"Brain death"--enemy of life and truth

Paul A. Byrne
© Paul A. Byrne, M.D.
June 25, 2008
Reproduced with Permission

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 "scientifically secure means of identifying the biological signs that a person has indeed died", 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."

"Brain Death"

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" (5) 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.

Organ Transplantation

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, and

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 vital 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 of someone who is certainly dead." 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).