Brain Death: What Catholics Should Know

Doyen Nguyen and Joseph M. Eble

Brain death (BD), the declaration of death by neurological criteria, is an established medicolegal practice in the USA and many countries worldwide. In 1968, the Harvard Medical School Ad Hoc Committee introduced BD by defining (in the opening paragraph of its report) “irreversible coma as a new criterion for death.” BD has been a controversial issue ever since. That brain-dead donors are the primary source of organ transplants has further intensified the controversy, as evidenced by the increasing number of lawsuits challenging the legitimacy of BD. A well-known example is the McMath case.

The BD controversy is of great importance for two main reasons. First, it seems that the Church, through Pope John Paul II, has accepted BD as a valid criterion for the determination of death. Second, there is an ongoing push for changing the existing law, the Uniform Determination of Death Act (UDDA), so that it will preclude families from challenging the validity of BD. We will focus on those aspects of BD most relevant to Catholics, basing our discussion on factual evidence and the principles of Catholic anthropology.

What Is Death, and What Is Brain Death?

Though people may have heard about BD, many have no clear picture thereof, thinking that BD is the same thing as death (the irreversible stoppage of all vital functions as determined by traditional cardiopulmonary criteria). The most direct approach to understand BD is to compare it with death itself. Death is both: (i) a metaphysical event — the separation of the soul from the body — which, as John Paul II indicates, “no scientific technique or empirical method can identify directly” — and, (ii) a biological phenomenon, the natural process of the somatic/bodily disintegration of the corpse. This process, which takes place immediately after the metaphysical event of death has occurred, manifests the unstoppable increasing entropy which no technological intervention can reverse. Because death is a biological phenomenon:

(i) it is species-nonspecific and applies equally to other warm-blooded mammals, such that when we say “our cousin died,” we mean the same thing as when we say “our pet dog died.”

(ii) there is a constellation of recognizable signs indicating that the once-living warm-blooded being has died. In addition to the complete cessation of all vital bodily functions beyond the possibility of resuscitation, one of the earliest identifiable signs of bodily disintegration is a rapid drop in temperature of the corpse to the level of the ambient temperature. The rapid draining of the blood from surface capillaries into the deep veins leaves the skin gray and lifeless. Other signs of death, namely livor mortis and rigor mortis, set in within a few hours.

In defining irreversible coma as a new criterion for death, the 1968 Harvard report advanced the following....

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