The National Catholic Bioethics Center (NCBC) issued a statement on April 11 titled "Integrity in the Determination of Brain Death: Recent Challenges and Next Steps".

The NCBC highlighted a breakdown in public consensus on death and organ donation. They attribute it to unresolved disputes regarding the determination of brain death.

Catholic teaching supports organ donation. Pope St John Paul II called it "a particularly praiseworthy example" of "everyday heroism", so long as the donation is made with free and informed consent and the donor is truly dead.

The act of removing the organs must not kill the donor.

However, recent attempts to redefine death pose ethical dilemmas. Proposed revisions to the Uniform Determination of Death Act (UDDA) and updated guidelines from medical organisations have sparked controversy.

The UDDA states that a person can be declared dead following the "irreversible" shutdown of circulatory and respiratory functions, or of "all functions of the entire brain, including the brain stem".

The act states that medical professionals must determine death "in accordance with accepted medical standards".

Various groups opposed the proposed changes to the UDDA, prompting a temporary halt in September 2023. These changes aimed to modify criteria for determining death.

Erroneous declarations of death

Additionally, revised guidelines published in October 2023 by medical associations - such as the American Academy of Neurology - now permit clinicians to declare brain death despite evidence of neuroendocrine function.

Critics argue that such changes deviate from the traditional understanding of death, which is seen as the irreversible cessation of all brain functions.

"The law pretty much says that … brain death involves all irreversible cessation of all functions of the entire brain" says John Brehany, the NCBC's executive vice president.

"And yet the guidelines of the most influential organisation (the AAN) were not testing for all functions ... of the entire brain. We think that's very problematic."

Moreover, the NCBC voiced reservations about potential revisions to the UDDA that would shift from a standard of whole-brain death to partial-brain death, resulting in potentially erroneous declarations of death.

Experts warn that ambiguity in determining death could negatively impact both organ donors and the thousands of individuals awaiting transplants.

In response to these concerns, the NCBC urges Catholics to clarify and promote a concept of death consistent with Catholic teachings and rigorous clinical testing. They emphasise the importance of reinforcing ethical standards and educating stakeholders about the complexities of organ donation and the determination of death.

The NCBC asserts that addressing these issues will require concerted efforts from individuals and institutions with expertise in bioethics and medical practice.

Sources

The Boston Pilot

CathNews New Zealand

At the heart of the matter is the Uniform Determination of Death Act, initially proposed by the Uniform Law Commission (ULC) in 1981.

ULC is a nonprofit organisation responsible for drafting model legislation for US lawmakers. It aims to clarify and stabilise critical areas of state statutory law.

During the ULC's 132nd annual meeting in Honolulu, slated for this week, the revision of the definition of whole-brain death is a topic of heated debate.

The proposed change would replace the current standard of "irreversible cessation" of key brain functions. It would consider "permanent coma" and "loss of brainstem reflexes" as indicators of death.

According to the Catholic groups, the revision relies on "deficient medical criteria" and lacks "compelling scientific evidence."

In a joint letter, the USCCB and the National Catholic Bioethics Center voiced their objection to this revision. They argued it would replace the standard of whole-brain death with a definition of partial-brain death.

"The basis for our objection is that the proposed revision will allow patients who exhibit partial brain function to be declared ‘legally dead' when they are not biologically dead," the Catholic groups wrote.

The Catholic groups emphasised that there is no basis in Catholic teaching to support lowering the criterion to anything less than "irreversible cessation of all functions of the entire brain."

Both groups firmly opposed any lowering of the standard without compelling scientific evidence to justify it.

Implications for organ donation

The issue also has implications for organ donation. Both Catholic groups endorse organ donation as a generous act in line with ethical teachings. However, they insist that it must be done under the proper conditions. The suggestion that "partial brain death is sufficient for vital organ retrieval" could dissuade individuals from becoming donors themselves.

Moreover, the new proposed standards could potentially be used to justify protocols that deliberately block blood flow to the brain, causing the death of the donor. This is an alarming prospect that the bishops and the bioethics centre urge to be addressed.

In light of these concerns, the USCCB and the National Catholic Bioethics Center called upon the ULC to maintain the original language of the Determination of Death Act.

The group also urged ULC to encourage medical professionals to update clinical testing guidelines to align with the current legal definition of brain death. This is preferred over altering the legal definition to comply with insufficient medical criteria.

Nature, a renowned scientific journal, reported earlier this month that the proposed revisions were motivated by a desire to harmonise state laws surrounding the determination of death due to imprecise language in existing laws.

The revisions are scheduled to be discussed at the Honolulu meeting. However, final approval will occur at a later date.

Sources

Catholic News Agency

National Catholic Register

The ‘Leave Them Certain' campaign has been launched by the NHS Blood and Transplant following a law change that has introduced an opt-out or "deemed consent" system for organ donation. As of May last year, organs and tissues of a deceased person can be automatically transplanted, unless the person concerned has explicitly expressed the desire not to donate.

The aim of the campaign is to ensure that the donation does not take place against the will of the deceased. This is why it is important for people to make their decision clear and talk to their loved ones about organ donation before they die.

Read More

A collection of silent films was played with a live organ accompaniment at St John the Evangelist Anglican Church last Saturday. Read more

The aim is to help to deter organ trafficking and transplant tourism crimes.

The Catholic church in Australia supports voluntary, legal organ donation.

In a position statement in which a number of religious groups make their stance on organ donation clear, the Catholic church says "Many people owe their lives to organ and tissue transplants. Such new technologies are hailed by the Church as a great service to life.

"One way of nurturing a culture of life is through a willingness to donate organs and tissues with a view to offering a chance of health and even life itself to people who are sick."

While Australia already has strict laws for ensuring and regulating ethical practices in organ donation and transplants, the legislation does not cover crimes that occur outside the country's jurisdiction.

This is of concern as organs are harvested against people's will from several parts of the world, including the Philippines, India, Central America, Egypt and the Middle East.

The donors may be "kidnapped, killed and sold, especially children, for their organs," according to the UN Regional Information Centre for Western Europe.

In China, the UN says the majority of crimes occur within a controversial state-sanctioned system in which organs are sourced from prisoners.

The media suggests there have been about 10 to 20 cases of illegally harvested organs being used in Australian transplant surgery; however, some people think the number may be significantly higher.

Unfortunately there are few witnesses to this crime willing to stand up and be counted, which makes it difficult to estimate the number of Australians participating in illegal organ trafficking or transplant tourism.

Source

• The Epoch Times
• The Final Call
• ShareLife
• Image: Stop Organ Harvesting in China

Bishop Jacob Muricken completed all legal formalities on Friday so he could donate a kidney to a man who media named as E. Sooraj.

Bishop Muricken, 52, is the auxiliary bishop of Syro-Malabar diocese of Palai in India.

A kidney transplant is needed to save the life of Mr Sooraj, 30, who is suffering from organ failure.

"This is perhaps for the first time in the history, a serving bishop is donating one of his kidneys to save a valuable life," said Kidney Federation chairman Fr Davis Chiramal.

He said the organ transplantation surgery involving the bishop will be performed at Lakeshore Hospital, Ernakulam, on June 1.

"Sooraj belongs to a very poor family. He is the sole bread winner of his family comprising his mother and wife", Fr Chiramal said.

He had lost his father four years ago. Later, his brother died of heart attack.

"Hearing his sad stories, the bishop decided to donate one of his kidneys to the Hindu [man]

"We also want to generate money from generous people for successfully completing the organ transplantation surgery," the priest said.

Fr Chiramal had previously donated one of his own kidneys to an ailing patient.

Bishop Muricken said he felt inspired upon hearing a talk given by the priest.

Sources

• Udupit Today
• Times of India
• Catholic Hierarchy
• Image: The Week India

Responding to a proposed Organ and Tissue Donation bill, the Church's parliamentary office called an opt-out system "intrinsically discriminatory".

This is because "it denies the integrity of the person by overriding the requirement for consent on how a person's organs may be used".

"The proposal aims to establish a principle in law that the consent of the person can be determined by the authority of the state," the Church's response explained.

The Church affirmed that it is an enthusiastic supporter of organ donation providing it is based on "free and consensual giving".

But it is not "morally acceptable" if the donor or his proxy has not given explicit consent.

"In aiming to meet the demand for organs and transplantations it is important not to sacrifice important ethical principles," the Church said.

The proposed bill would mean that adults would have to specify that they do not want their organs donated.

The current "opt-in" system "recognises the importance of genuine consent in the treatment of persons and the charitable nature of organ donation which is based on a gratuitous act of kindness on behalf of the donor", the Church said.

The Church response went on uphold the role of family members in the consent process.

It also supported a campaign promoting organ donation, provided it is "based on free and consensual giving".

Pope John Paul II and Pope Benedict XVI both lent their support to organ donation, with the latter at one point being a card carrying organ donor.

In 2008, Pope Benedict said that "organ donation is a peculiar form of witness to charity".

"In a period like ours, often marked by various forms of selfishness, it is ever more urgent to understand how the logic of free giving is vital to a correct conception of life," Benedict said.

A similar move to introduce an opt-out system of organ donation has been proposed in Wales and was also opposed by the Church.

There is pressure to increase the number of donated organs which can often be used in life-saving operations.

Sources

• The Tablet
• Scottish Catholic Media Office
• Image: The Guardian