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Dr. Haas responds:

Dr. Paul Byrne, a valiant pro-life physician, opposes current Catholic teaching on the moral legitimacy of determining death using cardiopulmonary or neurological criteria. He objects specifically to the use of neurological criteria for determining death prior to the extraction of vital organs for transplantation. Dr. Byrne insists that a body with a brain that is dead but with a heart which is kept beating artificially is a live person. However, this is the very question being debated. Are we dealing with a corpse or a living person?

Traditionally, persons were declared dead by a physician when they stopped breathing and their heart stopped beating. When blood and oxygen no longer reached the brain, then that organ would die along with the other organs in the body, and the death of the person was certain. But now bodies can be placed on mechanical support so that oxygenated blood is artificially forced through the bodies keeping certain organs alive even though the brain is dead.

The laws in every one of our 50 states accept that death can be determined using either cardio-pulmonary or neurological signs. The American Academy of Neurology has accepted the legitimacy of neurological criteria for determining death and issued updated tests in 2010. The neurological signs can be more difficult to determine than the ceasing of breathing and a heartbeat, but they are a more certain sign that death has occurred. If tests determine that there is no blood flow and no electrical activity in the brain, and if certain tests on the body also indicate no brain activity, then the person can be declared dead.

Dr. Byrne rejects the legitimacy of these tests and maintains that if the brain is dead and the heart is kept beating with mechanical support, the person is alive. So Dr. Byrne then applies every papal statement against killing the innocent to the removal of organs from people who have been declared dead using these neurological signs. Yet this is an unwarranted application of papal teaching since Blessed John Paul II himself accepted the legitimacy of neurological criteria for determining death. Therefore, when the Pope denounced the killing of the innocent, he was not talking about organ transplantation from those who had been declared dead using neurological criteria because he did not consider the donors to be alive! In his encyclical The Gospel of Life, John Paul II even encouraged organ donation.

There is one steadfast rule which holds in both Catholic and secular medical fields, and it is the "dead donor rule" – organs cannot be taken from a donor until there is moral certitude that the donor is dead. This moral certitude can be established using either cardio-pulmonary or neurological criteria, according to the Church and contemporary medicine.

Dr. Byrne points out that a number of criteria for brain death have been developed since the so-called Harvard criteria of 1968. This, however, is a good thing since the criteria have been ever more rigorously formulated to determine that the donor is indeed dead.

Where can a Catholic turn to find guidance as to whether it is morally legitimate to donate an organ after "brain death" or to receive an organ from someone declared dead using neurological criteria? Catholics of course receive moral guidance from the Magisterium. And there has never been a single statement from any pope or any Vatican dicastery which has rejected the moral legitimacy of using the neurological criterion.

In fact, an essay by Dr. Byrne against neurological criteria was submitted a number of years ago to Pope John Paul II by Dr. Theodore Steinman, a transplant physician at Harvard. Dr. Steinman received the following response from Cardinal Elio Sgreccia, who at the time was the President of the Pontifical Academy for Life: "The Secretary of State of His Holiness . . . has asked me to respond to your letter of April 7, 2001. In it you express your perplexity and conscientious concern after reading the article that appeared in the periodical Catholic World Report (March 2001) entitled ‘Are Organ Transplants Ever Morally Licit’? I can confirm that this article does not reflect the official doctrine of the Church. The Church’s thinking continues to be what was expressed in the Holy Father’s discourse of August 29, 2000. . . . I would like to take this opportunity to thank you on behalf of the Holy Father both for the confidence and appreciation you expressed for his Magisterium, and for your commitment in the service of patients. In the Holy Father’s name, I am pleased to extend to you his apostolic blessing as a sign of the Lord’s accompaniment in the comforting task you carry out for patients and their families in the delicate area of surgery."

This is hardly a statement from the Vatican equating organ donation with "euthanasia" or the illicit taking of innocent life as Dr. Byrne argues. What Blessed John Paul II said in the Address referenced by Cardinal Sgreccia is the following: "It is a well-known fact that for some time certain scientific approaches to ascertaining death have shifted from cardio-respiratory signs to the so-called ‘neurological criterion’. . . Here it can be said that [this] criterion . . . does not seem to conflict with the essential elements of a sound anthropology. Therefore, a health care worker professionally responsible 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 has not been the teaching only of Pope John Paul II. The Pontifical Academy of Sciences in 1985, 1989 and again in 2008 accepted the legitimacy of the neurological criterion for determining death. So did the Pontifical Council for Pastoral Care to Health Workers 1995 in its 1995 Charter for Health Care Workers. The Charter was reviewed prior to publication by the Congregation for the Doctrine of the Faith of which Cardinal Ratzinger was the head. The Charter states: "In order that a person be considered a corpse, it is enough that cerebral death of the donor be ascertained." This is also the position of the Pontifical Academy for Life, the Catholic Bioethics Center at the Sacred Heart University in Rome, and the International Federation of Bioethics Institutes of Personalist Inspiration (FIBIP) founded by Cardinal Elio Sgreccia.

This teaching of the Church is of course not an irreformable, dogmatic teaching that a Catholic must accept in order to be saved! However, if faithful Catholics want to look to the Church for moral guidance, they should know that the Church allows organ donation after a person has been declared dead using neurological criteria.

Dr. Paul Byrne is a tireless pro-life warrior who has no obligation to accept current Church teaching with respect to the transplantation of vital organs. But faithful Catholics ought to know that his views do not reflect the current moral teachings of the Church on the subject.

John M. Haas, Ph.D., S.T.L., is president of The National Catholic Bioethics Center in Philadelphia.

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12:30 PM
Chippanee Golf Club, Bristol, Bristol, United States
The 15th annual Rev. Robert A. Lysz Memorial Golf Tournament will have a shotgun start at 12:30 p.m. July 31 at [...]
Date :  July 31, 2014

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