By John-Henry Westen
ROME, August 18, 2008 (LifeSiteNews.com) - Organ donation is becoming ever more controversial as stories of patients declared "brain dead" who live to tell about it are reported more and more frequently. Inside the Catholic Church the issue has been very divisive as well. An upcoming Vatican conference promoting organ donation has brought to the fore an internal struggle, a struggle which is gradually becoming more public. The stakes of the debate run as high as life and death itself.
The Pontifical Academy for Life (PAV), the World Federation of Catholic Medical Associations (FIAMC), and the Italian National Transplant Centre (CNT) are sponsoring a conference on organ donation for November 6-8 in Rome. Billed as an International Congress, the conference is titled: "A Gift for life. Considerations on organ donation." The conference brochure leaves no doubt that the conference will be promoting organ donation. In addition to the fact that it is being run in conjunction with Italy's national transplant centre, the brochure says plainly that it will address "the importance of spreading the culture of organ donation." (see the brochure: http://www.agiftforlife2008.org/presentation.htm )
LifeSiteNews.com has learned that several official members of the Pontifical Academy for Life (PAV), appointments to which are made by the Pope, have written the head of the Academy, Archbishop Salvatore Fisichella, demanding that the organ donation-promoting conference be cancelled. LifeSiteNews.com attempted to interview Archbishop Fisichella for this story but was informed that the Archbishop was outside Rome and unavailable until late next week.
The controversy hit the front page of the Vatican newspaper L'Osservatore Romano this week with an editorial by Professor Lucetta Scaraffia, vice-president of the Italian Association for Science and Life and a member of the Italian National Committee on Bio-Ethics. The editorial noted that a declaration of 'brain death' cannot be considered the end of life in light of new scientific research. (see coverage: http://www.lifesitenews.com/ldn/2008/sep/08090310.html )
Such a determination would prohibit single vital organ donation, such as heart transplants, for Catholics or Catholic institutions, since Catholic teaching requires such organ donors to be truly dead. If potential donors cannot be said with certainty to be dead, vital organ removal would in effect constitute killing the donor. As Pope John Paul II put it in 2000, "Vital organs which occur singly in the body can be removed only after death, that is from the body of someone who is certainly dead . . . This requirement is self-evident, since to act otherwise would mean intentionally to cause the death of the donor in disposing of his organs."
With organ removal for donation from 'brain dead' patients taking place in Catholic hospitals all over North American and Europe, an official teaching from the Church on the matter would be momentous. Should the Church accept the scientific evidence that 'brain death' does not constitute real death, Church-run hospitals would immediately cease involvement with vital organ donation programs, and may even publicly repent of unknowingly being complicit in causing death via organ harvesting.
In addition to the high moral stakes of the debate, the financial stakes are also towering. It would mean in the US alone, for some 600 Catholic hospitals, the loss of a stake in the billion dollar industry of organ transplantation.
LifeSiteNews.com spoke with one of the Members of the Academy who is involved in the upcoming conference, who noted that the controversy around 'brain death' and thus organ donation has been longstanding but is limited to a small minority within the Academy. The Member, who wished to remain anonymous, named three Members of the Academy who openly disagree with the brain death criteria: Dr. Joseph Seifert, Dr. Wolfgang Wolfstein and Mercedes Wilson.
However, LifeSiteNews.com has confirmed that letters sent to Archbishop Fisichella have come from far more than the three members mentioned. Moreover, as Professor Scaraffia points out in L'Osservatore Romano, in the Vatican itself "the certification of brain death is not used."
The internal disagreements go beyond the Pontifical Academy for Life, into the Pontifical Academy for Sciences, which had a conference on the matter in 2005 where a majority of the participants were opposed to 'brain death' as a true definition of death. However, findings of that 2005 conference were suppressed and another conference in the same name was convened the following year with most of those opposed to the notion of brain death as true death uninvited. Instead the 2006 conference findings were published, stating that brain death is recognized as "the true criterion for death." The findings of the 2005 conference were eventually published privately.
Beyond the members of the Pontifical Academies, various members of the Catholic hierarchy openly oppose the notion that 'brain death' constitutes true death. Lincoln Nebraska Bishop Fabian Bruskewitz, Kansas City- St. Joseph Bishop Robert Finn, and Baker Oregon Bishop Robert Vasa have all publicly opposed the 'brain death' definition.
In answer to the editorial in L'Osservatore Romano, Italy's organ donor centre has noted that Pope Benedict XVI prior to his elevation to the pontificate had enlisted as an organ donor. In 1991, then-Cardinal Josef Ratzinger noted his having an organ donor card. His card is however invalidated by the fact that as Pope, his organs may not be removed until after the establishment of real death - which would make the organs unusable for transplant. Further, one of the most prominent opponents of the notion of brain death as true death is German philosopher Robert Spaemann, a man held in very high regard by the Pope. In addition to the fact that Spaeman participates in Pope Benedict XVI's Schülerkreis (a private conference lead by Benedict which has been convened since the late 1970s) in 1987 Ratzinger dedicated a book to Spaemann.
In addition to a growing number of medical doctors who reject 'brain death' as real death and thus refuse to engage in vital organ donation, physicians that are fully in support of organ donation have themselves admitted that 'brain death' does not constitute real death.
In a article published last month in the New England Journal of Medicine, Dr. Robert D. Truog, a professor of medical ethics and anesthesia (pediatrics) in the Departments of Anesthesia and Social Medicine at Harvard Medical School and Dr. Franklin G. Miller, a faculty member in the Department of Bioethics, National Institutes of Health, note that the available literature on the subject does not show that the 'brain death' diagnosis proves patients are "really dead." They suggest therefore that hospitals simply do away with the requirement that organ donors be dead. (see coverage: http://www.lifesitenews.com/ldn/2008/aug/08081406.html )
LifeSiteNews.com spoke with long time Vatican reporter Phil Lawler, editor of Catholic World News, who is aware of the struggle in the Vatican over the matter. Lawler pointed to the fact that immediately after L'Osservatore Romano published the article, Fr. Frederico Lombardi, the director of the Vatican Press Office, issued a statement noting that the article "is not an act of the Church's magisterium, nor a document of a pontifical organism," and that the opinions expressed "are to be attributed to the author of the text, and are not binding for the Holy See."
"You have two statements from the Vatican which pretty clearly point in different directions," said Lawler, "and that in itself is pretty much worthy of note and that should be a tip off to the reader that there is a policy dispute occurring."
Lawler said that the debate has been going on for quite a while. He noted that while editor of Catholic World Report, he published an article by Bishops Bruskewitz and Vasa and others which contested the brain death diagnosis. "Personally I was all in favour of organ donation too," said Lawler, "until I started reading about what was involved and talking with doctors who had done it and changed their minds."
"I haven't seen a convincing response to the criticism of the brain death diagnosis," Lawler concluded. "I think it's troubling that rather than answer the criticism a lot of people who are invested in that diagnosis would prefer to silence the critics."
One of the critics most silenced in the debate is Dr. Paul Bryne, a neonatologist who has studied the issue of organ donation intensely for the past thirty years. His articles refuting the brain death diagnosis were published in major refereed journals - the Journal of the American Medical Association and the Gonzaga Law Review - as early as 1979 and have never been refuted. LifeSiteNews.com also spoke with Dr. John Shea a Toronto-based physician who has done extensive reviews of the literature on the subject and who has also concluded that the scientific arguments against considering brain death as true death have never been effectively countered.
Given the added attention, many Catholic will be watching the November Vatican conference on organ donation - should it not be cancelled. Of particular importance will be the speech the Pope is set to give to conference participants on the final day of the proceedings.
See Dr. Byrne's articles in the journals:
Brain Death - An Opposing Viewpoint
Published in the Journal of the American Medical Association 1979 Nov 2;242(18):1985-90.
Brain Death--The Patient, The Physician, And Society
Slightly revised version of article published in the Gonzaga Law Review 18:3 (1982/83):429ˆ516.
See a summary article on the scientific literature on the topic by Dr. John Shea: