BIOETHICS
Ethics of Organ Transplantation

 

THE BEATING HEART DONORS Discover  May 2012







SPECIAL REPORT







Dr Paul Byrne is president of the Catholic Medical Association. Dr Byrne has been practicing medicine since 1957 and writing on brain death since 1975.

While the Church has not made a statement specifically about heart transplant, the position of the Church is clear to me, beginning with the Council of Vienne, 1313:

"Moreover, with the approval of the said council, we reject as erroneous and contrary to the truth of the Catholic faith, every doctrine raising asserting that the substance of the rational or the intellectual soul is not of itself and essentially the form of the human body, or casting doubt on this matter. In order that all may know the truth of the faith in its purity and all error may be excluded, we define that anyone who presumes henceforth to assert, defend or hold stubbornly that the rational or intellectual soul is not the form of the human body of itself and essentially, is to be considered a heretic."

(This passage asserts that it is heretical to believe that the soul is a component of the brain or some other part of the body. The church teaches that the soul is an entity to itself, indeed created in the Image and Likeness of the Creator.)

The position was reaffirmed by the Lateran Council, 1512 - 1517.

An address by Pope Pius XII in 1957, stated:

"But considerations of a general nature allow us to believe that human life continues for as long as its vital functions - distinguished from the simple life of organs- manifest themselves spontaneously or even with the help of artificial processes".

Also, Pope Pius XII, in an address about corneal transplant, stated,
"...public authorities have the duty ... to take care that a 'corpse' shall not be considered and treated as such until death has been sufficiently proved."

Pope John Paul II stated in 1991 to a group on organ transplants:
"... A person can only donate that of which he can deprive himself without serious danger or harm to his own life or personal identity, and for a just and proportionate reason. It is obvious that
vital organs can only be donated AFTER DEATH."

Pope John Paul II to the participants of the 1989 Pontifical Academy of Science stated:

"The problem of the moment of death has serious implications at the practical level and this aspect is also of great interest to the church. In practice there seems to arise a tragic dilemma. On one hand there is the urgent need to find replacement organs for sick people who would otherwise die or at least would not recover. In other words, it is conceivable that in order to escape certain and imminent death a patient may need to receive an organ which could be provided by another patient, who may be lying next to him in the hospital, but about whose death there still remains some doubt. Consequently, in the process there arises the danger of terminating human life, of definitively disrupting the psychosomatic unity of a person. More precisely, there is a real possibility that the life whose continuation is made unsustainable by the removal of a vital organ may be that of a living person, whereas the respect due to human life absolutely prohibits the direct and positive sacrifice of that life, even though it may be for the benefit of another human being who might be felt to be entitled to preference."

Another important reference is to #2296 of the CATECHISM OF THE CATHOLIC CHURCH:

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 a noble and meritorious act and to be encouraged as an 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 TO BRING ABOUT the disabling mutilation OR DEATH of a human being, even in order to delay the death of other persons.

(Next refers to a question about "The Charter for Health Care Workers" which expresses the opinion that it is morally admissible to harvest the organs when brain death is established. Dr Byrne points out that this document is not in accordance with the "two Councils cited and the statements by the Pope Pius XII and Pope John Paul II)

The position of the Catholic church must be that vital organ excision is prohibited unless the patient (donor) is already dead. And this is a contradiction in itself. Is the soul no longer present when the heart is still beating, there is a recordable blood pressure, a normal temperature, normal salt and water balances, and many internal organs and systems are still functioning and maintaining the unity of the body? These are the findings when a heart or other vital organs are taken for transplant. IF THE SEPARATION OF THE BODY AND THE SOUL CANNOT BE VERIFIED OR THERE IS DOUBT ABOUT THE SEPARATION OF THE BODY AND THE SOUL, VITAL ORGAN EXCISION IS PROHIBITED.

(Dr Byrne was asked to detail the types of organ harvesting and which is acceptable to the church)

There are three types of transplantation:
TISSUE, A PAIRED ORGAN (i.e. you have two of them like for example, a kidney is a paired organ) OR BONE MARROW FROM A LIVING PERSON. The tissue or organ must not be essential for the life or health of the donor such as two kidneys.

TISSUE AFTER DEATH e.g. the cornea, heart valves, skin, bone and connective tissue (tendon and ligaments).

UNPAIRED VITAL ORGANS SUCH AS THE HEART OR THE LIVER AFTER A DECLARATION OF BRAIN DEATH. Such determination of brain death is based on absence of functioning of the brain. Again, if this is 'death', why is there a need to call it 'brain death'? The heart is beating; there is normal blood pressure and temperature; there are normal salt and water balances and many internal organs and systems are functioning to maintain the unity of the body. During the hour it takes to remove a heart for transplant, the heart is still beating. Only a beating heart is acceptable for transplant.

As you can see, you can donate one of a paired organ (i.e. where you have two of them like a kidney) during life or tissue after death as explained in #1 and #2 above. It would be best to inform a family member about your decision, and make sure they are aware of the problems with heart and liver donation.
"It is never lawful, even for the gravest reasons, to do evil that good may come of it."

(CF ROM 3 - Veritas Splendor #80)
Courtesy of: HLI Reports, Ap 1998

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Morally acceptable Organ
Donation and Transplantation:
And Catholic Church teaching

By Richard Mahoney, Founder
NATIONAL  AMERICAN  HOLOCAUST  MEMORIAL


With sacred biblical teaching, I will explain why the donation of vital organs is prohibited and immoral. Our Lord tells us in sacred scripture that "the life is in the blood" (Genesis 9 and Leviticus 17). Physiologically the fundamental building blocks of the human person are at the cellular level. Each cell within the body receives the oxygen and biochemical nutrients it needs for cellular metabolism through the blood.  When perfusion (blood flow) ceases at the cellular level, whether through cardiopulmonary arrest, cardiopulmonary insufficiency, shock, exsanguination, etc. and the cells are no longer supplied with blood, metabolic acidosis ensues.  For a certain time period this respiratory and/or metabolic acidosis is reversible by reestablishing ventilation and sufficient blood flow (perfusion) to the cells and vital organs. This is the basis of CPR (Cardiopulmonary Resuscitation) and ACLS (Advanced Cardiac Life Support). A person, who arrives at a medical center in cardiac arrest and asystole and is resuscitated, was not dead and then brought back to life. The CPR and ACLS merely reestablished adequate perfusion to the cells and vital organs before such an extensive ischemia and necrosis takes place as to make it irreversible (persistent irreversible catabolic state).  Physiologically, death is an irreversible catabolic state leading to total cellular necrosis of the entire human body.  Spiritually, death is the separation of body and soul. When the soul, which inhabits and animates the human person, no longer has a living organism to embody, it leaves the body and goes to its Creator.

Having thus laid the most basic premises of human physiology, life and death, we will now expose the falsehood and immorality of epivalothanasia (the Greek word for "imposed death") and euthanasia.  In organ transplantation the donor's organs are taken while their heart is still beating and their vital organs adequately perfused.  The donor is not only alive while his organs are being excised for transplantation, physiologically his organs are very healthy and in good shape. Historically over the past 40 years, in order to justify abortion and epivalothanasia, the American Medical Association has redefined the beginning of life, from the moment of conception to the moment of nidation (implantation) and has redefined death as a cerebral phenomena which they have coined "brain dead". In so doing, the vast majority of the medical establishment has chosen the "quality of life" ethic over the "sanctity of life" ethic.  Initially they used cerebral electroencephalographic activity as a measure of classification.  Currently, medical institutions have been using a Glascow Coma Scale as a screening criterion for organ donation. A human being's worth or quality of life even after a severe cerebral trauma (subdural hematoma, subarachnoid hemorrhage or ventricular bleed, etc.), pathology or anomaly cannot justify any "death dealing excision" of his vital organs.  In the worst case scenario, although a medullary or pontine infarct would precipitate nearly immediate fatal demise, to excise organs while a person is alive is murder. To use a utilitarian philosophy to promote or actuate the death of a human person is heinous and immoral. The Church teaches that the donation of non-vital organs that would not cause death or debilitation of the donor is allowable as well as certain tissues such as corneas, bone and skin, which can still be useful for donation even after death.

In conclusion Pope John Paul II reminds us "Neither human life nor the human person can ever be treated as an object to be manipulated or as a disposable commodity; rather each human being at every stage of existence, from conception to natural death, is endowed by God with a sublime dignity that demands the greatest respect in vigilance on the part of individuals, communities, nations and international bodies". Father John Powell states in his book Abortion:  The Silent Holocaust, "The problem of birth control and birth selection are extended inevitably to death selection and death control whether by the individual or by society". Quoting Malcolm Muggeridge, "We will not recognize the true value of our own lives until we affirm the value in the lives of others; however low it flickers or fiercely burns, it is still a Divine Flame which no man dare to presume to put out, be his motives ever so humane and enlightened".

Richard Mahoney, RRT CPT





 




More on Organ Donations

Dr. Paul Byrne's article “Phase II of Kevorkian's Prescription Medicide” from the February 1998 issue of HLI Reports has generated many calls and letters. Following are two typical letters; Dr. Byrne's responses may help clarify his position on organ donation and Catholic teaching.

What the Catholic Church Teaches About Organ Donation

Dear Editor: The article on page 8 of HLI's February newsletter says that "the Catholic Church teaches that donation of the heart and liver is immoral, due to the fact that they must be harvested from a living person."

Of course to remove vital organs from a living person is wrong. But where does the Church say the donation the heart and liver in the present circumstances is necessarily wrong? I find instead the following authoritative statements in the Charter for Health Care Workers, a Vatican curial document, published in 1994:

In order that a person be considered a corpse, it is enough that cerebral death of the donor be ascertained, which consists in the 'irreversible cessation of all cerebral activity.' When total cerebral death is verified with certainty . . . it is licit to remove organs and also to surrogate organic functions artificially in order to keep the organs alive with a view to transplant. Ethically, not all organs can be donated. The brain and the gonads may not be transplanted because they ensure the personal and procreative identity respectively. . .

Nevertheless, the problem with ascertaining irreversible cessation of all cerebral activity is problematic: are the criteria for determining cerebral death adequate? If so, is it applied properly?

Duane Brown Louisville, KY


Dr. Byrne's Response

The respondent points out a statement in the Charter for Health Care workers about "cerebral death" and includes a partial quote of #87 of the Charter. It is noted that the reference to this statement is to the 1985 Pontifical Academy of Sciences meeting. Pope John Paul II's statement at the beginning of a 1989 meeting of the Pontifical Academy of Sciences brings into question the conclusions of the 1985 Academy Meeting to which the Charter refers.

While the Church has not made a statement specifically about heart transplant, the position of the Church is clear to me, beginning with the Council of Vienne, 1313:

Moreover, with the approval of the said council, we reject as erroneous and contrary to the truth of the Catholic faith every doctrine or proposition rashly asserting that the substance of the rational or the intellectual soul is not of itself and essentially the form of the human body, or casting doubt on this matter. In order that all may know the truth of the faith in its purity and all error may be excluded, we define that anyone who presumes henceforth to assert, defend or hold stubbornly that the rational or intellectual soul is not the form of the human body of itself and essentially, is to be considered a heretic.

This position was reaffirmed by the Fifth Lateran Council, 1512-1517.

An Address by Pope Pius XII in 1957 stated: "But considerations of a general nature allow us to believe that human life continues for as long as its vital functions-distinguished from the simple life of organs-manifest themselves spontaneously or even with the help of artificial processes." Also, Pope Pius XII, in an address about corneal transplant, stated   " . . . public authorities have the duty to take care that a 'corpse' shall not be considered and treated as such until death has been sufficiently proved."

Pope John Paul II stated in 1991 to a group on organ transplants: " . . . a person can only donate that of which he can deprive himself without serious danger or harm to his own life or personal identity, and for a just and proportionate reason. It is obvious that vital organs can only be donated after death."

Pope John Paul II to the participants of the 1989 Pontifical Academy of Science stated:

The problem of the moment of death has serious implications at the practical level, and this aspect is also of great interest to the Church. In practice there seems to arise a tragic dilemma. On the one hand there is the urgent need to find replacement organs for sick people who would otherwise die or at least would not recover. In other words, it is conceivable that in order to escape certain and imminent death a patient may need to receive an organ which could be provided by another patient, who may be lying next to him in the hospital, but about whose death there still remains some doubt. Consequently, in the process there arises the danger of terminating a human life, of definitively disrupting the psychosomatic unity of a person. More precisely, there is a real possibility that the life whose continuation is made unsustainable by the removal of a vital organ may be that of a living person, whereas the respect due to human life absolutely prohibits the direct and positive sacrifice of that life, even though it may be for the benefit of another human being who might be felt to be entitled to preference.

Another important reference is to #2296 of the Catechism of the Catholic Church:

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 a noble and meritorious act and is to be encouraged as an 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 the disabling mutilation or death of a human being, even in order to delay the death of other persons.

Thus, does the statement quoted from the Charter for Health Care workers express the principles found in the two Councils cited and the statements by the Pope Pius XII and Pope John Paul II? What does the Charter mean by "cerebral activity"? Does "cerebral" refer to the cerebral cortex, the brain or something else? The reader correctly asks a question about a problem with ascertaining "irreversible cessation of all cerebral activity." It should be asked what is meant by "irreversible"? The readers can refer to "Brain Death An Opposing Viewpoint," Journal of the American Medical Association, 2 November 1979, page 1988, where there is clarification regarding of the consideration of "irreversible" in the context of brain-related criteria for death.

The position of the Catholic Church must be that vital organ excision is prohibited unless the patient is already dead. And this is a contradiction in itself. Is the soul no longer present when the heart is still beating, there is a recordable blood pressure, a normal temperature, normal salt and water balances, and many internal organs and systems are functioning and maintaining the unity of the body? These are the findings when a heart or other vital organs are taken for transplant. If the separation of the body and the soul cannot be verified or if there is doubt about the separation of the body and the soul, vital organ excision is prohibited.

I hope and pray that this response will be helpful and useful to the respondent.

Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity. . . it is not morally admissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons. (Catechism of the Catholic Church, #2296)

Acceptable Types of Organ Donation

Dear Dr. Byrne: I read with a great deal of interest your interview, which appeared in the latest HLI Reports.

I have been carrying an "organ donor" card with me for the last few years and had absolutely no idea about the restrictions imposed by the Church.
Effective immediately, I am retracting my approval. However, I still wonder if you may have some documents that would allow me to be a donor within the Catholic Church's guidelines, or if you can direct me to a source that could provide me with the information.

Jose L. Palacio Ellicott City, MD


Dr. Byrne's Response

There are three kinds of transplantation:

1. Tissue, a paired organ or bone marrow from a living person. The tissue or organ must not be essential for the life or health of the donor, such as one of two kidneys.

2. Tissue after death, e.g., the cornea, heart valves, skin, bone and connective tissue (tendon and ligaments).

3. Unpaired vital organs such as the heart or the liver after a declaration of brain death. Such determination of brain death is based on absence of functioning of the brain. Again, if this is death, why is there a need to call it brain death? The heart is beating; there is normal blood pressure and temperature; there are normal salt and water balances and many internal organs and systems are functioning to maintain the unity of the body. During the hour it takes to remove a heart for transplant, the heart is still beating. Only a beating heart is acceptable for transplant.

As you can see, you can donate one of a paired organ during life or tissue after death as explained in # 1 and #2 above. It would be best to inform a family member about your decision, and make sure they are aware of the problems with heart and liver donation. "It is never lawful, even for the gravest reasons, to do evil that good may come of it
(CF Rom. 3)" Veritatis Splendor #80.

Dr. Paul Byrne is President of the Catholic Medical Association and has been practicing medicine since 1957. He began writing on brain death in 1975.



 

Phase II of Kevorkian's 1991 book, "Prescription: Medicide"
Dr. Paul Byrne exposes the truth regarding Epivalothanasia


Reprinted from the February issue of HLI Reports.

Editor's Note: In mid-October, 1997, Dr. Jack Kevorkian announced that he will begin to harvest from his future patients and make them available to waiting recipients. Kevorkian remarked that donating kidneys and livers from consenting assisted-suicide patients is the second phase in a three-part plan presented in his book, "Prescription: Medicide.” Dr. Paul Byrne is President of the Catholic Medical Association, member of American Academy of Pediatrics, American Medical Association, and HLI's Medical Professionals for Life. A practicing physician since 1957, he has written various publications on brain death beginning as early as 1975. He spoke recently with HLI's Penny Starrs.

HLIR: Dr. Byrne, before we begin, please explain the medical term, Epivalothanasia.

PB: Epivalothanasia is the Greek word for "imposed death." Epivalothanasia on the unborn is abortion. Epivalothanasia on the newborn is infanticide. Epivalothanasia on the adult is so-called "physician assisted suicide." While the Greek word euthanasia is commonly used, I would encourage epivalothanasia robe used side by side until everyone will have to use epivalothanasia and not euthanasia.

HLIR: Organ transplants were first tried in the 1950s. At that time, organs were removed after the donor's heart had stopped beating but most transplants failed to be successful. How has the technique for harvesting organs changed over the past 40+ years?

PB: Now organs are taken while the heart is beating and there is normal blood pressure and circulation. The donor is not dead prior to the excision of the beating heart or liver. There is a legalized fiction for the determination of death. This is called "brain death." Brain death is a "quality of life" decision. The quality of the life of the donor is considered to be of such low value to him/herself that the death-dealing excision of the beating heart can be done. Thus the intrinsic worth of the donor is in his/her parts that can be taken and implanted into another.

HLIR: Dr. Kevorkian uses either carbon monoxide gas or a lethal injection when he "assists" his patients to die. Won't these substances be damaging to a living organ?

PB: Yes. The lack of oxygen to the heart or liver after death from carbon monoxide or other lethal substances would make the organs useless for transplant. Only living organs can be used for transplant. In the case of an unpaired vital organ, e.g., the heart, the so-called donor must be alive.

HLIR: Dr. Kevorkian said that the organs he harvests will be available on a "first-come, first-served basis." Although the Transplantation Society of Michigan has denounced his plans, do you foresee any other transplantation organizations asking Kevorkian for these organs?

PB: No. In the past, Dr. Kevorkian wrote and spoke about being more "humane" because he planned to anesthetize the "donor," excise the organs, and then finish off the patient if he is not already dead. On the other hand if the patient becomes dead in the process of excision of the organs, he has done it more humanely because the standard way now is to simply paralyze the donor to prevent any moving or squirming during the excision procedure.

HLIR: Although the Catholic Church teaches that donation of the heart and liver is immoral due to the fact that they must be harvested from a living person, which denies the dignity of that person, which organs can be safely and morally donated?

PH: Only tissues such as the cornea, heart valves, bone and skin arc useful for transplant after death. Out of charity a person may give one of a paired organ, e.g., one of two kidneys, to another person in dire need. The excision of the organ must not cause death or debilitating mutilation to the donor.

HLIR: Dr. Byrne, not long ago the White House announced a federal campaign to encourage organ donation. What should our readers know before they decide to designate themselves as a donor?

PH: The person must know that unpaired vital organs are only useful for transplant while the donor is alive. They should consider the other answers I have already given.







 

Legacy Organ & Tissue Donor Registry
P.O. Box 8468, Metairie, LA. 70011-8468, Ph: 800-521-GIVE

REMOVAL FORM







Dear

The Louisiana Donor Registry has been informed that you wish to remove your name from the program. In order to accomplish this task, you must fill out this form, in its entirety, and return it to the Registry so that documentation can be maintained that you have changed your decision to donate organs and or tissue.

Please complete this form and return it to:

Legacy Donor Registry
P.O. Box 8468
Metairie, LA 70011-8468

Once our office has received the completed form, your name will be removed from
the Donor Registry. If you should have any questions, please feel free to contact
the Louisiana Donor Registry at 1-800-521-GIVE.

Please complete the following information:

Driver's License Number:_________________ Social Security Number:______________

I,_________________________ being of sound mind, do hereby desire to have my name
           (Print your name)

REMOVED from the Louisiana Donor Registry, Under Louisiana Law (R.S. 17:2351, et. seq.).
I DO NOT WISH to make an anatomical donation.


____________________________________________
Applicant (SIGNATURE)


___________________
Date










Dear Friends,


Below is an interesting article written by scientists and neurologists to voice their concern over the historical development of organ transplantation. This article was taken from Discover magazine (May 2012). It is a scientific magazine with no religious affiliation, and yet they see it more correctly than 99 percent of the Christian community does.


As you know, the Church teaches that death is the separation of body and soul. The Church was willing to give the Last Rites until all perfusion and ventilation had ceased (the heart had stopped beating and breathing had ceased), the body was cold, and rigor mortis had set in, in case there was any possibility at all that the person might still be alive.


We are on a campaign to stop "vital organ" transplantation, since it cannibalizes those people who have falsely been declared "brain dead." Non-vital organ donations that do not kill or injure the donor, such as kidney transplants, remain acceptable.


For a more extensive review, see the video by Dr. Paul Byrne and Bernice Jones, "Dead or Alive."


Ad Majorem Dei Gloriam,


Rich Mahoney