A broad coalition of 151 Catholics, including doctors, bioethicists and scientists, published a joint letter last week expressing concern about new guidelines issued by a major neurological society on “brain death.” Father Paweł Kosiński SJ talks about a controversial issue in the medical community and among believers.
The signatories of the letter claim that the current guidelines from the American Neurological Association (AT) regarding brain death, published in 2023 may in practice lead to the incorrect diagnosis of “brain death” in patients and then the removal of their organs for transplantation while still alive.
The Catholic Church has long supported – under leadership Pope Francis – the idea of voluntary organ donation as an act of mercy for others.
However, the letter’s authors argue that because of ambiguities in U.S. law and medical practice regarding the determination of brain death, Catholics should remove themselves from the organ donor registry in their state and develop advance directives prohibiting organ donation until the ambiguities are resolved.
The letter’s signatories encourage those involved in Catholic faith formation and pastoral counseling to reiterate the importance of “moral certainty” that a person has died.
He prepared the statement Joseph Maybephysician and president of the Tulsa Guild of the Catholic Medical Association; John DiCamillo, ethicist from the National Center for Catholic Bioethics; and Peter Colosiprofessor of philosophy at Salve Regina University.
What is brain death?
Brain death, also called “death by neurological criteria,” is the widely accepted practice of declaring a person dead based on the loss of brain function rather than the cessation of the heart and breathing. A “brain dead” person on a ventilator may appear, at least to the untrained eye, to still be alive.
Legal standards for determining brain death vary depending on the country, in the USA the applicable law is the Uniform Determination of Death Act (ODD).
All 50 states have adopted ODD to its own regulations, with a few changes in the language used.
According to a study conducted in 2020 r. brain death constituted 2% all deaths in American hospitals in years 2012–2016. In February 2021 in the United States 70% organ donors were considered deceased under applicable criteria.
What changed?
Since v 1968 year the concept of “brain death” was first introduced, there is an ongoing debate in the medical community as to what exactly it means.
Previous American Neurological Association guidelines (AT) published in 2010 did not require tests to detect the complete cessation of brain function beyond what could be diagnosed at the patient’s bedside, e.g. by an electroencephalogram.
In the guidelines AT per year 2023, announced in October, however, states that neuroendocrine function may persist in patients with permanent brain damage and is “not inconsistent with the whole-brain standard of death.”
United States Catholic bishops have made their views known, expressing concern that the new version “will replace the standard of defining the death of the entire brain with partial brain death”.
“Nothing in Catholic teaching supports lowering this criterion to anything less than ‘irreversible cessation of all functions of the entire brain,'” the bishops wrote.
Catholic view
Although the term “brain death” does not appear in the Catechism of the Catholic Church, Pope John Paul II stated w 2000 r that, in the case of a correct diagnosis, the complete and irreversible cessation of all brain function seems to be the appropriate way to judge with moral certainty that someone has died.
Moral certainty – said the Polish Pope – “is considered a necessary and sufficient basis for ethically correct behavior.”
Today’s Catholic doctors and ethicists largely echo the former pope’s words in stating that brain death, if correctly diagnosed, is not a “kind” of death; it’s just death, period.
However, brain death remains a hotly debated topic among some Catholic physicians and ethicists, in part because brain-dead donors are currently the main source of organ transplants. These may include organs such as the heart, lungs and pancreas, which are removed from brain-dead donors, as close to the moment of their death as possible.
In his speech with 2000 year Pope John Paul II stressed the importance of collecting organs only from people who have definitely died.
The pope’s speech was based on his encyclical The Gospel of Life z 1995 r.in which he condemned any practice whereby “organs are harvested without observing objective and appropriate criteria confirming the death of the donor,” calling such a practice a form of “secret euthanasia.”
The United States Conference of Catholic Bishops in its “Ethical and Religious Guidelines for Catholic Health Care Services” from 2018 r. states that “determination of death should be made by a physician or competent medical authority in accordance with responsible and generally accepted scientific criteria.”
Source: cna
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