The Brain Death Debate

Some have argued that the Pope's brain-death statements were misread.

Dr. Paul Byrne, a neonatologist practicing in Ohio and a past president of the Catholic Medical Association, was a co-author, with Bishops Fabian Bruskewitz of Lincoln, Neb., and Robert Vasa of Baker, Ore., and others of a March 2001 essay in Catholic World Report saying the Pope's address was misinterpreted to give unconditional approval for organ transplantation. The essay's authors saw his talk as a “strong condemnation of the inhumane procedures and violations of natural moral law that presently occur with the transplantation of certain organs.”

They correctly pointed out that there is no consistent U.S. standard of brain death.

“The removal of a healthy unpaired vital organ suitable for transplantation from someone who has been legally declared ‘brain dead’ but is not truly biologically dead is not ethically acceptable,” the essayists declared.

They also suggested the Pope had been misinformed about “clearly determined parameters commonly held by the international scientific community” involved in the determination of brain death. No such parameters exist, they said.

Noting that the Pope used the word “seem” when he said the brain-death criterion “does not seem to conflict with the essential elements of a sound anthropology,” the group insisted that he “indicates that the matter has not been completely resolved.”

The Pope went on in his address, however, to say that doctors using the brain-death criterion can reach the sufficient moral certainty to proceed with the transplant operation and will be thereby acting in an ethically correct manner.

And Bishop Elio Sgreccia, vice president of the Pontifical Academy for Life, in a response to a letter from an American surgeon in 2001, said the essay does not reflect the official doctrine of the Church. He restated guidelines issued by the Pontifical Council for Health Care Workers in its “Charter for Health Care Workers” in 1995: “Persons are dead when they have irreversibly lost all ability to integrate and coordinate the physical and mental functions of the body.”

Bishop Sgreccia said death has occurred either when the spontaneous functions of the heart and breathing have definitively ceased or with the irreversible arrest of all brain activity.

“In reality, he said, “brain death is the true criterion of death, although the definitive arrest of cardiorespira-tory activity very quickly leads to brain death.”

— Ellen Rossini