Sunday, July 17, 2016

So-Called Brain Death: Do "Precaution" and "Respect for the Life of the Donator" "Prevail", in an Absence of "Certainty"? Or Do Assumedly "Rigorously Applied" Criteria Now "SEEM" to "Conflict" with a "Sound Anthropology"?

Th USCCB's Ethical and Religious Directives for Catholic Health Care Services for Catholic Health Care Services certainly encourage us to provide for donation of organs to others in medical need, which we cannot donate while we are alive (e.g., the heart).  Common sense alone dictates that verification of any donor's death is absolutely essential!  Pope Benedict XVI addressed the issue of determining an organ donor's death: 
  • "individual vital organs cannot be extracted except ex cadavere....In these years science has accomplished further progress in certifying the death of the patient. It is good, therefore, that the results attained receive the consent of the entire scientific community in order to further research for solutions that give certainty to all. In an area such as this, in fact, there cannot be the slightest suspicion of arbitration and where certainty has not been attained the principle of precaution must prevail....the principal criteria of respect for the life of the donator must always prevail so that the extraction of organs be performed only in the case of his/her true death (cf. Compendium of the Catechism of the Catholic Church, n. 476)" (Address to Participants at an International Congress Organized by the Pontifical Academy for Life, 11/7/08).
To reiterate, "there cannot be the slightest suspicion of arbitration and where certainty has not been attained the principle of precaution must prevail....the principal criteria of respect for the life of the donator must always prevail."

Do "Precaution" and "Respect for the Life of the Donator"  "Prevail", in an Absence of "Certainty"?  Or Do Assumedly "Rigorously Applied" Criteria Now "SEEM" to "Conflict" with a "Sound Anthropology"?

  • "the criterion 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 [emphasis added] to conflict with the essential elements of a sound anthropology." 
In noting the significance of the word "seem", Dr. Peter Colosi of St. Charles Borromeo Seminary has said:
  • "if further knowledge reveals that brain death does seem to conflict with a sound anthropology, this would remove the moral certainty referred to later in the quotation, and it would follow that vital organ donations should not be done" (Bioethics of Organ donation, Our Sunday Visitor, 8/8/12)
While Colosi notes that Dr. John Haas, president of the National Catholic Bioethics Center, believes that "brain dead people (whole brain death) are [indeed] dead," he indicated that other members of the Pontifical Academy for Life — Dr. Paul Byrne and Josef Seifert — cast doubt. In a letter to the OSV editor, it was added that two other then members of the Academy — Judie Brown and Mercedes Arzu Wilson — shared those doubts.

Dr. Paul Byrne

Dr. Byrne is a neonatologist, clinical professor of pediatrics and past president of the Caholic Medical Association (USA):
  • "Dr. Paul Adam Byrne...was...the only physician to stand in the public square and declare, regardless of the official diagnosis of brain death, that Jahi McMath was not dead. The medical, legal, political and religious communities almost without exception, were silent ....In order to understand why this declaration of brain death is so important to the medical profession and its association with organ transplantation it is necessary to know something about how and why this diagnosis was developed....
"1967, South Africa, Dr. Christiaan Barnard performed the first heart transplant, from a living donor,  prior to any brain death declaration. Three days later, in New York, a heart was removed from a 3 day old baby and transferred into the body of an 18 day old baby. Both died, the 3 day old died when his heart was removed, the 18 day old died within hours of the transplant. 
"1968, An Ad Hoc Committee of the  Harvard Medical School published an article entitled, 'A definition of Irreversible Coma.' The first line of the article states that: 'Our primary purpose is to define irreversible coma as a new criterion for death.' 
"1971, The Minnesota Criteria, followed by 30 'disparate sets of criteria' including the 1975 American Bar Association - ABA - referred to as the Uniform Determination of Death Act, or UDDA. 

"The UDDA codified several definitions stepping off from the basically recognized Common Law which was for a multitude of decades  the accepted criteria of cessation of heart and respiratory activity.  The UDDA added loss of brain and brain stem activity as another means of determining at least legally the death of a human being....

"The UDDA, according to Dr. Byrne, is a legal tool enabling the medical profession to bypass the understanding and reality of non-total death without placing the transplant doctor and team in the position of being charged with criminal activity when organs needed to sustain life are removed from one living body, causing instant death and placed into another living body to facilitate the continuation of that life....

"Truth, he says, is simple. Life begins at true conception (not what the abortion industry says is conception) and true death occurs when all bodily functions stop and decomposition begins, as opposed to what the UDDA declares death to be" (Dr. Paul A. Byrne: A Man on a Mission, Spero News, 3/11/14).

  • If you click here and move to 22:35, you will hear a radio "debate" between Dr. Byrne and National Catholic Bioethics Center President Dr. John Haas (NOT a physician).  While Byrne suggests that Haas is "misleading the world" on so-called "brain death",  Haas speaks as though Pope John Paul II unequivocally endorsed so-called brain death criteria (Kresta in the Afternoon, 1/8/14). 

Josef Seifert

  • "we are led to the conclusion that this new definition of death ought to be rejected....Given the immense practical pressure (from the established centers of organ-transplant medicine) on each institution regarding this matter, and given the duty towards the truth, we must certainly refuse to adapt to prevailing modern opinion on death simply because it prevails.  Each one of us must resist the temptation to adjust his position on any issue in accordance with social expectations and desires of hospitals....we have the task to speak out on the truth in season and out of season, while undertaking every effort to make the truth understood and accepted by men" (Is Brain Death Actually Death?, 1993)

Judie Brown

  • "The problem with using a diagnosis of 'brain death' to pronounce a person dead is that the definition of brain death itself is imprecise and can lead to killing a living person by removing a ventilator or feeding tube.  Removal of a ventilator causes death by suffocation, while removal of a feeding tube causes death by starvation. Either way, 'brain death' itself didn’t cause the death; death was imposed on the living patient....Because the 'brain death' diagnosis is inexact, it can easily be abused....Death is the total cessation of all brain activity, including the brain stem, combined with the cessation of cardiopulmonary functions. Neither the cessation of brain activity nor the cessation of cardiopulmonary functions alone is sufficient. A person is either truly dead or he is still living. The 'brain death' diagnosis indicates that, in fact, the patient is not actually dead" (Celebrate Life Magazine, March/April 2014)

Mercedes Arzu Wilson

  • "Is the Roman Catholic Church in imminent danger of becoming an accomplice in the sacrificing of 'brain dead' donors before their natural end? Many Catholic scientists, physicians, philosophers, and theologians are in deep anguish at having to plead with the Church's leadership to stop high-ranking Vatican officials from openly supporting the theory that 'brain death' constitutes a person's natural end. Such support would sanction the removal of organs from patients who are still alive....

    "In November 2008, an International Congress entitled 'A Gift for Life' was organized by the Pontifical Academy for Life, in collaboration with the World Federation of Catholic Medical Associations and the Italian National Transplant Centre....the Scientific Committee of the conference included individuals actively involved in the billion-dollar business of organ transplantation, such as presidents of European and Italian transplant societies. It also included Transplantation Societies of Europe and Canada, a 'Catholic' bioethics center from the USA (not an official entity of the Catholic Church) [?] that is aggressively in favor of 'brain death' as true death, and others of similar special interests" (Save The "Brain Dead" Victims, The Wanderer, 2009).

Is the National Catholic Bioethics Center "aggessively in favor of 'brain death' as true death," as Mercedes Arzu Wilson Appears to Have Intimated?

For July 2016, the National Catholic Bioethics Center has posted a 2011 article by its president.  The abstract states (in part):
  • "This article is not a defense of the legitimacy of neurological criteria for determining death but rather a presentation of the moral guidance currently offered by the Church on the legitimacy of organ donation after death has been determined by their use."  
The article appears to be dismissive and/or critical of those who embrace Catholic teaching but disagree with its author. For example, it identifies Paul Byrne, MD, as simply a "pediatrician", rather than neonatologist, clinical professor of pediatrics, and past president of the Catholic Medical Association (cf, Spero News, 3/11/14), as well as a past member of the Pontifical Academy for Life.  It should be kept in mind that the Holy Father Emeritus and Saint Pope John Paul II certainly appear to have acknowledged the legitimacy of concerns about "precaution" and "respect for the life of the donator" in an absence of "certainty," as well as whether criteria are indeed "rigorously applied" and can still be said to NOT "SEEM" to "conflict" with a "sound anthropology."

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