THE QUIESCENT BRAIN: A PERSON IS ALIVE AS LONG A SUBSTANTIAL UNITY-IN-TOTALITY SUBSISTS !

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August 18, 2011

Vital organ transplantation–not truly dead

 

By Paul A. Byrne, M.D. and Peter Damian Fehlner, F.I., S.T.D.

The August 29, 2000 Address of Blessed John Paul II is often quoted by those in support of obtaining vital organs for transplantation, but other statements by Pope John Paul II and a more recent statement by Pope Benedict XVI are ignored.

Blessed John Paul II wrote in Evangelium Vitae: “Nothing and no one can in any way permit the killing of an innocent human being, whether a fetus or an embryo, an infant or an adult, an old person, or one suffering from an incurable disease, or a person who is dying. Furthermore, no one is permitted to ask for this act of killing, either for himself or herself or for another person entrusted to his or her care, nor can he or she consent to it, either explicitly or implicitly ” (Ev. Vitae 52). On Feb 11, 2003, World Day of the Sick, His Holiness stated, “Every therapeutic procedure, all experimentation and every transplant must take into account this fundamental truth. Thus it is never licit to kill one human being in order to save another.”

Pope John Paul II’s Address to the Pontifical Academy of Sciences February 3-4, 2005 included, “It is well known that the moment of death for each person consists in the definitive loss of the constitutive unity of body and spirit. Each human being, in fact, is alive precisely insofar as he or she is ‘corpore et anima unus’ (Gaudium et Spes, 14), and he or she remains so for as long as this substantial unity-in-totality subsists.”

Many in support of vital organ transplantation base their position on the August 29, 2000 Address by Pope John Paul II: “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.”

A survey of the leading neurological institutions showed that there is no consensus of the many (more than 30, probably 100, or even more) disparate sets of criteria (Neurology, Jan 2010). Then, in Neurology, July 2010, it was published that “brain death” is not evidence based. Thus, for “brain death” can there be “clearly defined parameters commonly held by the international scientific community”? [“Evidence based is the modern standard that doctors are encouraged to follow; but it doesn’t exist for “brain death”!]

Many misconceptions about criteria for determining “brain death” revolve around “irreversibility.” Irreversibility cannot be observed by a doctor like a change in function or even destruction of tissue or an organ. Thus, “irreversibility cannot serve as evidence, nor can it rightly be made part of an observable criterion of death.” [1]

A presumption of irreversibility of a lack of brain functioning, even if “cerebrum, cerebellum and brain-stem” are included, is insufficient grounds for removing a patient’s vital organs or for immediate autopsy, cremation, or burial. Even though cerebellum is included, none of the many sets of criteria include evaluation of the cerebellum.

ABSOLUTE irreversibility of brain functioning, among other characteristics of a cadaver, reflects the fact of death. But such irreversibility can be known by us only if we already know the fact of death. Death is the criterion of absolute irreversibility, not vice-versa. RELATIVE irreversibility, viz., relative to our capacity to reverse the non-functional character of this brain, is not a criterion of death. If we are not sure of absolute irreversibility, then we are not sure that real death, as distinct from a clinical declaration of “brain death,” “heart death,” “as good as dead,” “soon to be dead,” etc., has occurred. Without such certainty organ extraction cannot begin without violating the fifth commandment.

The declaration of Pope John Paul II is a conditional one that has not been met because there are no “clearly determined parameters commonly held by the international scientific community.”

Pope Benedict XVI on November 7, 2008 specified: “Individual vital organs cannot be extracted except ex cadavere.” Pope Benedict XVI made his teaching clear and specific by using Latin, “ex cadavere,” which translates as “from a dead body.” Pope Benedict continued, “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).” Thus, Pope Benedict is very clear, vital organs cannot be taken except from a dead body after his/her true death. A dead body does not have a beating heart, circulation and respiration.

Genuine certainty must exist prior to any declaration of death. A very simple test of the certainty that this key condition concerning “brain death” has been fulfilled is the following: could it be wrong and is it often wrong? If the reply is yes, then the condition required for moral certainty to be genuine certainty in the sense of Pope John Paul II and Pope Benedict XVI, namely that this human body is not a living body, but is a cadaver, has not been realized. Can there be certainty of any kind if one would say a cadaver has a beating heart, circulation, and respiration? A cadaver (dead body) does not and cannot have signs of life like a beating heart, circulation and respiration; a cadaver is suitable for autopsy, embalming, cremation and burial.

Over time it has become clear that “brain death” is not true death. Many do not accept that “brain death” is true death. These include: “Brain Death is Not Death: A Critique of the Concept, Criterion, and Tests of Brain Death” [2] Rix, 1990; McCullagh, 1993; Evans, 1994; Jones, 1995; Watanabe, 1997; Cranford, 1998; Potts et al., 2000; Taylor, 1997; Reuter, 2001; Lock, 2002; Byrne and Weaver, 2004; Zamperetti et al., 2004; de Mattei, 2006; Joffe, 2007; Truog, 2007; Karakatsanis, 2008; and Verheijde et al., 2009. Even the President’s Council on Bioethics (2008) in its white paper, has rejected “brain death” as true death.

There are many news accounts of people recovering after a declaration of “brain dead.” [3] Zack Dunlap from Oklahoma was declared “brain dead.” There was no blood flow to his brain as evidenced by a PET scan. The helicopter was landing to extract Zack’s organs. A cousin who is a nurse in the ICU did another test. A response was observed. The transplant was stopped. This and others were recorded for the national and international community. Even one such patient should be enough to wake people up to the fact “brain death” is not true death. And there are many!

NOTES:

[1]  Byrne PA,O’Reilly S, Quay PM:Brain Death — An Opposing Viewpoint. JAMA 242:1985-1990 . 1979.

 

[2]  Joffe, A. Brain Death is Not Death: A Critique of the Concept, Criterion, and Tests of Brain Death. Reviews in the Neurosciences, 20, 187-198 (2009), and

References that “brain death” is not true death include: Rix, 1990; McCullagh, 1993; Evans, 1994; Jones, 1995; Watanabe, 1997; Cranford, 1998; Potts et al., 2000; Taylor, 1997; Reuter, 2001; Lock, 2002; Byrne and Weaver, 2004; Zamperetti et al., 2004; de Mattei, 2006; Joffe, 2007; Truog, 2007; Karakatsanis, 2008; Verheijde et al., 2009. Even the President’s Council on Bioethics (2008), in its white paper, has rejected “brain death” as true death.

 

© Paul A. Byrne, M.D. and Peter Damian Fehlner, F.I., S.T.D.

About abyssum

I am a retired Roman Catholic Bishop, Bishop Emeritus of Corpus Christi, Texas
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