CV NEWS FEED // Over 150 Catholic scholars, doctors, religious and civic leaders, and bioethicists signed a major statement uniting against current “brain death” criteria, asserting that the “inadequate” criteria enables organ harvesting while the majority of donors are still alive.
Joseph M. Eble, bioethicist John Di Camillo, and philosophy professor Peter Colosi authored the February 27 statement. The authors warn that the current “brain death” (BD) criteria does not actually provide “moral certainty of death.” As such, the authors stated that even if a patient is declared “brain dead,” physicians should not then presume that the patient is truly dead and then procure vital organs.
Eble is President of the Tulsa Guild of the Catholic Medical Association. Among those who signed the statement are Fr. Nicanor Pier Giorgio Austriaco, Janet Smith, Bobby Schindler, and Bishop Joseph Strickland. Read the full list of the statement’s signers here.
History of “Brain Death” Criteria and the Catholic Church:
The “controversial” definition of brain death was introduced in 1968, and “claims that death has occurred when the brain no longer functions,” the authors explained.
However, the most recent medical guidelines provided by the American Academy of Neurology (AAN) for determining brain death “state that clinicians can declare a person brain-dead despite evidence of persistent function of the hypothalamus, which is a part of the brain.”
Using these AAN guidelines, a patient can be declared dead even if the brain is determined to be only “partially” dead.
In 2000, Pope John Paul II made it “clear that BD could potentially offer moral certainty of death only if there were ‘complete and irreversible cessation of all brain activity,’” the authors wrote:
We recognize that many Catholics supporting the validity and use of the existing BD criteria have been unaware of the frequency of hypothalamic function in patients declared brain-dead.
Evidence from within the last decade “demonstrates that as many as 84% of patients declared brain-dead using the AAN guidelines have preserved hypothalamic function,” the authors stated.
This evidence “makes it very clear that the current clinical criteria for determining BD, including the AAN guidelines and less rigorous variations of those guidelines, do not establish complete and irreversible cessation of all functions of the entire brain,” the authors continued:
Simply put, the current BD criteria in widespread use do not provide moral (prudential) certainty of death.
“As Catholics, we have an obligation to defend the sacredness of human life from conception to natural death,” the authors continued:
Given the facts above, even as there remains disagreement about whether and how the criteria could be improved, we call on our fellow Catholics to unite against utilization of the current BD criteria, especially when determining death before vital organ transplantation.
Depending on the hospital and state, physicians will follow current AAN guidelines or a variation that is even less rigorous. Given “the lack of moral certainty of death whenever the current BD criteria are used, a clear majority of vital organ donors can be presumed alive at the time of organ harvesting,” the authors wrote.
As such, the authors warned:
A person considering organ donation does not have good reason to expect that he or she will be truly dead at the time of vital organ procurement.
Recommendations for Patients, Physicians, Leaders, and Health Care Institutions:
In light of these concerns, the authors listed several action recommendations for patients to protect themselves from unethical organ harvesting.
Among the recommendations are: that patients should decline organ donor status when offered, document refusal of organ donation after death, and carry a wallet card refusing organ donation. An alternative “gift of self after death” the authors recommend is “consenting to bone or tissue donation in advance directives.”
The authors urged health care professionals to “[decline] making declarations of death using the current BD criteria” and “object to involvement with organ procurement following declarations of death using the current BD criteria.”
The recommendations for stakeholders and policymakers included advocating “for the right of physicians who decline to utilize BD criteria not to be penalized in any way,” and for the AAN to establish a standard of “whole” brain death criteria instead of “partial” brain death.
For Catholics who teach or give pastoral guidance, and for individual and organizational Catholic leaders, the authors stressed educating Catholics well on the difference between extraordinary and ordinary means of preserving life.
Health care institutions also have the responsibility to educate staff and patients about the use and refusal of extraordinary measures, the authors wrote. Finally, these institutions should also “[renegotiate] agreements with organ procurement organizations, if necessary, to ensure respect for institutional policies and protocols around declarations of death.”
“If they cannot be renegotiated,” the authors wrote, “consider shutting down deceased donor organ transplantation programs and ending these agreements altogether.”
The post Catholic Ethicists Issue ‘Call to Action’ Against ‘Inadequate’ Brain Death Criteria and Organ Harvesting appeared first on CatholicVote org.