|Vital Organ Transplantation|
and “Brain Death”
A Re-Examination of the
Basic Issues by Dr. Paul A. Byrne
Note: The following important interview with distinguished physician and pro-life advocate Dr. Paul Byrnes is conducted by Randy Engel. It is from the latest “Friends of Michal Fund Newsletter”
Randy Engel: Dr. Byrne, how would you describe the body of a human being?
Dr. Byrne: A human person on earth is composed of body and soul. God creates the person. Biologically speaking, the body is composed of cells, tissues, organs and eleven systems, including three major vital systems. No one organ or system controls all other organs and systems. Interdependent functioning of organs and systems maintains unity, homeostasis, immune defenses, growth, healing and exchange with environment, e.g., oxygen and carbon dioxide. Life on earth is a continuum from its conception to its natural end. The natural end (true death) occurs when the soul separates from the body.
RE: Most adults and children, even if they are not physicians, recognize signs of life, don’t they?
Dr. Byrne: Yes, of course. The vital signs of a living human being include temperature, pulse, blood pressure and respiration. Physicians, nurses and paramedics listen to the beating heart with a stethoscope. Patients in intensive care units have monitors to demonstrate the beating heart, blood pressure, respiration and oxygen in the blood.
RE: What about the signs of death?
Dr. Byrne: Throughout the ages, death has been and is a negative, an absence – the state of the body without life. The soul has left the body and decomposition has begun. After death what is left on earth is a corpse. The remains are empty, cold, blue, rigid and unresponsive to all stimuli. There is no heartbeat, pulse or blood pressure. The patient has stopped breathing. There is poor color of the skin, nails, and mucous membranes. Ventilation will not restore respiration in a corpse. A pacemaker can send a signal but it cannot initiate the heartbeat in the corpse. Healing never occurs in a patient that is truly dead.
RE: When we speak of vital organs, what organs are we talking about?
Dr. Byrne: Vital organs (from the Latin vita, meaning life) include the heart, liver, lungs, kidneys and pancreas. In order to be suitable for transplant, they need to be removed from the donor before respiration and circulation cease. Otherwise, these organs are not suitable, since damage to the organs occurs within a brief time after circulation of blood with oxygen stops. Removing vital organs from a living person prior to cessation of circulation and respiration will cause the donor’s death.
RE: Are there some vital organs which can be removed without causing the death of the donor?
Dr. Byrne: Yes. For example, one of two kidneys, a lobe of a liver, or a lobe of a lung. The donors must be informed that removal of these organs decreases function of the donor. Unpaired vital organs however, like the heart or whole liver, cannot be removed without killing the donor.
RE: Since vital organs taken from a dead person are of no use, and taking the heart of a living person will kill that person, how is vital organ donation now possible?
Dr. Byrne: That’s where “brain death” comes in. Prior to 1968, a person was declared dead only when his or her breathing and heart stopped for a sufficient period of time. Declaring “brain death” made the heart and other vital organs suitable for transplantation. Vital organs must be taken from a living body; removing vital organs will cause death.
RE: I still recall the announcement of the first official heart transplant by Dr. Christian Barnard in Cape Town, South Africa in 1967. How was it possible for surgeons to overcome the obvious legal, moral and ethical obstacles of harvesting vital organs for transplant from a living human being?
Dr. Byrne: By declaring “brain death” as death.
RE: You mean by replacing the traditional criteria for declaring death with a new criterion known as “brain death”?
Dr. Byrne: Yes. In 1968, an ad hoc committee was formed at Harvard University in Boston for the purpose of redefining death so that vital organs could be taken from persons declared “brain dead,” but who in fact, were not dead. Note that “brain death” did not originate or develop by way of application of the scientific method. The Harvard Committee did not determine if irreversible coma was an appropriate criterion for death. Rather, its mission was to see that it was established as a new criterion for death. In short, the report was made to fit the already arrived at conclusions.
RE: Does this mean that a person who is in a cerebral coma or needs a ventilator to support breathing could be declared “brain dead”?
Dr. Byrne: Yes.
RE: Even if his heart is pumping and the lungs are oxygenating blood?
Dr. Byrne: Yes. You see, vital organs need to be fresh and undamaged for transplantation. For example, once breathing and circulation ceases, in five minutes or less, the heart is so damaged that it is not suitable for transplantation. The sense of urgency is real. After all, who would want to receive a damaged heart?
RE: Did the Harvard criterion of “brain death” lead to changes in state and federal laws?
Dr. Byrne: Indeed. Between 1968 and 1978, more than thirty different sets of criteria for “brain death” were adopted in the United States and elsewhere. Many more have been published since then. This means that a person can be declared "brain dead" by one set of criteria, but alive by another or perhaps all the others. Every set includes the apnea test. This involves taking the ventilator away for up to ten minutes to observe if the patient can demonstrate that he/she can breathe on his/her own. The patient always gets worse with this test. Seldom, if ever, is the patient or the relatives informed ahead of time what will happen during the test. If the patient does not breathe on his/her own, this becomes the signal not to stop the ventilator, but to continue the ventilator until the recipient/s is, or are, ready to receive the organs. After the organs are excised, the “donor” is truly dead.
RE: What about the Uniform Determination of Death Act (UDDA)?
Dr. Byrne: According to the UDDA, death may be declared when a person has sustained either “irreversible cessation of circulatory and respiratory functions” or “irreversible cessation of all functions of the entire brain, including the brain stem.” Since then, all 50 states consider cessation of brain functioning as death.
RE: How does the body of a truly dead person compare with the body of a person declared “brain dead”?
Dr. Byrne: The body of a truly dead person is characterized in terms of dissolution, destruction, disintegration and putrefaction. There is an absence of vital body functions and the destruction of the organs of the vital systems. As I have already noted, the dead body is cold, stiff and unresponsive to all stimuli.
RE: What about the body of a human being declared to be “brain dead”?
Dr. Byrne: In this case, the body is warm and flexible. There is a beating heart, normal color, temperature, and blood pressure. Most functions continue, including digestion, excretion, and maintenance of fluid balance with normal urine output. There will often be a response to surgical incisions. Given a long enough period of observation, someone declared “brain dead” will show healing and growth, and will go through puberty if they are a child.
RE: Dr. Byrne, you mentioned that “brain dead” people will often respond to surgical incisions. Is this referred to as “the Lazarus effect?”
Dr. Byrne: Yes. That is why during the excision of vital organs, doctors find the need to use anesthesia and paralyzing drugs to control muscle spasms, blood pressure and heart rate changes, and other bodily protective mechanisms common in living patients. In normal medical practice, a patient’s reaction to a surgical incision will indicate to the anesthesiologist that the anesthetic is too light. This increase in heart rate and blood pressure are reactions to pain. Anesthetics are used to take away pain. Anesthesiologists in Great Britain require the administration of anesthetic to take organs. A corpse does not feel pain.
RE: I know that there have been instances where young pregnant women have sustained serious head injuries, declared “brain dead,” and have given birth to a live child.
Dr. Byrne: That is true. With careful management, these “brain dead” women have delivered a live baby. In the longest recorded instance, the child was carried for 107 days before delivery.
RE: Are there other uses for “brain dead” patients besides being the source of fresh vital organs?
Dr. Byrne: Legally, “brain dead” patients are considered corpses or cadavers, and are called such by organ retrieval networks. These “corpses” can be used for teaching purposes and to try out new medical procedures. Yet these same “corpses” are carrying unborn children to successful delivery. Certainly this is extraordinary behavior by a “cadaver!”
RE: What if a potential organ donor does not meet the criteria for “brain death,” but has sustained certain injuries or has an illness suggesting that death will soon occur?
Dr. Byrne: Such cases have brought about the development of a what is called “non heart-beating donation” (NHBD), more recently labeled “donation by cardiac death” (DCD)–in which treatments considered extraordinary means, such as mechanical ventilation, are discontinued and cause the patient to become pulseless. As soon as circulation stops, death is declared.
RE: Then what?
Dr. Byrne: This stopping of life supporting treatments is done in the operating room. After a few minutes–the time varies in different institutions–procedures to take vital organs begins.
RE: But how can this be accomplished if the person declared to be dead, is truly dead?
Dr. Byrne: It can’t.
RE: What about insurance coverage for “brain dead” patients?
Dr. Byrne: Hospitals allow them to occupy a bed and insurance companies cover expenses as they do for other living patients. If the patients’ organs are suitable for transplantation, any transfer of the patients to another hospital is covered by insurance. Insurance also covers the cost of life support, blood transfusions, antibiotics and other medications needed to maintain organs in a healthy state. This also applies to “brain dead” patients to be used in medical teaching facilities.
RE: I know that the federal government has taken an active role in promoting so-called “living wills.” Has it also played a role in promoting vital organ donations?
Dr. Byrne: The federal government has, for reasons that are unclear, been deeply involved in promoting vital organ transplantation. For example, a federal mandate issued in 1998 states that physicians, nurses, chaplains, and other health care workers may not speak to a family of a potential organ donor without first obtaining approval from the regional organ retrieval system. If the potential for transplantation exists, a trained “designated requester” visits with the family of the patient first, including families that adamantly oppose organ donation. If someone at the hospital speaks to the family of the patient first, the hospital risks losing its accreditation and possibly federal funding.
RE: Why the “designated requester”?
Dr. Byrne: That’s because studies show that these specialists have a greater success obtaining permission for organ donations from grieving family members. They are trained to “sell” the concept of organ donation, using emotionally-laden phrases such as “giving the gift of life,” “your loved one’s heart will live on in someone else,” and other similar platitudes, all empty of true meaning. Don’t forget that the donation and transplant industry is a multi- billion dollar enterprise. In 1996, Forbes Magazine ran an informative series on this issue, but as a rule it is difficult, if not impossible, to obtain solid financial data. One thing, however, is clear: donor families do not receive any monetary benefit from their “gift of life.”
RE: There appears to be a strong utilitarian aspect to vital organ transplantation.
Dr. Byrne: That is because the philosophy that inspires the practice is based on the error that man is an end to himself, and the sole maker with supreme control of his own destiny. Slavery bought, sold and treated enslaved persons as chattel. The human transplantation industry and the “bioethics” groups that promote vital organ transplantation also consider human beings to be chattel, that is, they can be used as a source of organs for transplantation. This utilitarian ethic should be rejected. “Brain death” and all forms of imposed death are contrary to the Natural Moral Order and against God’s Ordinance “Thou shall not kill.”
RE: It is obvious that organ donation is a very serious matter – literally a matter of life and death for the potential donor and the family of a potential donor, and that everyone ought to be implicitly and explicitly informed about the true nature of so-called “brain death” and vital organ transplantation. Would you review for our readers some of the questions they should ask themselves before signing an organ donor card or giving permission for a loved one to be declared “brain dead” in anticipation of organ transplantation?
Dr. Byrne: If there is any question in the mind of your readers as to the fact that “brain death” is not true death, perhaps they may want to ask themselves the following questions regarding “brain death” and vital organ transplantation:
· Why can health insurance cover intensive care costs on “brain dead” patients?
· Why do “brain dead” patients often receive intravenous fluids, antibiotics, ventilator care, and other life support measures?
· Is it right and just for physicians and “designated requesters” to tell families that their “brain-dead” loved one is dead when she or he is not dead?
· How can “brain dead” patients have normal body functions, including vital signs, if they are really dead?
· How can a “brain-dead” pregnant mother deliver a normal, healthy infant?
· Why does a ventilator work on someone declared “brain dead,” but not on a corpse?
· Why is it wrong to carry out the burial or cremation of a “brain-dead” person?
· Are persons who have been declared “brain dead” truly dead?
· If “brain-dead” persons are not truly dead, are they alive?
RE: Thank you on behalf of The Michael Fund for providing this valuable information to our readership?
Dr. Byrne: Thank you for this opportunity to inform your readers about this vital issue of vital organ transplantation. If they don’t remember every thing that I have said, I hope that they will remember this one point: “brain death” is not true death. Instead of signing a donor organ card, I would encourage everyone to obtain a Life Support Directive. A free copy of this document is available from Citizens United Resisting Euthanasia at: email@example.com or write C.U.R.E, 303 Truman Street, Berkeley Springs, WV 25411.
Dr. Paul A. Byrne is a neonatologist and a Clinical Professor of Pediatrics. He is a member of the Fellowship of Catholic Scholars and past-President of the Catholic Medical Association. He is the producer of the film Continuum of Life and the author of Life, Life Support and Death, Beyond Brain Death, and Brain Death is Not Death. Dr. Byrne has presented testimony on life-death issues to eight state legislatures beginning in 1967. He opposed Dr. Jack Kevorkian on the television program “Cross-Fire.” and has appeared on “Good Morning America” and the British Broadcasting Corporation (BBC).
The International Foundation for Genetic Research, popularly known as The Michael Fund, is a U.S.-based pro-life genetic research agency specializing in Down syndrome research. Please visit us at www.michaelfund.org.
From the January 2008 issue of
Catholic Family News
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|Debate Over Brain Death Continues|
Book Release Highlights Lingering Questions
By Carrie Gress
ROME, MARCH 2, 2008 (Zenit.org).- While brain death has been accepted as death legally, from an ethical and ecclesial perspective, the debate is still open, says Professor Roberto de Mattei.
De Mattei affirmed this Wednesday during the release of the Italian edition of "Finis Vitae: Is Brain Death Still Life," a book he edited that compiles essays considering the issue of brain death from legal, medical, philosophical and sociological perspectives.
The book was published by the Council for Research, not an ecclesiastical body, but an Italian public organization focusing on the area of scientific research. They released the English edition in 2006.
While Bishop Fabian Bruskewitz of Lincoln, Nebraska, is a contributor, along with three members of the Pontifical Academy for Life, the Church has not yet made an official determination about brain death. There are others in the Church who argue that brain death is a licit criterion for death.
In addition to de Mattei, those attending the book release included Mercedes Wilson, of Family of the Americas; Dr. Paul Byrne, of St. Vincent's Medical Center, Ohio; Josef Seifert, of the International Academy of Philosophy of Lichtenstein; and Dr. Cicero Galli Coimbra, of the University of São Paulo, Brazil.
Byrne, a neonatologist who was invited by the Pontifical Academy of Sciences in February 2005 to speak on this issue, said: "Brain death is not true death. Brain death is a fiction concocted to get organs. After true death very few, if any, organs are suitable for transplantation."
"True death," Byrne explained, "is the body without life, when disintegration sets in. It is more than just non-functioning, which brain death revolves around."
"With true death," the American doctor continued, "there is no pulse, no movement. With brain death someone can be declared dead although the heart is beating, the skin is pink, the body is warm, they are growing, and wounds are healing. A pregnant woman declared brain dead can still deliver a healthy baby and her body will produce milk.
"Many think that brain death means flat brain waves, when in fact some criteria do not include even the recording of brain waves in their evaluation, much less the demand for no electrical activity.
"Every set of criteria for brain death includes an apnea test -- apnea means the absence of breathing. This test, which has no benefit for the comatose patient, and in fact aggravates the patient's already compromised condition, is done without the knowledge or informed consent of family members."
"The sole purpose of the apnea test is to determine the patient's ability/inability to breathe on his own in order to declare the individual brain dead. Without the apnea test," Byrne summarized, "the diagnosis of brain death is impossible, and without the diagnosis of brain death, transplantation of unpaired vital organs is not permissible."
He added, "A living person can give blood and bone marrow to another person. A living person might give one of their two kidneys, a part of their liver, or one lobe of a lung to another person. The word 'might' is purposely used to alert potential donors that as long as such donation does not cause death or disabling mutilation to the donor, it is acceptable."
|Doctor Says about "Brain Dead" Man Saved from Organ Harvesting - "Brain Death is Never Really Death"|
Expert says, "Brain death was concocted, it was made up in order to get organs. It was never based on science."
By John Jalsevac
OKLAHOMA, March 27, 2008 (LifeSiteNews.com) - 21-year-old Zack Dunlap, a man who was diagnosed as "brain dead" and who was mere minutes away from having his organs harvested, now says, four months after the accident that brought him to the brink of death, that he feels "pretty good." Dunlap's story was told in an NBC piece aired earlier this week, in which the young man himself was interviewed.
While Zack's case is being touted in the media as a "miracle", a neonatologist and expert on brain-death has told LifeSiteNews.com that Zack's case, while remarkable in a sense, is not as rare as the mainstream media's reporting makes it seem.
"The young man was never dead," said Dr. Paul Byrne, a former president of the Catholic Medical Association who began writing about brain death in 1977. What makes Dunlap's case unusual, though not unheard of, says Byrne, is that Zack was lucky enough to be found out to be alive before his vital organs were removed.
"While the story is put out as something that's miraculous," he told LifeSiteNews, "I don't want to take anything away from God, but it's not supernatural what occurred. If there is anything miraculous about it, it is that they didn't get his organs before someone was able to notice some sort of other response. He was always living - his heart was always beating, there was always blood pressure, he was always very much alive."
Dr. Byrne says that over the years he has collected information pertaining to numerous cases where patients labeled brain dead have "returned from the dead." The reason being, says Byrne, is that "brain death is never really death."
Zack Dunlap suffered numerous broken bones and severe head trauma last November after he was involved in an accident, in which he lost control of the four-wheeler he was driving and flipped over. At the hospital doctors diagnosed the young warehouse worker as "brain dead". Oklahoma officials were informed that Zack was legally dead and that his organs were about to be harvested.
"We wanted to make sure that some lucky person got to live on through Zack's heart," Zack's mother Pam told NBC.
Plans to remove her son's organs, however, were put on hold in a dramatic fashion.
Two of Zack's cousins, both nurses, said that, in the final moments before the medical team that was to harvest Zack's organs arrived, they felt that their cousin wasn't truly gone. On a hunch Dan Coffin ran his pocket knife across Zack's foot. The supposedly brain dead patient reacted immediately by jerking back his foot. Coffin then dug his fingernail beneath Zack's fingernail, a particularly tender spot on the body, and his cousin once again reacted by drawing his arm across his body.
"We went from the lowest possible moment to, 'Oh, my gosh, our son is still alive!'" related Pam Dunlap.
Zack's grandmother said that she too felt, like Zack's cousins, that her grandson wasn't ready to go. Shortly before her grandson began to show signs of life again, she had gone into his room and prayed for a miracle. "He was too young for God to take him," she said tearfully in the NBC interview. "It wasn't time."
"I had heard of miracles all my life. But I had never seen a miracle. But I have seen a miracle. I've got proof of it," she said.
"We both feel that God has some big plan for Zack. We'll do everything in our power to help him pursue it - whatever it is," said Dunlap's mother.
The young man himself told NBC that he heard the doctors pronounce him brain dead, and said, "I'm glad I couldn't get up and do what I wanted to do." When asked what he wanted to do, he responded, "There probably would have been a broken window they went out."
"It just makes me thankful, it makes me thankful that they didn't give up," he said about his relatives' last attempts to find out if he was still alive. "Only the good die young, so I didn't go."
Zack's father, Doug Dunlap, says that he doesn't blame anyone, indicating that the doctors assured him that his son was dead, and that there was no blood-flow to his brain. "They said he was brain-dead, that there would be no life, so we were preparing ourselves."
48 days after Zack's accident, the young man returned home, walking on his own two feet. He still suffers some emotional problems, memory loss and other consequences from the accident, and a full recovery may take up to a year. But his parents say that are simply thankful that their son is alive.
Dr. Byrne, on the other hand, told LifeSiteNews.com that Zack's story should be taken as a warning about the insufficiency of the brain death criteria. "While this story tells the young man hearing them talking about his declaration of brain death, the question is, is how many of the other organ donors are in a similar situation, that the only thing is that they end up getting their organs?" he said.
"Brain death was concocted, it was made up in order to get organs. It was never based on science."
In 2007 Dr. John Shea, LifeSiteNews.com's medical advisor, wrote in agreement with Byrne's concerns about brain death, saying that the criteria of "brain death" is scientific theory, and not fact, adding that it is a theory that is particularly open to utilitarian abuse and therefore should be treated with extra caution. He also pointed out that there is the added trouble that there are a number of various sets of brain-death criteria, such that a person may be considered dead according to one, and not by another.
See previous LifeSiteNews.com stories on this issue:
Denver Coroner Rules "Homicide" in Organ-Donor Case
Russian Surgeons Removing Organs Saying Patients Almost Dead Anyway
|The mother who came back from the dead - ten minutes after her life support machine was turned OFF|
By Paul Thompson
A mother of two has stunned doctors by apparently coming back from the dead.
Velma Thomas's heart stopped beating three times and she was clinically brain dead for 17 hours. Her son had left the hospital to make funeral arrangements, having been told she would not survive.
But ten minutes after her life support system was shut down and doctors were preparing to take her organs for donation, the 59-year-old woke up.
Heart specialist Kevin Eggleston said: 'There are things that as physicians and nurses we can't always explain. I think this is one of those cases.'
He said Mrs Thomas had no pulse, no heartbeat or brain activity after her admission to hospital. She had been found unconscious after suffering a heart attack at her home in West Virginia.
While at the Charleston Area Medical Centre she suffered two further heart attacks and was placed on a life support system.
About 25 family members and friends gathered inside the hospital waiting room. 'We just prayed and prayed and prayed,' said her son Tim, 36. 'And I came to the conclusion she wasn't going to make it.
'I was given confirmation from God to take her off the ventilator and my pastor said the same thing. I felt a sense of peace that I made the right decision. Her skin had already started hardening, her hands and toes were curling up. There was no life there.'
He said after he left the hospital he was called and told she had shown signs of life.
By the time he got to her hospital room, Mrs Thomas was alert and talking. 'She had already asked, "Where's my son?",' he said.
Dr Eggleston added: 'It's a miracle.'
|Doctors Who Almost Dissected Living Patient Confess Ignorance about Actual Moment of Death|
Revives debate in France over organ donation, definition of "brain death"
By Matthew Cullinan Hoffman
PARIS, France, June 12, 2008 (LifeSiteNews.com) - A Parisian whose organs were about to be removed by doctors after he had "died" of a heart attack, revived on the operating table only minutes before doctors began to harvest his organs.
The 45 year-old man, whose name has been withheld by the French media, was given heart massage by paramedics after collapsing on a street in Paris earlier this year. He was then transferred to a nearby hospital for further emergency procedures, but doctors were not able to restore a consistent heartbeat.
After deciding that they would be unable to dilate the coronary artery (which supplies the heart with blood and is blocked or constricted during a heart attack), the doctors decided to extract the patient's organs for transplant. Transplant doctors were not available at the time, and heart massage was applied for an hour and thirty minutes until the doctors arrived. Le Monde newspaper says that during this period doctors were still unable to revive the heart.
However, when the transplant doctors prepared to operate, they noticed the patient was breathing, his pupils were dilating and he was reacting to pain. He was very clearly alive.
Several weeks later, the patient was walking and talking.
"All of the specialist medical literature on the subject comes to the conclusion that a person who is a victim of cardiac arrest who is given cardiac massage correctly for thirty minutes, is, in all likelihood, in a state of brain death," professor Alain Tenaillon, who is responsible for transplants with the French Agency of Biomedicine, told Le Monde. "But we must recognize that there are exceptions."
An ethics committee report created by the hospital in response to the case recorded comments from medical personnel who admitted that, while rare, such cases of "brain dead" patients spontaneously reviving are common knowledge among them.
The report acknowledged that, according to current hospital policies regarding brain death, the patient "would probably have been considered dead". Le Monde added that according to experts, "this situation is a striking illustration of the issues that persist in the field of resuscitation, procedures and criteria to conclude the failure of resuscitation".
As LifeSiteNews has reported in the past, the concept of "brain death" was first applied in 1968. The term is used to justify removing organs from patients who are breathing and have a heartbeat, the most common circumstance under which organ donation takes place. Prior 1968, the prolonged absence of heartbeat and respiration were the standard criteria for certifying death (http://www.lifesitenews.com/ldn/1999/mar/99030301.html).
Dr. John Shea, a medical advisor to Canada's Campaign Life Coalition, points out in a recent article that patients diagnosed as "brain dead" often continue to exhibit brain functions.
In "Organ Donation: The Inconvenient Truth" (http://www.lifesitenews.com/ldn/2007_docs/Organdonationincon...), Shea states that the criteria for "brain death" only "test for the absence of some specific brain reflexes. Functions of the brain that are not considered are temperature control, blood pressure, cardiac rate and salt and water balance. When a patient is declared brain dead, these functions are not only still present, but also frequently active."
Shea also notes that the very definition of "brain death" is vague and inconsistent: "There is no consensus on diagnostic criteria for brain death. They are the subject of intense international debate. Various sets of neurological criteria for the diagnosis of brain death are used."
"A diagnosis of death by neurological criteria is theory, not scientific fact," writes Shea. "Also, irreversibility of neurological function is a prognosis, not a medically observable fact."
The major media has reported three cases so far this year of individuals declared "brain dead" who later revived (see links below). In the case of 21 year-old Zack Dunlap, an MRI scan reportedly indicated no blood flow to his brain. Dunlap began to react to pain only moments before doctors were to remove his organs. He recovered with only some memory loss.
Organ Donation: The Inconvenient Truth, by Dr. John Shea
Related LifeSiteNews Coverage:
Woman's Waking After Brain Death Raises Many Questions About Organ Donation
Doctor Says about "Brain Dead" Man Saved from Organ Harvesting - "Brain Death is Never Really Death"
Woman Diagnosed as "Brain Dead" Walks and Talks after Awakening
The Inconvenient Truth About Organ Donations
Mother Alleges Doctor Murdered Her Handicapped Son to Harvest His Organs
Organ Donation after Cardiac Death a Danger to Critical Patients ~ Medical Professor
Questions Answered on Organ Donation: Interview with Dr. John B. Shea M.D
HEART TRANSPLANTS: IS BRAIN DEATH REAL DEATH?
|New England Journal of Medicine: 'Brain Death' is not Death - Organ Donors are Alive|
Will the Catholic Church now issue a form position against vital organ donation?
By John-Henry Westen
BOSTON, August 14, 2008 (LifeSiteNews.com) - In an article that is sure to rock the world of organ donation, the highly respected New England Journal of Medicine (NEJM) has backed up the objections of various pro-life groups, as well as some scientists and physicians, to certain types of organ donation which involve the removal of vital organs from patients believed to be dead. The problem, say the authors of the NEJM article, is that in many cases these patients may not be dead at all.
Key experts in the medical field have, since its inception, considered the 1968 invention of 'brain death' and the more recent criteria of 'cardiac death' as unsupportable criteria for true death. If it is true, however, that brain death and cardiac death are invalid as criteria for true death, it would make morally illicit vital organ donation, since such donation would in some cases result directly in the killing of the donor for the purpose of harvesting his organs.
The two authors of the article in the NEJM, both proponents of organ donation, argue that "as an ethical requirement for organ donation, the dead donor rule has required unnecessary and unsupportable revisions of the definition of death."
The article was co-authored by Dr. Robert D. Truog, a professor of medical ethics and anesthesia (pediatrics) in the Departments of Anesthesia and Social Medicine at Harvard Medical School and the Division of Critical Care Medicine at Children's Hospital Boston and Dr. Franklin G. Miller, a faculty member in the Department of Bioethics, National Institutes of Health, Bethesda, MD.
The many cases hitting the media of patients pronounced 'brain dead' and living to tell their stories have already led the public to question the notion of 'brain death'. A recent case in France where a patient revived on the operating table as surgeons were about to remove his organs, is only the latest in a string of such events. (see: http://www.lifesitenews.com/ldn/2008/jun/08061308.html )
Troug and Miller, after admitting that the scientific literature does not support the criteria for 'brain death' and 'cardiac death' as being real death, suggest instead that ethicists should simply remove the requirement for dead donors. "The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead," they write.
Similarly they note that with 'cardiac death', "although it may be ethical to remove vital organs from these patients, we believe that the reason it is ethical cannot convincingly be that the donors are dead." Troug and Miller suggest that, rather than insisting on dead donors, "ethical requirements of organ donation" should be looked at "in terms of valid informed consent under the limited conditions of devastating neurologic injury."
However, the dead donor criteria is precisely the thing that most moral ethicists agree makes it ethical to remove vital organs for transplant. Doing otherwise would constitute actively killing a person via removal of their vital organs.
In his August 29, 2000 address to the 18th International Congress of the Transplantation Society, Pope John Paul II stressed: "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 added: "This requirement is self-evident, since to act otherwise would mean intentionally to cause the death of the donor in disposing of his organs." (see the full address here: http://www.vatican.va/holy_father/john_pau...speeches/2000... )
Now that a prominent medical journal has come out and stated that brain death and cardiac death are invalid criteria for true death, some are hoping that the Catholic Church, which has not issued a formal position on vital organ donation, will officially come out in opposition to the practice - a practice which takes place in many Catholic hospitals throughout the world.
"The setting out of these facts should by all rights lead to a cessation of complete removal of any vital organ at Catholic hospitals", said Dr. John Shea, medical consultant to LifeSiteNews.com, who has written extensively on the subject of organ donation.
See the article from the NEJM online here:
|Reconsideration of ‘brain death’ criteria could affect ethics of organ donation|
Boston, Aug 18, 2008 / 01:00 am (CNA).- An article in the New England Journal of Medicine (NEJM), questioning the criteria of “brain death” and “cardiac death” especially in relation to organ donation, could affect the validity of ethical arguments approving the practice of organ donation at a person’s apparent death.
The NEJM article’s authors, Harvard Medical School professor Dr. Robert D. Truog and National Institutes of Health bioethics department faculty member Dr. Franklin G. Miller, argue that “as an ethical requirement for organ donation, the dead donor rule has required unnecessary and unsupportable revisions of the definition of death,” LifeSiteNews.com reports.
Saying that the scientific literature does not support the criteria which consider “brain death” and “cardiac death” to be actual death, the authors argue that the donation of vital organs taken from living human beings should not be considered unethical.
“The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead,” they write.
Drs. Troug and Miller suggest that ethical requirements of organ donation should not insist on dead donors but should consider organ donation “in terms of valid informed consent under the limited conditions of devastating neurologic injury.”
Unlike Troug and Miller, most moral ethicists consider the death of the donor as the event making it ethical to remove vital organs for transplant. They argue that removing vital organs from a living donor would constitute actively killing a person.
This is the generally accepted Catholic view.
In an August 29, 2000 address to the 18th International Congress of the Transplantation Society, Pope John Paul II emphasized that unpaired vital organs can be removed only after death, “from the body of someone who is certainly dead.”
Troug and Miller’s doubts about the ethical criteria used to justify organ donation have prompted some critics of organ donation to call for the cessation of the practice in Catholic hospitals.
“The setting out of these facts should by all rights lead to a cessation of complete removal of any vital organ at Catholic hospitals," said Dr. John Shea, a medical consultant to LifeSiteNews.com.
Dementia patients' 'right-to-die'
People should be able to say if they wish to die, Barnoess Warnock says
People with dementia should be able to end their lives if they feel they are a burden to others or to the NHS, according to a respected ethicist.
Baroness Mary Warnock, who has made similar calls in recent years, first made her remarks in a Church of Scotland magazine.
She told the BBC she believed there were many who "sank into dementia when they would very much prefer to die".
But Alzheimer's charities called her remarks "insensitive and ignorant".
Around 700,000 people in the UK have dementia and the number is expected to double within 30 years.
Lady Warnock says there should be more research to establish when people with dementia and Alzheimer's disease can still be regarded as mentally competent, so that they can make a decision that they wish to be helped to die if they reach a certain point in their illness.
The solution to our dementia crisis is not euthanasia
Rebecca Wood, Alzheimer's Research Trust
"We need more research to find out at what point one can say people diagnosed with Alzheimer's or dementia are still mentally competant to make the decision that they would prefer to die, rather than be a burden on their families or the NHS."
She praised the recently introduced Mental Capacity Act which gives people the right to appoint someone to act for them if cannot make decisions themselves.
But she addded: "I still think that there is a very huge number of people who sink into dementia and mental incapacity who would really very much prefer to die rather than continue in the state they are in.
"I think that's something most of us dread more then we dread any other form of dying."
Barnoness Warnock said many people with dementia became unable to swallow - "that's one of the most horrible conditions to be in".
"If one wants to avoid that, one should have the entitlement to make it clear what one wants to do, before that situation is reached."
She rejected the idea that allowing this would lead to pressure on assisted suicide for disabled people.
But Rebecca Wood, chief executive of the Alzheimer’s Research Trust, strongly criticised the peer's comments.
"Lady Warnock demonstrates a shocking ignorance when espousing her highly insensitive view that people with dementia are 'wasting people’s lives' and may have a 'duty to die.
"People with dementia can live quite comfortably when cared for properly.
"The solution to our dementia crisis is not euthanasia; the answer is more research so we can find new treatments, preventions and a cure.”
|QUOTE (Adesto @ Sep 19 2008, 07:50 PM)|
|People with dementia should be able to end their lives if they feel they are a burden to others or to the NHS, according to a respected ethicist.|
She praised the recently introduced Mental Capacity Act which gives people the right to appoint someone to act for them if cannot make decisions themselves.
But she addded: "I still think that there is a very huge number of people who sink into dementia and mental incapacity who would really very much prefer to die rather than continue in the state they are in.
|...Worrisome Vatican Organ Donation Conference|
The Vatican sponsored conference on organ donation is one of the more puzzling developments that we have encountered in recent years. It is a big story, but so far hardly any media, including pro-life and conservative media, have touched it. "Why?" is the big question.
LifeSiteNews has published a great number of positive reports on Vatican statements, conferences and actions over the years, but this conference is far outside the usual mold. The organ transplant industry itself is involved, which should send all kinds of warning signals.
Distinguished members of the Pontifical Academy For Life who have grave ethical concerns about how organs are harvested have been ignored and were all left off the original invitation list for the current meeting. The report agreed upon by the participants in a previous conference on the issue and which reflected serious concerns about organ harvesting practices was suppressed by the then Vatican Secretary of State. It was never made public. This was extremely unusual.
All we do know for certain is that the public has no idea how brain death and its many different definitions is determined and tested and the public is especially in the dark about the ghoulish aspects of organ harvesting, including the fact that in most cases, the donor must be kept alive almost up to the point of carving out the body parts for most parts to be useful. And there is more that we have discovered that would curl your hair.
Let's hope that full public disclosure on all aspects of organ harvesting, including how skilled organ industry negotiators are given the sole authority at hospitals to talk to family members after death has been declared, becomes one recommendation that comes out of the Vatican conference.
|Pope condemns organ transplant abuses as ‘abominable’|
Vatican City, Nov 7, 2008 / 11:54 am (CNA).- The Holy Father praised the generosity involved in the donation of organs or tissues and condemned the abuses in the transplant and trafficking of organs as he addressed an international congress on organ donation in Rome today.
Pope Benedict began his address to the conference entitled, “A Gift for Life. Considerations on Organ Donation.” by applauding the great advances of medical science in the realm of issue and organ transplants. Though these measures give hope to people who are suffering, he lamented the problem of a limited availability of organs, as evidenced “in the long waiting lists of many sick people whose only hopes of survival are linked to a minimal supply which in no way corresponds to effective need."
Despite the fact that the supply of organs is limited, the Pontiff emphasized that people can only donate, “if the health and identity of the individual are never put at serious risk, and always for morally-valid and proportional reasons. Any logic of buying and selling of organs, or the adoption of discriminatory or utilitarian criteria ... is morally unacceptable,” he stressed.
The Pope went on to address abuses in the transplant plant of organs and tissues such as organ trafficking, which often affect innocent people such as children. These abuses, he said, “must find the scientific and medical community united in a joint refusal. These are unacceptable practices which must be condemned as abominable.”
Pope Benedict also strongly criticized the idea of creating human embryos for organ harvesting. “The same ethical principle must be reiterated when it is suggested that human embryos be created and destroyed for therapeutic purposes. The very idea of considering the embryo as 'therapeutic material' contradicts the cultural, civil and ethical foundations upon which the dignity of the person rests."
The Holy Father then spoke about the necessity of informed consent being “a precondition of freedom,” ensuring "that transplants have the nature of a gift and are not interpreted as acts of coercion or exploitation."
He then recalled the dignity of a dead persons reminding the congress that "vital organs must not be removed save from a dead body, which also has a dignity that must be respected. Over recent years science has made further progress in ascertaining the death of a patient. ... In an area such as this, there must be no suspicion of arbitrariness, and where certainty has not been reached the principle of precaution must prevail."
The Pope also spoke to organ recipients saying that they “should be aware of the value” of the donation. “They are recipients of a gift that goes beyond its therapeutic benefit. What they receive, in fact, ... [it] is a testimony of love, and this must arouse an equally generous response so as to enhance the culture of giving and gratuity."
Transplants, "require all sides to invest every possible effort in formation and information, so as increasingly to awaken consciences to a problem that directly affects the lives of so many people,” the Holy Father concluded. ‘It is important, then, to avoid prejudices and misunderstandings, to overcome diffidence and fear replacing them with certainties and guarantees, so as to create in all people an ever- greater awareness of the great gift of life."
|Teenage girl wins right to die |
A terminally-ill girl has won the right to die after a hospital ended its bid to force her to have a heart operation.
Herefordshire Primary Care Trust dropped a High Court case after a child protection officer said Hannah Jones was adamant she did not want surgery.
Hannah, 13, of Marden, near Hereford, has refused a heart transplant because it might not work and, if it did, would be followed by constant medication.
The girl, who has a hole in her heart, says she wants to die with dignity.
Hannah was interviewed by the child protection officer after the trust applied for a court order in February to force the transplant.
She said she wanted to stop treatment and spend the rest of her life at home.
The BBC's Jane Deith, who has followed Hannah's legal battle, said: "Hannah managed to convince this officer that this was a decision she had made on her own and she had thought about it over a long period of time, and eventually the court proceeding was dropped."
Our reporter said that the girl's parents supported her decision and were "very proud of her".
"She didn't take the decision lightly, and she had chosen that she wanted to live and die in dignity at home with her parents."
The Daily Telegraph quoted Hannah's father Andrew, 43, as saying: "It is outrageous that the people from the hospital could presume we didn't have our daughter's best interests at heart.
"Hannah had been through enough already and to have the added stress of a possible court hearing or being forcibly taken into hospital is disgraceful."
Hannah previously suffered from leukaemia and her heart has been weakened by drugs she was required to take from the age of five.
|No ‘moral certainty’ that brain death is really death: prominent Catholic ethics professor Brugger|
by Hilary White
Fri Feb 04, 2011 18:21 EST
ROME February 4, 2011 (LifeSiteNews.com) – A prominent American professor of Catholic medical ethics has said that in “brain death” criteria there is no “moral certitude” that a patient is really dead, a condition laid out by Popes John Paul II and Benedict XVI as necessary for removing organs.
The available evidence, he said, “raises a reasonable doubt that excludes ‘moral certitude’ that ventilator-sustained brain dead bodies are corpses.”
Professor E. Christian Brugger, a Senior Fellow of Ethics at the Culture of Life Foundation gave this judgment in a question and answer article published today by the Rome-based news agency Zenit.
Brugger quoted Pope John Paul II, who told a congress on organ transplants that death is “a single event consisting in the total disintegration of that unity and integrated whole that is the personal self.”
E. Christian Brugger
“Although we cannot identify the event directly, we can identify biological signs consequent upon the loss of that unity,” said Brugger. But according to many experts, those biological signs are not present in “brain death” cases.
In his address to the 2000 organ transplant conference, Pope John Paul II had said that when “rigorously applied” brain death criteria “does not seem to conflict with the essential elements of a sound anthropology” but that this judgment must reach “moral certainty.”
Brugger suggests, however, that this statement does not “properly speaking” qualify as an authoritative statement of the magisterium, since the Church’s authority extends to matters of faith and morals. The validity of “brain death,” however, is based upon a “scientific premise that such and such empirical indicators correspond to an absence of human life.”
“This is a technical matter bearing on the adequacy of those indicators for accurately signifying that death has occurred,” he pointed out.
Brugger references the research of D. Alan Shewmon, which, he says, “demonstrates conclusively that the bodies of some who are rightly diagnosed as suffering whole brain death express integrative bodily unity to a fairly high degree.”
In fact, he says, “brain dead” patients on ventilator support “have been shown to undergo respiration at the cellular level … assimilate nutrients … fight infection and foreign bodies … maintain homeostasis … eliminate, detoxify and recycle cell waste throughout the body; maintain body temperature; grow proportionately; heal wounds … exhibit cardiovascular and hormonal stress responses to noxious stimuli such as incisions; gestate a fetus … and even undergo puberty.”
All of this, says Brugger, would seem to indicate that “brain death” fails to meet Pope John Paul’s definition of death as “the total disintegration of that unity and integrated whole that is the personal self.”
The controversy over organ transplants stems from the widespread application of various “brain death” criteria, as well as so-called “non-heart beating” death criteria to determine whether organs can be removed from a patient on life support. Physicians, eager to obtain organs, are routinely removing organs from patients whose vital signs are still strong, while family members frequently report being placed under heavy pressure to consent to organ “harvesting.”
This problem, however, has yet to be thoroughly addressed by the various relevant Vatican offices, with a strong trend among officials in favor of brain death criteria.
In November 2009, Pope Benedict XVI gave an address to a prestigious international conference on organ transplants in which he warned that the principle of moral certainty in determining death must be the highest priority of doctors. In its roster of speakers, that conference, partially sponsored by the Vatican’s own Pontifical Academy for Life, did not address the moral issue that is at the heart of the controversy over organ transplants.
The pope said, however, that donation of organs can only be licit if it does not “create a serious danger” to the health of the donor.
“There must not be the slightest suspicion of arbitrariness. Where certainty cannot be achieved, the principle of precaution must prevail,” he warned. Benedict added, “Informed consent is the precondition of freedom, so that the transplant has the characteristic of a gift and cannot be interpreted as an act of coercion or exploitation.”
Despite the uniformly positive approach of conference attendees towards brain death criteria, the pope’s statement was taken by many as a ringing warning.
The following February, at a separate conference on “brain death,” an international gathering of medical, neurological and philosophical experts roundly condemned the criteria, saying that they result in the deaths of patients by premature removal of organs.
|Brain Death & Organ Harvesting|
In light of the commentaries concerning Pope Benedict XVI's withdrawal of his consent to act as an organ donor, we think it appropriate to present this brief expose by Fr. Peter Scott on this important moral question which is often confusing for Catholics.
Fr. Peter Scott studied medicine before entering the seminary was ordained in 1988 by Archbishop Lefebvre. He served as a seminary professor of Theology, Philosophy, Latin and History, two consecutive terms as the SSPX's USA District Superior, and rector of Holy Cross Seminary in Goulburn, Australia. He is currently an academy principal in Ontario, Canada. His erudite articles and answers on modern medical issues have been much appreciated over the years.
The frequency of organ transplantation in recent years has brought to a head the debate which Popes John Paul II and Benedict XVI have been unable to resolve, despite several discourses on the question. The debate does not concern the morality of organ transplantation in itself. This question was in fact resolved by Pope Pius XII, when he spoke on the question of the transplantation of the cornea of the eye, which can be taken from the cadaver of a deceased person. He had this to say in his discourse to specialists of eye surgery on May 14, 1956: “The cadaver is not, in the proper sense of the word, a subject of rights, for it is deprived of the personality that can alone make it the subject of rights. The extirpation is no longer the removal of a good; the visual organs have, in effect, no longer the character of good in the cadaver, for they no longer serve it, and have no relationship to an end.” Hence the conclusion he draws: “The deceased person from whom the cornea is taken is not harmed in any of the goods to which he has a right, nor in his right to these goods.” (Quoted in Courrier de Rome, #312, June 2008)
The same principles can be applied to the transplantation of organs necessary for life, morally permissible provided that they are taken from a cadaver. John Paul II confirmed this very clear teaching in a discourse to the 18th International Medical Congress on Transplantation on August 24, 2000: “Individual vital organs in a body can only be removed after death. This requirement is obvious, since to act differently would mean to intentionally bring about the death of the donor by removing his organs.”
Brain Death & Real Death
However, the debate concerns the determination of the moment of death, necessary to morally remove organs for organ transplantation. The difficulty lies in the fact that the moment of death, the separation of body and soul, is not an event that is always obvious to empirical investigation. Furthermore, it is clear that, as both Pius XII and John Paul II admit, the determination of this moment is not a question for theology or for the Church’s Magisterium, but is a technical one for which the medical profession is responsible.
Before 1968, the determination of the moment of death was done by the cessation of respiratory and cardiac functions, entirely necessary to maintain the unity of a living being. However, it was in 1968 that the Harvard criteria were first proposed and accepted, namely that brain death could be used to determine the fact of death. Professor Seifert, a specialist on the question, had this to say to LifesiteNews of February 24, 2009: "We look in vain for any argument for this unheard of change of determining death ...except for two pragmatic reasons for introducing it, which have nothing to do at all with the question of whether a patient is dead but only deal with why it is practically useful to consider or define him to be dead …the wish to obtain organs for implantation and to have a criterion for switching off ventilators in ICUs."
It is the identification between brain death and real death that has become the moral basis of all transplantation of organs necessary for life since 1968, for it allows organs to be taken from a person considered juridically dead (consequently not really a person, and no longer considered as having either human dignity or rights, except as determined in a previous last will), but in all appearance biologically alive, given that his cardiac and respiratory functions are being artificially maintained. Encouragement was given to this opinion by Pope John Paul II when, in the abovementioned discourse of August 2000 he declared:
This opinion was further confirmed by a 2006 statement from the Holy See, entitled “Why the Concept of Brain Death Is Valid as a Definition of Death” and signed by Cardinal Georges Cottier, then theologian to the papal household; Cardinal Alfonso Lopez Trujillo, at the time president of the Pontifical Council for the Family; Cardinal Carlo Maria Martini, the former Archbishop of Milan; and Bishop Elio Sgreccia, the then president of the Pontifical Academy for Life.
However, John Paul II’s statement was certainly not definitive, and like Pius XII, he accepted the principle that when in doubt a person was presumed to be alive and not dead at all: “Moreover, we recognize the moral principle according to which even the simple suspicion of being in the presence of a living person brings with it the obligation of full respect for him and of abstaining from any action that aims at bringing about death” (March 20, 2004; Discourse to a congress of Catholic physicians). His acceptation of doubt on this question was shown by his approval of the decision of the Pontifical Academy for Life to convoke a meeting of specialists in February 2005 “On the Determination of the Precise Moment of Death,” which would have had no purpose if the neurological criteria were the final word on the question.
Benedict XVI has continued the same rather ambiguous attitude, on the one hand being in favor of organ transplantation as an act of charity (being himself a card carrying organ donor until elected pope), but on the other hand insisting that it is actual death that is required to legitimize organ transplantation. Professor E. Christian Brugger, Senior Fellow of Ethics at the Culture of Life foundation, points out that in his November 2009 address to a conference on organ transplantation organized in part by the Pontifical Academy of Life, Benedict XVI “warned that the principle of moral certainty in determining death must be the highest priority of doctors. In its roster of speakers, that conference… did not address the moral issue that is at the heart of the controversy over organ transplants” (LifeSiteNews, February 4, 2011).
While such traditionally-minded ethicists are hoping that opinion in the Vatican may swing back around to condemning brain death as a criterion of real death, we must ask ourselves the question as to why there is such timidity on such an important question. Why is it that the obvious common sense observation that brain death does not bring about dissolution of the organism, nor of its unity, nor of its vital activities, is not clearly admitted by the modernist theologians? There can be only one explanation: the influence of situation ethics, namely that the morality of each particular act depends essentially on the circumstances rather than on the act itself, with the consequent hesitation to condemn acts as intrinsically evil. This combined with the focus on a more secular ethics, concentrating on the value of man’s physical existence, rather than the sovereign importance of his soul, and of his eternal salvation, has led to the confusion. If only we had the clarity of Pope Pius XII, who in his discourse on the problems of resuscitation had this to say: “Human life continues for as long as its vital functions—which is not the same thing as the simple life of the organs—continue to manifest themselves spontaneously or with the help of artificial procedures”(in Courrier de Rome, op cit.).
The Dead Donor Rule False
A very interesting contribution to the whole consideration of the morality of the removal of organs from persons said to be brain dead has come from an unexpected source. It is the New England Journal of Medicine that published, on August 14, 2008, vol. 359 (7), p. 674-675, an article that demonstrates beyond all serious doubt that the harvesting of organs is done from persons that truly are living, and that in point of fact it is the harvesting of the organs necessary for life, such as lungs, heart, two kidneys, complete liver and pancreas, that is actually the cause of death.
The title of the article is “The Dead Donor Rule and Organ Transplantation” and it was written by Dr. Truong & Professor Miller (see the excerpt below).
The authors do not conclude that organ transplantation ought not therefore to be done, but to the contrary justify it on the purely utilitarian non-principle that the person was going to die in any case. This we cannot accept, as the Church has constantly taught, for the end does not justify the means, and you cannot kill a person on account of the good that can come to another person. Nevertheless, the passage attached as a note below illustrates the principle that the donor of the organs is indeed a living person, and hence that act of taking the organs is the deliberate termination of life, and that transplantation of organs necessary for life can only be justified as the taking of one life to save or prolong another life—that is, by playing God. The authors are entirely in favor of such immorality, but at least they avoid the hypocrisy of attempting to justify it by pretending that the brain dead person is actually a dead non-person, pointing out that he retains many vital functions, and can live for years in such a state.
In their own words: “The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead.” They do not even hesitate to question the motives of the medical profession changing from the definition of death by cessation of cardiac function, to that of brain death, purely and simply to obtain organs for transplantation: “At worst, this ongoing reliance suggests that the medical profession has been gerrymandering the definition of death to carefully conform with conditions that are most favorable for transplantation. At best, the rule has provided misleading ethical cover that cannot withstand careful scrutiny.”
This leaves us with the acute moral problem of patients who are dying, and whose only hope for physical survival lies in heart, lung, or liver transplants. Surely if it is up to the medical profession to determine the moment of death, it is also up to the Church to state loud and clear that brain death is not actual death, and cannot be used as a justification for organ transplantation. Surely if it is up to the medical profession to determine the moment of death, it is also up to the Church to state loud and clear that brain death is not actual death, and cannot be used as a justification for organ transplantation. These organs can only be usefully obtained from a body which still has all its vital functions, and which is still intact—that is biologically alive. The fact that the person is brain dead changes nothing to this. Such persons have no alternative but to accept their terminal illness and to prepare for a holy death. To accept the donation of organs is to accept the termination of another person’s life for one’s own good.
However, a clear distinction must be made from those persons who could receive a donation of an organ from a living person, without the removal of the organ causing his death. This is the case of the transplantation of one kidney, a part of a liver or pancreas, (either from a person in good health or one who is going to die), a cornea, or such harmless procedures as bone marrow transplantations. To the contrary, such transplantations, which require a sacrifice on the part of the donor, but not the loss of life, are strongly to be encouraged, whenever such means are a proportional and appropriate medical treatment.
Finally, Catholics ought to be reminded that they should not grant a general permission for organ transplantation from their own body, as is frequently requested, and that they should not allow such a permission to be included on their driver’s license. This would effectively be to grant permission for the immoral removal of their organs, and for their own murder, should they become brain dead, and it would take away from their Catholic relatives the power to stop the medical profession from taking these measures.
The Dead Donor Rule and Organ Transplantation
By Dr. Truong & Professor Miller
Published in the New England Journal of Medicine; August 14, 2008, vol. 359 (7), p. 674-675
Since its inception, organ transplantation has been guided by the overarching ethical requirement known as the dead donor rule, which simply states that patients must be declared dead before the removal of any vital organs for transplantation.
Before the development of modern critical care, the diagnosis of death was relatively straightforward: patients were dead when they were cold, blue, and stiff. Unfortunately, organs from these traditional cadavers cannot be used for transplantation. Forty years ago, an ad hoc committee at Harvard Medical School, chaired by Henry Beecher, suggested revising the definition of death in a way that would make some patients with devastating neurologic injury suitable for organ transplantation under the dead donor rule.
The concept of brain death has served us well and has been the ethical and legal justification for thousands of lifesaving donations and transplantations. Even so, there have been persistent questions about whether patients with massive brain injury, apnea, and loss of brain-stem reflexes are really dead. After all, when the injury is entirely intracranial, these patients look very much alive: they are warm and pink; they digest and metabolize food, excrete waste, undergo sexual maturation, and can even reproduce. To a casual observer, they look just like patients who are receiving long-term artificial ventilation and are asleep.
The arguments about why these patients should be considered dead have never been fully convincing. The definition of brain death requires the complete absence of all functions of the entire brain, yet many of these patients retain essential neurologic function, such as the regulated secretion of hypothalamic hormones. Some have argued that these patients are dead because they are permanently unconscious (which is true), but if this is the justification, then patients in a permanent vegetative state, who breathe spontaneously, should also be diagnosed as dead, a characterization that most regard as implausible. Others have claimed that “brain-dead” patients are dead because their brain damage has led to the “permanent cessation of functioning of the organism as a whole.” Yet evidence shows that if these patients are supported beyond the acute phase of their illness (which is rarely done), they can survive for many years. The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead.
Over the past few years, our reliance on the dead donor rule has again been challenged, this time by the emergence of donation after cardiac death as a pathway for organ donation. Under protocols for this type of donation, patients who are not brain-dead but who are undergoing an orchestrated withdrawal of life support are monitored for the onset of cardiac arrest. In typical protocols, patients are pronounced dead 2 to 5 minutes after the onset of asystole (on the basis of cardiac criteria), and their organs are expeditiously removed for transplantation. Although everyone agrees that many patients could be resuscitated after an interval of 2 to 5 minutes, advocates of this approach to donation say that these patients can be regarded as dead because a decision has been made not to attempt resuscitation.
This understanding of death is problematic at several levels. The cardiac definition of death requires the irreversible cessation of cardiac function. Whereas the common understanding of “irreversible” is “impossible to reverse” in this context irreversibility is interpreted as the result of a choice not to reverse. This interpretation creates the paradox that the hearts of patients who have been declared dead on the basis of the irreversible loss of cardiac function have in fact been transplanted and have successfully functioned in the chest of another. Again, although it may be ethical to remove vital organs from these patients, we believe that the reason it is ethical cannot convincingly be that the donors are dead.
At the dawn of organ transplantation, the dead donor rule was accepted as an ethical premise that did not require reflection or justification, presumably because it appeared to be necessary as a safeguard against the unethical removal of vital organs from vulnerable patients. In retrospect, however, it appears that reliance on the dead donor rule has greater potential to undermine trust in the transplantation enterprise than to preserve it. At worst, this ongoing reliance suggests that the medical profession has been gerrymandering the definition of death to carefully conform with conditions that are most favourable for transplantation. At best, the rule has provided misleading ethical cover that cannot withstand careful scrutiny. A better approach to procuring vital organs while protecting vulnerable patients against abuse would be to emphasize the importance of obtaining valid informed consent for organ donation from patients or surrogates before the withdrawal of life-sustaining treatment in situations of devastating and irreversible neurologic injury…
|QUOTE (ecce lupo @ Mar 26 2011, 01:01 PM)|
|There is worse on the way. They are now experimenting with womb transplants. Slowly man is trying to take over God's work. This is a total insult to the Most High. Exsuscitare!|
|QUOTE (confederate catholic @ Mar 28 2011, 06:34 PM)|
|i have a book produced just before the council Medico-Moral ethics. the book states quite clearly that organ transplanting is moraly wrong if it is from man or animal. Pius XII was quoted quite clearly upholding that men have the right to bodily integrity an violation of this natural law is always wrong (ie:a mortal sin). He was talking about organs that a man can live without in his talk so if this is wrong then obviously removing single organs would also be wrong)...the churches consistant teachin that MEN WILL DIE and that to transplant organs from one human being to another is in direct violation of the natural law.|
|QUOTE (confederate catholic @ Mar 28 2011, 07:00 PM)|
| yes the leg came from a dead man that is ok. now they take from live people.|
sorry if that was not clear :never from the living to living ---ok from dead to living
|QUOTE (Para 209)|
Organic transplantation (corneal, ovarian, renal, etc) according to the supreme law of charity, is probably lawful if it confers a proportionate benefit upon the recipient without depriving the donor completely of an important function. Nor does this seem to conflict with the teaching of Pius XII on the Principle of Totality. It is certainly lawful for a dying person to will his corneas to an eye bank.
|It is certainly lawful for a dying person to will his corneas to an eye bank.|
|Inter vivos donations|
In every instance, inter vivos transplants (vital homografts) demand answers to serious ethical and moral questions. Because these donations require a transplant from one living person to another, a moral dilemma involving the principle of totality arises. According to this principle, the parts of the body are ordered to the good of that specific body. Therefore, the surgical mutilation of a donor for the good of the recipient must not seriously impair or destroy bodily functions or beauty of the donor. 
For example, both eyes are necessary for certain visual functions. A living person would seriously impair his ability to see if an eye were donated to another. Such a sacrifice would detract from the wholeness or full functioning of the donor's body. It would be a bad means to a good end, and therefore morally wrong.
Some argue that each person has a right over their body to provide self-sacrifice for another in need. They cite people who gave their lives to save another, like St. Maximilian Kolbe. The analogy fails. Kolbe and others freely accepted death, but did not choose death. They did not end their own life. Rather, these martyrs accepted death so as to save another's life. In contrast, an organ donor does choose to impair or destroy bodily functions within himself by transferring these functions, via transplant, to another. 
Based upon the law of fraternal charity, one may intend to sacrifice an organ for the sake of another, but one also has the responsibility for the integrity of one's body. Therefore, the principle of totality sets limits on inter vivos organ donations. Otherwise, inter vivos transplants could lead to euthanasia or assisted suicide.
|An address given September 14, 1952 by His Holiness Pope Pius XII to the First International Congress on the Histopathology of the Nervous System.|
1. The "First International Congress on the Histopathology of the Nervous System" has succeeded in covering a truly vast amount of material. Through detailed explanation and demonstration it had to put into exact perspective the causes and first beginnings of the diseases of the nervous system properly so called and of the diseases we call psychic. A report was read and an exchange of views held on recent ideas and discoveries concerning lesions of the brain and other organs, which are the origin and cause of nervous diseases as well as of psychopathic illness. These discoveries have been made, partly, through entirely new means and methods. The number and nationality of the participants in the Congress, and especially of the speakers, show that specialists of the most diverse countries and nationalities have exchanged experiences for their own mutual benefit and to promote the interests of science, the interests of the individual patient and the interests of the community.
2. You do not expect Us to discuss the medical questions which concern you. Those are your domain. During the past few days you have taken a general view of the vast field of research and work which is yours. Now, in answer to the wish you yourselves have expressed, We want to draw your attention to the limits of this field-not the limits of medical possibilities, of theoretical and practical medical knowledge, but the limits of moral rights and duties. We wish to make Ourself the interpreter of the moral conscience of the research worker, the specialist and the practioner and of the man and Christian who follows the same path.
3. In your reports and discussions you have caught sight of many new roads, but there remain a number of questions still unsolved. The bold spirit of research incites one to follow newly discovered roads, to extend them, to create new ones and to renew methods. A serious, competent doctor will often see with a sort of spontaneous intuition the moral legality of what he proposes to do and will act according to his conscience. But there are other instances where he does not have this security, where he may see or think he sees the contrary with certainty or where he doubts and wavers between Yes and No. In the most serious and profound matters, the man in the physician is not content with examining from a medical point of view what he can attempt and succeed in. He also wants to see his way clearly in regard to moral possibilities and obligations.
4. We would like to set forth briefly the essential principles which permit an answer to be given to this question. The application to specific cases you will make yourselves in your role of doctor, because only the doctor understands the medical evidence thoroughly both in itself and in its effects and because without exact knowledge of the medical facts it is impossible to determine what moral principle applies to the treatment under discussion. The doctor, therefore, looks at the medical aspect of the case, the moralist, the laws of morality. Ordinarily, when explained and completed mutually, the medical and moral evidence will make possible a reliable decision as to the moral legality of the case in all its concrete aspects.
5. In order to justify the morality of new procedures, new attempts and methods of research and medical treatment, three main principles must be kept in mind:
1) The interests of medical science.
2) The interests of the individual patient to be treated.
3) The interests of the community, the "bonum commune."
6. We ask whether these three interests, taken singly or even together, have absolute value in motivating and justifying medical treatment or whether they are valid merely within certain determined limits? In the latter case, what are these limits? To this We shall try to give a brief answer.
I. The Interests of Science as Justification for Research and the Use of New Methods.
7. Scientific knowledge has its own value in the domain of medical science no less than in other scientific domains, such as, for example, physics, chemistry, cosmology and psychology. It is a value which must certainly not be minimized, a value existing quite independently of the usefulness or use of the acquired knowledge. Moreover, knowledge as such and the full understanding of any truth raise no moral objection. By virtue of this principle, research and the acquisition of truth for arriving at new, wider and deeper knowledge and understanding of the same truth are in themselves in accordance with the moral order.
8. But this does not mean that all methods, or any single method, arrived at by scientific and technical research offers every moral guarantee. Nor, moreover, does it mean that every method becomes licit because it increases and deepens our knowledge. Sometimes it happens that a method cannot be used without injuring the rights of others or without violating some moral rule of absolute value. In such a case, although one rightly envisages and pursues the increase of knowledge, morally the method is not admissible. Why not? Because science is not the highest value, that to which all other orders of values-or in the same order of value, all particular values-should be subordinated. Science itself, therefore, as well as its research and acquisitions, must be inserted in the order of values. Here there are well defined limits which even medical science cannot transgress without violating higher moral rules. The confidential relations between doctor and patient, the personal right of the patient to the life of his body and soul in its psychic and moral integrity are just some of the many values superior to scientific interest. This point will become more obvious as We proceed.
9. Although one must recognize in the "interests of science" a true value that the moral law allows man to preserve, increase and widen, one cannot concede the following statement: "Granted, obviously, that the doctor's intervention is determined by scientific interest and that he observes the rules of his profession, there are no limits to the methods for increasing and deepening medical science." Even on this condition, one cannot just concede this principle.
II. The Interests of the Patient as Justification of New Medical Methods of Research and Treatment.
10. In this connection, the basic considerations may be set out in the following form: "The medical treatment of the patient demands taking a certain step. This in itself proves its moral legality." Or else: "A certain new method hitherto neglected or little used will give possible, probable or sure results. All ethical considerations as to the licitness of this method are obsolete and should be treated as pointless."
11. How can anyone fail to see that in these statements truth and falsehood are intermingled? In a very large number of cases the "interests of the patient" do provide the moral justification of the doctor's conduct. Here again, the question concerns the absolute value of this principle. Does it prove by itself, does it make it evident that what the doctor wants to do conforms to the moral law?
12. In the first place it must be assumed that, as a private person, the doctor can take no measure or try no course of action without the consent of the patient. The doctor has no other rights or power over the patient than those which the latter gives him, explicitly or implicitly and tacitly. On his side, the patient cannot confer rights he does not possess. In this discussion the decisive point is the moral licitness of the right a patient has to dispose of himself. Here is the moral limit to the doctor's action taken with the consent of the patient.
13. As for the patient, he is not absolute master of himself, of his body or of his soul. He cannot, therefore, freely dispose of himself as he pleases. Even the reason for which he acts is of itself neither sufficient nor determining. The patient is bound to the immanent teleology laid down by nature. He has the right of use, limited by natural finality, of the faculties and powers of his human nature. Because he is a user and not a proprietor, he does not have unlimited power to destroy or mutilate his body and its functions. Nevertheless, by virtue of the principle of totality, by virtue of his right to use the services of his organism as a whole, the patient can allow individual parts to be destroyed or mutilated when and to the extent necessary for the good of his being as a whole. He may do so to ensure his being's existence and to avoid or, naturally, to repair serious and lasting damage which cannot otherwise be avoided or repaired.
14. The patient, then, has no right to involve his physical or psychic integrity in medical experiments or research when they entail serious destruction, mutilation, wounds or perils. 15. Moreover, in exercising his right to dispose of himself, his faculties and his organs, the individual must observe the hierarchy of the orders of values-or within a single order of values, the hierarchy of particular rights -insofar as the rules of morality demand. Thus, for example, a man cannot perform on himself or allow doctors to perform acts of a physical or somatic nature which doubtless relieve heavy physical or psychic burdens or infirmities, but which bring about at the same time permanent abolition or considerable and durable diminution of his freedom, that is, of his human personality in its typical and characteristic function. Such an act degrades a man to the level of a being reacting only to acquired reflexes or to a living automation. The moral law does not allow such a reversal of values. Here it sets up its limits to the "medical interests of the patient."
16. Here is another example. In order to rid himself of repressions, inhibitions or psychic complexes man is not free to arouse in himself for therapeutic purposes each and every appetite of a sexual order which is being excited or has been excited in his being, appetites whose impure waves flood his unconscious or subconscious mind. He cannot make them the object of his thoughts and fully conscious desires with all the shocks and repercussions such a process entails. For a man and a Christian there is a law of integrity and personal purity, of self-respect, forbidding him to plunge so deeply into the world of sexual suggestions and tendencies. Here the "medical and psychotherapeutic interests of the patient" find a moral limit. It is not proved-it is, in fact, incorrect-that the pansexual method of a certain school of psychoanalysis is an indispensable integrating part of all psychotherapy which is serious and worthy of the name. It is not proved that past neglect of this method has caused grave psychic damage, errors in doctrine and application in education, in psychotherapy and still less in pastoral practice. It is not proved that it is urgent to fill this gap and to initiate all those interested in psychic questions in its key ideas and even, if necessary, in the practical application of this technique of sexuality.
17. We speak this way because today these assertions are too often made with apodictic assurance. Where instincts are concerned it would be better to pay more attention to indirect treatment and to the action of the conscious psyche on the whole of imaginative and affective activity. This technique avoids the deviations We have mentioned. It tends to enlighten, cure and guide; it also influences the dynamic of sexuality, on which people insist so much and which they say is to be found, or really exists, in the unconscious or subconscious.
18. Up to now We have spoken directly of the patient, not of the doctor. We have explained at what point the personal right of the patient to dispose of himself, his mind, his body, his faculties, organs and functions, meets a moral limit. But at the same time We have answered the question: Where does the doctor find a moral limit in research into and use of new methods and procedures in the "interests of the patient?" The limit is the same as that for the patient. It is that which is fixed by the judgment of sound reason, which is set by the demands of the natural moral law, which is deduced from the natural teleology inscribed in beings and from the scale of values expressed by the nature of things. The limit is the same for the doctor as for the patient because, as We have already said, the doctor as a private individual disposes only of the rights given him by the patient and because the patient can give only what he himself possesses.
19. What We say here must be extended to the legal representatives of the person incapable of caring for himself and his affairs: children below the age of reason, the feebleminded and the insane. These legal representatives, authorized by private decision or by public authority have no other rights over the body and life of those they represent than those people would have themselves if they were capable. And they have those rights to the same extent. They cannot, therefore, give the doctor permission to dispose of them outside those limits.
III. The Interests of the Community as Justification of New Medical Methods of Research and Treatment.
20. For the moral justification of the doctor's right to try new approaches, new methods and procedures We invoke a third interest, the interest of the community, of human society, the common good or "bonum commune," as the philosopher and social student would say.
21. There is no doubting the existence of such a common good. Nor can we question the fact that it calls for and justifies further research. The two interests of which We have already spoken, that of science and that of the patient, are closely allied to the general interest.
22. Nevertheless, for the third time we come back to the question: Is there any moral limit to the "medical interests of the community" in content or extension? Are there "full powers" over the living man in every serious medical case? Does it raise barriers that are still valid in the interests of science or the individual? Or, stated differently: Can public authority, on which rests responsibility for the common good, give the doctor the power to experiment on the individual in the interests of science and the community in order to discover and try out new methods and procedures when these experiments transgress the right of the individual to dispose of himself? In the interests of the community, can public authority really limit or even suppress the right of the individual over his body and life, his bodily and psychic integrity?
23. To forestall an objection, We assume that it is a question of serious research, of honest efforts to promote the theory and practice of medicine, not of a maneuver serving as a scientific pretext to mask other ends and achieve them with impunity.
24. In regard to these questions many people have been of the opinion and are still of the opinion today, that the answer must be in the affirmative. To give weight to their contention they cite the fact that the individual is subordinated to the community, that the good of the individual must give way to the common good and be sacrificed to it. They add that the sacrifice of an individual for purposes of research and scientific investigation profits the individual in the long run.
25. The great postwar trials brought to light a terrifying number of documents testifying to the sacrifice of the individual in the "medical interests of the community." In the minutes of these trials one finds testimony and reports showing how, with the consent and, at times, even under the formal order of public authority, certain research centers systematically demanded to be furnished with persons from concentration camps for their medical experiments. One finds how they were delivered to such centers, so many men, so many women, so many for one experiment, so many for another. There are reports on the conduct and the results of such experiments, of the subjective and objective symptoms observed during the different phases of the experiments. One cannot read these reports without feeling a profound compassion for the victims, many of whom went to their deaths, and without being frightened by such an aberration of the human mind and heart. But We can also add that those responsible for these atrocious deeds did no more than to reply in the affirmative to the question We have asked and to accept the practical consequences of their affirmation.
26. At this point is the interest of the individual subordinated to the community's medical interests, or is there here a transgression, perhaps in good faith, against the most elementary demands of the natural law, a transgression that permits no medical research?
27. One would have to shut one's eyes to reality to believe that at the present time one could find no one in the medical world to hold and defend the ideas that gave rise to the facts We have cited. It is enough to follow for a short time the reports on medical efforts and experiments to convince oneself of the contrary. Involuntarily one asks oneself what has authorized, and what could ever authorize, any doctor's daring to try such an experiment. The experiment is described in all its stages and effects with calm objectivity. What is verified and what is not is noted. But there is not a word on its moral legality. Nevertheless, this question exists, and one cannot suppress it by passing it over in silence.
28. In the above mentioned cases, insofar as the moral justification of the experiments rests on the mandate of public authority, and therefore on the subordination of the individual to the community, of the individual's welfare to the common welfare, it is based on an erroneous explanation of this principle. It must be noted that, in his personal being, man is not finally ordered to usefulness to society. On the contrary, the community exists for man.
29. The community is the great means intended by nature and God to regulate the exchange of mutual needs and to aid each man to develop his personality fully according to his individual and social abilities. Considered as a whole, the community is not a physical unity subsisting in itself and its individual members are not integral parts of it. Considered as a whole, the physical organism of living beings, of plants, animals or man, has a unity subsisting in itself. Each of the members, for example, the hand, the foot, the heart, the eye, is an integral part destined by all its being to be inserted in the whole organism. Outside the organism it has not, by its very nature, any sense, any finality. It is wholly absorbed by the totality of the organism to which it is attached.
30. In the moral community and in every organism of a purely moral character, it is an entirely different story. Here the whole has no unity subsisting in itself, but a simple unity of finality and action. In the community individuals are merely collaborators and instruments for the realization of the common end.
31. What results as far as the physical organism is concerned? The master and user of this organism, which possesses a subsisting unity, can dispose directly and immediately of integral parts, members and organs within the scope of their natural finality. He can also intervene, as often as and to the extent that the good of the whole demands, to paralyze, destroy, mutilate and separate the members. But, on the contrary, when the whole has only a unity of finality and action, its head-in the present case, the public authority-doubtlessly holds direct authority and the right to make demands upon the activities of the parts, but in no case can it dispose of its physical being. Indeed, every direct attempt upon its essence constitutes an abuse of the power of authority.
32. Now medical experiments-the subject We are discussing here immediately and directly affect the physical being, either of the whole or of the several organs, of the human organism. But, by virtue of the principle We have cited, public authority has no power in this sphere. It cannot, therefore, pass it on to research workers and doctors. It is from the State, however, that the doctor must receive authorization when he acts upon the organism of the individual in the "interests of the community." For then he does not act as a private individual, but as a mandatory of the public power. The latter cannot, however, pass on a right that it does not possess, save in the case already mentioned when it acts as a deputy, as the legal representative of a minor for as long as he cannot make his own decisions, of a person of feeble mind or of a lunatic.
33. Even when it is a question of the execution of a condemned man, the State does not dispose of the individual's right to life. In this case it is reserved to the public power to deprive the condemned person of the enjoyment of life in expiation of his crime when, by his crime, he has already disposed himself of his right to live.
34. We cannot refrain from explaining once more the point treated in this third part in the light of the principle to which one customarily appeals in like cases. We mean the principle of totality. This principle asserts that the part exists for the whole and that, consequently, the good of the part remains subordinated to the good of the whole, that the whole is a determining factor for the part and can dispose of it in its own interest. This principle flows from the essence of ideas and things and must, therefore, have an absolute value.
35. We respect the principle of totality in itself but, in order to be able to apply it correctly, one must always explain certain premises first. The basic premise is that of clarifying the quaestio facto, the question of fact. Are the objects to which the principle is applied in the relation of a whole to its parts? A second premise is the clarification of the nature, extension and limitation of this relationship. Is it on the level of essence or merely on that of action, or on both? Does it apply to the part under a certain aspect or in all its relations? And, in the field where it applies, does it absorb the part completely or still leave it a limited finality, a limited independence? The answers to these questions can never be inferred from the principle of totality itself. That would be a vicious circle. They must be drawn from other facts and other knowledge. The principle of totality itself affirms only this: where the relationship of a whole to its part holds good, and in the exact measure it holds good, the part is subordinated to the whole and the whole, in its own interest, can dispose of the part. Too often, unfortunately, in invoking the principle of totality, people leave these considerations aside, not only in the field of theoretical study and the field of application of law, sociology, physics, biology and medicine, but also of logic, psychology and metaphysics.
36. Our plan was to draw your attention to certain principles of deontology which define the limits and confines of research and experimentation in regard to new medical methods to be immediately applied to living men.
37. In the domain of your science it is an obvious law that the application of new methods to living men must be preceded by research on cadavers or the model of study and experimentation on animals. Sometimes, however, this procedure is found to be impossible, insufficient or not feasible from a practical point of view. In this case, medical research will try to work on its immediate object, the living man, in the interests of science, in the interests of the patient and in the interests of the community. Such a procedure is not to be rejected without further consideration. But you must stop at the limits laid down by the moral principles We have explained.
38. Without doubt, before giving moral authorization to the use of new methods, one cannot ask that any danger or any risk be excluded. That would exceed human possibilities, paralyze all serious scientific research and very frequently be to the detriment of the patient. In these cases the weighing of the danger must be left to the judgment of the tried and competent doctor. Nevertheless, as Our explanation has shown, there is a degree of danger that morality cannot allow. In doubtful cases, when means already known have failed, it may happen that a new method still insufficiently tried offers, together with very dangerous elements, appreciable chances of success. If the patient gives his consent, the use of the procedure in question is licit. But this way of acting cannot be upheld as a line of conduct in normal cases.
39. People will perhaps object that the ideas set forth here present a serious obstacle to scientific research and work. Nevertheless, the limits We have outlined are not by definition an obstacle to progress. The field of medicine cannot be different in this respect from other fields of man's research, investigations and work. The great moral demands force the impetuous flow of human thought and will to flow, like water from the mountains, into certain channels. They contain the flow to increase its efficiency and usefulness. They dam it so that it does not overflow and cause ravages that can never be compensated for by the special good it seeks. In appearance, moral demands are a brake. In fact, they contribute to the best and most beautiful of what man has produced for science, the individual and the community.
40. May Almighty God in His benevolent Providence give you His blessing and grace to this end.
|Breakthrough: New heart grown using adult stem cells|
by Hilary White
Mon Apr 04, 2011 16:05 EST
April 4, 2011 (LifeSiteNews.com) – Researchers at the University of Minnesota used adult stem cells to create a living human heart that they hope will revolutionize transplants.
The breakthrough, said lead researcher Dr. Doris Taylor, could ultimately mean that “donated” hearts are no longer used in transplant operations, circumventing the ethical problems involved in organ donation and obviating the need for drugs to combat immune system rejection.
Dr. Taylor, director of the university’s Center for Cardiovascular Repair, is one of the world’s leaders in heart organ repair and regeneration and has said it is her goal to create a living heart that can be transplanted into a patient, entirely out of stem cells.
She presented her team’s findings at the American College of Cardiology’s annual conference in New Orleans.
“The hearts are growing, and we hope they will show signs of beating within the next weeks,” she told the Daily Mail. “There are many hurdles to overcome to generate a fully functioning heart, but my prediction is that it may one day be possible to grow entire organs for transplant.”
The breakthrough is a follow-up on work Dr. Taylor completed in 2008 in which her team used stem cells to rebuild the hearts of rats. They removed all the muscle cells in a rat heart, leaving just a “scaffold” of other tissues such as blood vessels and valves. This scaffold was then repopulated with stem cells, which took their cues from the scaffold tissue to regenerate healthy, functioning heart muscle.
The latest step in Dr. Taylor’s research took that theme one step further and removed the muscle cells from a heart obtained from a human donor, regrowing the muscle using stem cells taken from a second person. The researchers say that a heart taken from a pig may also be suitable.
The muscle cells are removed using detergents, leaving an extracellular matrix or “skeleton.” The stem cells used this skeleton to grow millions of new heart cells and create heart muscle tissue.
“We are a long way off creating a heart for transplant, but we think we’ve opened a door to building any organ for human transplant,” she said.
A similar technique was used in March last year to create a new trachea for a ten year-old boy.
In related news, a team of researchers at the University of Miami has shown that damaged heart tissue can be repaired by injecting the patient’s own stem cells directly into the heart. In the experiment, published in the March edition of the Journal of the American College of Cardiology, donated stem cells were injected into the hearts of eight male volunteers who suffer from chronically enlarged, low-functioning hearts. The Miami researchers have already documented a significant reduction in size, scar tissue, and a notable improvement in heart function.
The creation of whole working organs for transplant is the “Holy Grail” of stem cell research. Stem cells that have been used in this research and in some current disease treatments have been taken from patients’ skin, bone marrow, fat, teeth and blood.