Wednesday, November 14, 2012

Catholicism and Brain Death

There is currently no uniform Catholic opinion in regards to "brain death."

The old standby has always been a statement by Pope Pius XII in 1958 in which he says that it is not religion's place to define death. He felt that it is up to the medical community to determine when life ends. Various moral theologians in recent years have wondered however if we have given science a little too much leeway in making that determination. Various Catholic theologians have wondered if the current definition of "brain death" really does mean dead.

This is an important and highly emotionally charged issue because, on the one hand, without the donated organ people will die and, on the other, if you declare someone dead who isn't dead, you are essentially murdering them if you harvest their organs.

Looking at the Catechism of the Catholic Church and the Ethical and Religious Directives for Catholic Health Care Services, we see similar statements in regards to this issue.

The Cathechism of the Catholic Church (CCC) states:
2296 Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good that is sought for the recipient. Organ donation after death is noble and meritorous act and is to be encouraged as a expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible directly to bring about a disabling mutilation or death of a human being, even in order to delay the death of other persons. 

The Ethical and Religious Directives for Catholic Health Care Services states:
30. The transplantation of organs from living donors is morally permissible when such a donation will not sacrifice or seriously impair any essential bodily function and the anticipated benefit to the recipient is proportionate to the harm done to the donor. Furthermore, the freedom of the prospective donor must be respected, and economic advantages should not accrue to the donor.

In the back of the CCC, there is a glossary that includes the definition for almost anything religious that you could possibly want a definition for, but it does not contain a definition for death.

I have to add my name it to list of theologians who have a sense of moral discomfort with the current definition for "brain death." Essentially, the current definition is stating that anyone who has no higher brain activity is missing an important part of "personhood" and therefore is not alive. Isn't our personhood and our dignity dependent on more than brain function?

I see this definition and I worry about it's implications. On the other side of the life spectrum, wouldn't this definition mean that an unborn child is not a person until the brain is developed? I wonder about some of my residents from my work with the severely handicapped: Some of my residents were essentially in a persistent vegetative state, are these people dead according to this criteria? One of the articles I've read brings up the example of an anencephalic infant: These infants without assistance can have a heartbeat and breathe for days.

Another of the articles that I cite below (Catholic Moral Theology) mentions two other points that give me pause. Those who created the current definition state that one of the reasons behind the definition is to ease the "burden" of caring for the brain dead patient. When is a human life a "burden"? I'm sure no pro-life person would agree to calling any human life a burden. This definition of "brain death" can be subjective and is not uniformly applied, so certain patients (for example, the elderly or the homeless) are unjustly victimized. There are stories from all over the United States of people who were likely not dead but were declared dead by "brain death" criteria and their organs harvested. I agree that decisions cannot be made on the basis of anecdotal evidence alone. Organ donation is such a wealthy industry, can't someone afford to do a study on this?

Don't get me wrong. I do think that organ donation can be an admirable and moral decision, but I am not convinced that the current definition of "brain death" doesn't amount to murder. I do intend to be an organ donor, but I do not want my organs removed until I am dead by cardiopulmonary standards (ie: My heart stops beating and I am no longer breathing). I know that this will leave some of my more vital organs to be completely useless for transplantation and I am sorry for that. Maybe instead of trying to justify murder, we can try to find a way to make those organs useful for a longer period of time?

For more info (articles that agree with me as well as articles that disagree):

The American Life League 

America Magazine (This article disagrees with me completely)

Catholic Culture

Catholic Moral Theology

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