiritual, a clear understanding of their nature is vital to the survival of both life and truth, life's guardian.
Since the question of organ transplantation cannot be properly judged either logically or ethically in the absence of what the Pope describes as "a scientifically secure means of identifying the biological signs that a person has indeed died" (4), we must first examine the concept of "brain death," which serves as the rationalization for the removal of vital organs from those described as "donors."
Noting a shift in emphasis in the determination of death "from the traditional cardio-respiratory signs to the so-called' neurological criterion," the Holy Father states that this change consists in "establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum, and brain stem)."
The parameters variously set forth for declaring a person "brain dead," however, are neither "clearly determined" nor are they "commonly held" by the scientific community. Rather the myriad permutations of "brain death" criteria introduced since the publication of the revealingly titled "A Definition of Irreversible Coma" in 1968 more than 30 sets in the first decade alone have grown increasingly permissive. At the same time, a growing number of members of the scientific community have taken a closer look at "brain death" and are voicing their concerns.
To know with moral certainty that "the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum, and brain stem)" has occurred would require the total absence of all circulation and respiration. Confirmation of this absence would necessitate that the cerebrum, cerebellum, and brain stem have been destroyed and the circulatory and respiratory systems as well.
None of the shifting sets of "'so-called' neurological criterion" for determining death fulfills the Pope's requirement that they be "rigorously applied" to ascertain "the complete and irreversible cessation of all brain activity." In fact, "brain death" is not death, and death ought not to be declared unless the entire brain and the respiratory and circulatory systems have been destroyed.
Reiterating his words in Evangelium Vitae (86), the Holy Father "suggested that one way of nurturing a genuine Culture of Life 'is the donation of organs, performed in an ethically acceptable manner.'"
A manner that is "ethically acceptable" is one that corresponds to the Natural Moral Law and its four axioms:
- Good ought to be done, and evil must be avoided.
- Good may not be withheld.
- Evil may not be done.
- Evil may not be done that good might come of it.
Thus the harvesting of organs in a manner that would bring about the debilitating mutilation or the death of the "donor" would not be "ethically acceptable."
Describing the decision to donate an organ quite aptly as "a decisive gesture," the Pope cautioned,
"The human authenticity' of such a decisive gesture requires the individuals to be properly informed about the processes involved, in order to be in a position to consent or decline in a free and conscientious manner."
To be properly informed, the person considering organ donation should be educated about the nature of organ transplantation. In particular, he should be advised that prior to excision, his heart is healthy and capable of normal circulation and respiration, but after any vital organ necessary and required to live has been moved from his body, he will die. The prospective "donor" should also be informed that a paralyzing agent will be administered to prevent him from moving when the incision is made and advised whether anesthesia will be administered to him prior to the excision of his organs, as has been recommended by anesthesiologists.
Lest freedom be confused with license, it must be noted that freedom consists in the liberty to exercise one's free will in accordance with right reason, which seeks good and avoids evil. To murder oneself or another can never be in accord with right reason.
The Holy Father makes a critical restriction on the removal of organs in light of "the unique dignity of the human person," stipulating that "vital organs which occur singly in the body can be removed only after death, that is from the body from someone who is certainly dead." (4) He goes on to add that "the requirement is self-evident, since to act otherwise would mean intentionally to cause the death of the donor in disposing of his organs."
For vital organs to be suitable for transplantation, however, they must be living organs removed from living human beings. Moreover, as noted above, persons condemned to death as "brain dead" are not "certainly dead" but, to the contrary, are certainly alive.
Thus adherence to the restrictions stipulated by the Pope and the prohibitions imposed by God Himself in the Natural Moral Law precludes the transplantation of unpaired vital organs, an act which causes the death of the "donor" and violates the fifth commandment of the divine Decalogue, "Thou shalt not kill" (Deut. 5:17).
Paul A. Byrne, M.D., FAAP Past President, Catholic Medical Association Oregon, Ohio
Walt F. Weaver, M.D., FACCClinical Associate Professor, School of Medicine University of Nebraska Omaha, Nebraska
Prof. Josef Seifert, Ph.D. Rector, International Academy for Philosophy Furstentum, Liechtenstein
Mercedes Arzu Wilson, L.H.D. President, Family of the Americas Foundation Dunkirk, Maryland
Bishop Fabian Wendelin Bruskewitz, Diocese of Lincoln Lincoln, Nebraska
Bishop Robert F. Vasa, Diocese of Baker, Baker, Oregon
Julie Grimstad, Director, Center for the Rights of the Terminally Ill Stevens Point, Wisconsin
Earl E. Appleby, Jr. Director, Citizens United Resisting Euthanasia Berkeley Springs, West Virginia
Neleide Abila, Professor of Law Universida de Paranaense Guiara, Brazil,
Marcos Antonio Aranda, M. D. Director, ICU Chief, Department of Pulmonology Hospital Clinicordis São Paulo, Brazil
Christopher R. Bell President, Good Counsel, Inc. Hoboken, New Jersey
Joan Andrews Bell Director, PIETA Mission Hoboken, New Jersey
Yuri Belozorov Director, Choose Life Vladivostock, Russia
Robin Bernhoft, M.D., FACS Chairman, National Parents Commission Johnstown, Pennsylvania
Giuseppe Bertolini, M. D. Specialist in Anesthesia and Resuscitation Ospidali Riunti di Roma, Rome, Italy
Cledson Ramos Bezerra, Attorney at Law, João Pessoa, Brazil
Jerrold G. Black, M.D. Family Practice Physician, Lincoln, Nebraska
Wallace L. Boever, M.S. Clinic Manager Holy Family Medical Specialties, Lincoln, Nebraska
Michael Brear, MB, BS, DTM&H, LMCC General Practitioner, Vancouver, Canada
William Brennan, Ph. D. Professor, School of Social Service St. Louis University, St. Louis, Missouri
Paul R. Burch, M. D. Past President, Connecticut Right to Life Corporation Southbury, Connecticut
Léo Brust, Attorney at Law, Porto Alegre, Brazil
Fr. Christian Marie Charlot, Professor of Bioethics, President, World for Children Bagnoregio, Italy
Celso Galli Coimbra, Attorney at Law, Porto Alegre, Brazil
Cicero Galli Coimbra, M.D., Ph. D. Associate Professor, Department of Neurology and Neurosurgery Federal University of São Paulo, São Paulo, Brazil
Kurt Clyne, M.S., Pharm D. Director, Pharmacy St. Elizabeth Regional Medical Center Lincoln, Nebraska
Dr. A.P. Cole, FRCP, RFCPCH Director Lejeune Clinic London, England, UK
Kathy Coll Director, Pro-Life Coalition Havertown, Pennsylvania
William F. Colliton, Jr., M.D., FACOG Clinical Professor Emeritus of Obstetrics and Gynecology George Washington University Washington, D.C.
Carlito V. Cruz, M. D. General Surgeon St. John Hospital and Medical Center Detroit, Michigan
Lorna L. Cvetkovitch, M. D. Obstetrician and Gynecologist Lincoln, Nebraska
Michael Davies, President, International Una Voce Federation London, England, UK
Dr. Michael Delany London, England, UK
Robert Desmond, M. D. Emergency Department Wood County Hospital Bowling Green, Ohio
Dr. Bert P. Dorenbos, President, Schreeow Om Leven Hilversum, Netherlands
John F. Downs, President, Apostolatus Uniti, Mt. Jackson, Virginia
Jim Dowson National Organizer, Precious Life Scotland Cumbernauld, Scotland
Sr. Lucille Durocher Founder, St. Joseph's Workers for Life & Family Vanier, Canada
Cheryl Eckstein, R. N. Founder and President, Compassionate Health Care Network Surrey, Canada
David Wainwright Evans, M.D., FRCP Fellow Commoner of Queens' College Cambridge, England, UK
Martyn Evans, B.A., Ph. D. Swansea, Wales, UK
Joseph C. Evers, M.D., FAAP Pediatrician McLean, Virginia
Sydney O. Fernandes, M.D., M.B.B.S., F.C.P.S., ABIM, ABFP Internal Medicine Oregon, Ohio
Vera Maria Vargas Ferreira, Attorney, Porto Alegre, Brazil
Timothy H. Fisher, M. D. Family Practice Physician Lincoln, Nebraska
Jeffrey L. Fortenberry, M.S., M. A. Member, Lincoln City Council, Lincoln, Nebraska
Nelson Fragelli, Director, Droit de Naître, Paris, France
Luigi Gagliardi, M. D. Head Physician, Department of Thoracic Surgery (retired) Ospidale Forlalini di RomaProfessor Emeritus Università degli Studî di Roma "La Sapienza", Rome, Italy
Karel F. Gunning, M. D. President, World Federation of Doctors Who Respect Life, Rotterdam, Netherlands
Denny Hartford Director, Vital Signs Ministries Omaha, Nebraska
Lucky M. Hatta Founder and President, Pro Life Indonesia, Turanggaa Bandung, Indonesia
The Rt. Rev. Mark Haverland, Ph. D. Bishop Ordinary, Diocese of the South Anglican Catholic Church, Athens, Georgia
Paul L. Hayes, M. D. Obstetrician and Gynecologist Lincoln, Nebraska
David J. Hill, M.A., FRCA Emeritus Consultant Anaesthetist Cambridge, England, UK
Helen Hull Hitchcock, Director, Women for Faith & Family, St. Louis, Missouri
James Hitchcock, Ph. D. Professor of History, St. Louis University, St. Louis, Missouri
Benno Hofschulte, Director, Aktion SOS LEBEN, Frankfurt am Main, Germany
The Reverend Canon Eric Jarvis, M. A. Canon Emeritus, Cathedral Church of St. Peter and St. Winfred Ripon, England, UK
Fr. David Albert Jones, O.P., M. A. Director designate, Linacre Centre for Healthcare Ethics London, England, UK
Anthony M. Kam, M.D., FACS Chief of Staff Sheridan Community Hospital Sheridan, Michigan
M.A. Klopotek, Dr. Eng. Habil. Professor, Institute of Computer Science Akademia Polska, Siedice, Poland
Thomas H. Lieser, M. D., MPH, FACOEM Board Certified, Family Practice and Occupational and Environmental Medicine Adjunct Faculty Medical College of Ohio, Toledo, Ohio
Johann Loibner, M. D. General Practitioner, Graz, Austria
Luiz Anderson Lopes, M. D. Pediatric Department, Ecola Paulista de Medicina Universidade Federal São Paulo, Professor of Pediatrics Universida de Santo Amoro, São Paulo, Brazil
Prof. Roberto de Mattei Professor of Modern History University of Cassino Cassino, Italy
Maria Cristina Mattioli Federal Labor Judge Federal Labor Court of the 15th Circuit, Campinas, Brazil
Fr. Daniel Maurer, C. J. D. Canons Regular of Jesus the Lord, Vladivostok, Russia
Philip D. McNeely, M.D.Family Practice Physician Lincoln, Nebraska
Walter Menz, Attorney at Law Porto, Alegre, Brazil
Judge Joseph Moylan, Omaha, Nebraska
Nerina Negrello, President, Lega Nazionale Contro la Predazione di Organi e la Morte A cuore Battente, Bergamo, Italy
Dr. Claude E. Newbury, M.B.B.Ch., D.T.MTH., D.O.H., M.F.G.P., D.P.H.,D.A., D.C.H., M. Prax. Med. President, Pro-Life South Africa, Johannesburg, South Africa
Richard G. Nilges, M.D., FACS Neurosurgeon, Valparaiso, Indiana
Dr. Peggy Norris, MD, ChB, BAO Chairman, A.L.E.R.T. Hon. Secretary, Doctors Who Respect Life, London, England, UK
Marquis Luigi Coda Nunziante di San Fernando, President, Famiglia Domani, Rome, Italy
Dr. Charles O'Donnell, MRCP, DA, EDIC, FFAGM Consultant in Emergency and Intensive Care Medicine Whipps Cross Hospital, London, England, UK
Ruth D. Oliver, M.D., FRCP(C) Pyschiatry, Surrey, Canada
Tony C. Palmer, ScD, FRCVS Veterinary Neurologist University of Cambridge, England, UK
Larry Parsons, M. D. Family Practice Physician, Board Certified, Omaha, Nebraska
Luca Poli, M. D. Neurologist Boselga de Piné, Trento, Italy
Michael Potts, Ph. D. Associate Professor of Philosophy Methodist College Fayetteville, North Carolina
Walter Ramm, Director, AKTION LEBEN, e.V. Abtsteinach, Germany
Marlene Reid President, Human Life Alliance, St. Paul, Minnesota
Charles E. Rice, Ll. M., J. S. D. Professor Of Law University of Notre Dame, Notre Dame, Indiana
Fr. George M. Rinkowski, Toledo, Ohio
Gelson Luis Roberto, Clinical Psycholigist Associação Brasileira de Etnopsiquiatria e Psiquiatria Social, Porto Alegre, Brazil
Gilson Luis Roberto, M. D. Clinical Medicine Medical Clinic, Porto Alegre, Brazil
Derek Sakowski, Seminarian, Pontifical College Josephinum Columbus, Ohio
Rich Scanlon, Executive Director, Human Life Alliance, St. Paul, Minnesota
Ingolf Schmid-Tannwald, M.D. Professor of Gynecology and Obstetrics , Medical School University of Munich, President, Ärtze für das Leben e.V., Munich, Germany
Elida Seguin, Ph. D. Professor of Law, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Mary Senander, Minneapolis, Minnesota
Giueseppi Sermonti, Profesor Emeritus of Genetics, Universities of Palermo and Perugia Editor, Rivista di Biologia, Rome, Italy
Rogério Passos Severo, MA Professor of Philosophy of Law and Logic Faculdades Ritter dos Reis, Porto Alegre, Brazil
Jerome T.Y. Shen, M.D., FAAP Clinical Professor Emeritus of Pediatrics St. Louis University School of Medicine,St. Louis, Missouri
Saulo Sirena, Attorney at Law, Porto Alegre, Brazil
Fr. Robertas Gedydas Skrinskas, President, Pro Vita Kauno, Lithuania
Dick Sobsey, Professor of Educational Psychology University of Alberta, Alberta, Canada
Robert Sutherland, President, Right to Life Association of Thunder Bay and Area Thunder Bay, Canada
Dr. Pravin Thevatathasan, MRC Psych., MSc. Consultant Psychiatrist, London, England, UK
Fr. Hugh S. Thwaites, S.J. Bexhill, England, UK
Adrian Treloar, MRCP, MRC Psych. Consultant and Senior Lecturer in Old Age Psychiatry Guys, Kings and St. Thomas Hospital, London, England, UK
Dr. Cristina Valea, Predident, Pro Vita MedicaTimasoara, Romania
Sr. Paula Vandegaer, SSS, LCWS Founder, Scholl Institute of Bioethics President, International Life Services, Los Angeles, California
Josephine Venn-Treloar, MRCGP General Practioner, London, England, UK
Prof. Guido Vignelli, Director. SOS Ragazzi, Rome, Italy
Dr. Paul Vooht, Stevenage Herts, England, UK
Yoshio Watanabe, M.D., FACC Professor Emeritus of Medicine, Fujita Health University Consultant Cardiologist, Chiba Tokushu-kai Hospital, Funabashi, Japan
Germaine Wensley, R.N., B.S. Immediate Past President, California Nurses for Ethical Standards, Los Angeles, California
John W.S. Yun, M.D., FRCP(C)Internal Medicine and Medical Oncology Richmond Health Science Centre, Richmond, Canada