Eastern Oklahoma Catholic July/August 2010 : Page 9
Pope John Paul went on to state that, as Pope Pius XII taught, “it is for the doctor to give a clear and precise definition of ‘death’ and of the ‘moment of death’ of a patient who lapses into a state of unconsciousness.” In an address to the International Congress on Transplants, Pope John Paul spoke of the shift in emphasis away from cardiopulmonary signs of death to the neurological signs. The neurological signs of death involved the complete and irreversible cessation of all brain activ-ity including the brain stem. Pope John Paul went on to state, “with regard to the parameters used today for ascertaining death – whether the ‘encephalic’ signs or the more traditional cardiorespira-tory signs – the Church does not make technical decisions. She limits Herself to the Gospel duty of comparing the data offered by medical science with the Chris-tian understanding of the unity of the person, bringing out the similarities and the possible conflicts capable of endan-gering respect for human dignity.” Here it can be said that the crite-rion adopted in more recent times for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential ele-ments of a sound anthropology. Therefore a health worker professionally respon-sible for ascertaining death can use these criteria in each individual case as the basis for arriving at that degree of assurance in ethical judgment which moral teaching describes as “moral certainty.” This moral certainty is considered the necessary and sufficient basis for an ethically correct course of action. Only where such cer-tainty exists, and where informed consent has already been given by the donor or the donor’s legitimate representatives, is it morally right to initiate the technical procedures required for the removal of organs for transplant. (Address by Pope John Paul II to the International Congress on Transplants) Pope Pius XII and Pope John Paul II both said the Church has no competency in determining death; this properly be-longs to medical doctors and to scientists. (National Catholic Bioethics Center) Even though the predominant criteria for determining death have been based on the neurological standard since the 1970s when the “Harvard Criteria” became the standard used to determine death, there has been much discus-sion in both the religious and scientific community as to its ethical and scientific acceptability. The importance of this issue revolves around organ transplantion and the ethical standard of the “dead donor rule.” This rule states that a patient must be declared dead before any vital organs may be removed for transplantion. This requires that the death of a patient cannot be assisted and end of life may not be hastened. The dignity of human life and its sanctity must not be compromised. Dr. Edmund D. Pellegrino, one of the great bio-ethicists and medical doctors and a professor at Georgetown Univer-sity, in expressing his personal view as chairman of the President’s Council on Bioethics, expressed his concern regarding the relaxation of the dead donor rule. He stated that it is “a morally unacceptable and logically specious way to deal with the uncertainties of the criteria for death of the donor. It leaves the choice of criteria for death to individual preference, amounting to eventual abolition of any stable criteria for death.” Dr. Pellegrino went on to state: “I believe there is as much – or more – moral assurance of death of the donor with the cardiopulmonary as with the neu-rological standard (of death.) … (With) the cardiopulmonary standard, there is a higher degree of certainty of death than there is with the heart-beating donor, as in (neurological death) heart, lung and brain have all ceased functioning.” In theNew England Journal of Medicine, Volume 359:674-675, Aug. 14, 2008, Number 7, the authors stated that “the definition of brain death requires the complete absence of all functions of the entire brain, yet many of these patients retain essential neurological function.” There seems to be a very legitimate reason for concern as to the validity of the neuro-logical criteria of death. Father Alex Kennedy, pastor of Holy Ghost Church in Vinita and St. Elizabeth Church in Grove, is member of the National Catholic Bioethics Center and the Society of Law, Medicine and Ethics. of the Lord Aug. 6 | St. Sixtus II, pope and martyr, and his companions, martyrs Aug. 7 | St. Teresa Benedicta of the Cross, virgin and martyr Aug. 9 | Feast of St. Lawrence, deacon and martyr Aug. 10 “Others have claimed that ‘brain-dead’ patients are dead because their brain dam-age 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 uncom-fortable 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.” Pope Benedict has stated that respect for the life of the donor should be as-sumed as the primary criterion, in such a way so that the extraction of the organs only takes place after having ascertained the patient’s true death. “There must not be the slightest suspicion of arbitrariness. Where certainty cannot be achieved, the principle of precaution must prevail.” The discussion will and should con-tinue. As for now, the Church’s position is that of Pius XII and John Paul II and reaf-firmed by Pope Benedict: that it is up to science and medicine to determine when death has occurred, however there must always be a respect for human dignity and for the sanctity of human life. Lastly, regardless of which standard is used, Pope John Pope John Pope John Pope John
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