Catholic Transcript Magazine of the Roman Catholic Archdiocese of Hartford Connecticut

Sunday, February 25, 2018


Haas-8616Dr. John M. Haas, president of the National Catholic Bioethics Center in Philadelphia, delivers a talk as part of the Pope John Paul II Bioethics Lecture Series in the chapel at Holy Apostles College and Seminary in Cromwell. (Photo by Deacon James Papillo)

CROMWELL – Determining brain death – one of the hottest pro-life issues in an ongoing debate over organ transplants – was painstakingly discussed by Dr. John M. Haas at the spring 2011 Pope John Paul II bioethics lecture series held recently at Holy Apostles College and Seminary.

Dr. Haas, who is president of the National Catholic Bioethics Center in Philadelphia, reiterated that organ transplants are accepted by the Church as "a generous act of self-denial"; and that using "neurological criteria" to determine brain death is compatible with Church teaching.

However, in his talk, titled "Determining Death: Catholic Teaching on the Use of Neurological Criteria," he said that misunderstandings of Catholic teaching and irresponsible comments in the media continue to create confusion for the faithful.

Among detractors, he said, is Dr. Paul Byrne, a neonatologist in Ohio, who has defined the excision of organs of patients declared dead even according to neurological criteria as "murder"; and wrote that "the holocaust of abortion and transplantation of organs from living donors will go down in history as the two most tragic and transcendental offenses of the last two centuries."

Others stirring debate are Professor E. Christian Brugger, a moral theologian at St. John Vianney Theological Seminary in Denver, and D. Allen Shewmon, professor of pediatric neurology at UCLA Medical Center, who challenges the reliability of the widely accepted neurological standard, he said.

"It is understandable that pro-life Catholics are going to be very sensitive to any possible violation of the human person’s fundamental right to life," said Dr. Haas. But some of them "misunderstand Catholic teaching in their pro-life zeal and deny that certain actions are indeed morally permissible."

According to Dr. Haas, the traditional determination for death were the "cardiopulmonary criteria," which indicate that when the person has stopped breathing and the heart has stopped beating, the brain dies as well.

However, the determination grew more complex with the development of life support systems such as ventilators, when people who would have died in the past because of the cessation of breathing and heartbeat now are being kept alive, and, in some cases, recover.

In 1968, the "Harvard criteria" was proposed and accepted, stating that brain death, using neurological criteria, could be used to determine death. Tests were developed to determine if the brain is dead. And, in 1981, the National Conference of Commissioners on Uniform State Laws issued the Uniform Definition of Death Act, which has been accepted in all 50 states, and which accepts neurological as well as cardiopulmonary criteria for determining death.

The Church also accepted the legitimacy of neurological criteria through an evolving series of documents and presentations, Dr. Haas said.

In 1985, the Pontifical Academy of Sciences used the following definition of death: "A person is dead when he has irreversibly lost all capacity to integrate and coordinate the physical and mental functions of the body. Death has occurred when: (a) the spontaneous cardiac and respiratory functions have definitively ceased; or (b) an irreversible cessation of every brain function is verified."

In 1989, Pope John Paul II looked at the issue again to seek greater clarity relative to organ donation and transplantation, and came to the same conclusion concerning the definition of death as in 1985. The Pontifical Academy again revisited the issue in 2006; the findings, published in 2008 and signed by four cardinals, said that neurological criteria were legitimate means for determining death.

In 1993, another group, the Pontifical Council for Health Care Workers, in issuing its charter for health care workers, also accepted the legitimacy of the neurological criteria.

Then, in his 1995 encyclical "The Gospel of Life," Pope John Paul II encouraged organ donation as a "generous act of self-denial," saying that it offers "a chance of health and even of life itself to the sick who sometimes have no other hope."

He later approved the neurological criteria to determine death in his address before the Congress on Transplantation in 2000.

"It is a well-known fact that for some time, certain scientific approaches to ascertaining death have shifted the emphasis from the traditional cardiorespiratory signs to the so-called ‘neurological’ criterion," the Pope said.

"Specifically," he stated, "this consists in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum and brain stem). This is then considered the sign that the individual organism has lost its integrative capacity."

The Pope said that when "rigorously applied," the brain death criterion "does not seem to conflict with the essential elements of a sound anthropology" but that this judgment must reach "moral certainty."

"Pope John Paul II did not call for ‘absolute certitude,’" explained Dr. Haas, "but he said moral prudential certitude was the necessary and sufficient basis for action."

Therefore, according to Church teaching, a faithful Catholic may receive organs from a donor who is declared dead by neurological criteria, said Dr. Haas. A faithful Catholic may also make provisions for the donation of his or her own organs in the event of his death whether it is determined by cardiopulmonary or neurological criteria.

Dr. Haas, who is also a member of the governing council of the Pontifical Academy for Life and a consultor to the Pontifical Council for Healthcare Workers, is the father of nine children, including a son, Brother Isaac, who is with the Franciscan Friars of the Immaculate in Griswold.

The lecture was preceded by a performance of the "Spring" concerto from Vivaldi’s The Four Seasons and Beethoven’s Sonata No. 7 in C minor for Violin and Piano performed by celebrated violinist Charles Rex, accompanied by Eunice Kim, who is a staff accompanist at The Juilliard School in New York.

Mr. Rex has performed for eight years with the Philadelphia Orchestra under Eugene Ormandy and as associate concertmaster of the New York Philharmonic under Zubin Mehta. He has also been guest choirmaster of the London Symphony and choirmaster of the Dallas, Reading (Pa.) and Delaware Symphony Orchestras. His wife, Elizabeth Rex, is an adjunct professor at Holy Apostles.