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April 24, 2007

Comments

John Weidner

From the article:
...Bishop Fabian W. Bruskewitz of Lincoln, Neb.... asked how the Catholic Church can accept a lack of brain function as a definition of death yet still oppose the willful destruction of human embryos, which have not yet developed a brain..

Jimmy, this logic would seem to say that if I take a poison that kills my brain but leaves my heart beating, I have not commited suicide.

Paulo Gaucho

"...Bishop Fabian W. Bruskewitz of Lincoln, Neb.... asked how the Catholic Church can accept a lack of brain function as a definition of death yet still oppose the willful destruction of human embryos, which have not yet developed a brain.."

That is like asking how we can accept not being able to speak as a sign of mental retardation in adults while not applying the same standard to infants.

Ed Peters

...the distinction between an official document of the magisterium and an advisory document that the Holy See has given permission to publish..."

Hmm. We still need to tweak this. But another day.

SDG

Jimmy, this logic would seem to say that if I take a poison that kills my brain but leaves my heart beating, I have not commited suicide.

If a body with a beating heart is still alive, as Bishop Bruskewitz and others believe it is, then you have not technically committed suicide, but you have still committed a grave sin against the fifth commandment, just as you would if you took drugs to put yourself in a comatose state indefinitely without actually inducing brain death.

That is like asking how we can accept not being able to speak as a sign of mental retardation in adults while not applying the same standard to infants.

Now we are cooking with gas. This is a more serious objection to Bishop Bruskewitz's argument, which as quoted does strike me as less than compelling as far as it goes.

JoAnna

...Bishop Fabian W. Bruskewitz of Lincoln, Neb.... asked how the Catholic Church can accept a lack of brain function as a definition of death yet still oppose the willful destruction of human embryos, which have not yet developed a brain..

The key words there are not yet developed. Left unhindered (i.e., NOT KILLED), most embryos will eventually develop a perfectly normal, healthy brain. Even so, brain development continues well after we are born. I think an infant's brain expands at an exponential rate at the first two years after birth.

With a comatose person, FWIU, brain fuction seldom improves and often degenerates.

If a machine is doing the work of the brain and/or the heart, one is only prolonging the inevitable, IMO.

Layne

Of course, we should also remember that without artificial means "brain-dead" humans would soon be "dead-dead".

100 years ago this would not have been a question because the person would naturally die without the help of ventilators, etc.

It would seem that when the brain no longer performs its functions which keep the body alive that death has occurred. As above, this is quite different than keeping a fetus from developing. This is a case where a previously fully-functioning, fully-developed brain has ceased working.

Kevin Cary

I'm no doctor, but I'm quite sure that our brains stop developing around the age of 25ish.. something like that. From then on, you may have a normally functioning brain, but it is not developing. I'm just wondering if the distinction should be made in regards to a developing brain, or if, in fact, the distinction is intended to be made between a functioning brain and non-functioning brain. The latter seems like much more of a gray area, to me.

Also, 100 years ago, you may have died because you didn't have access to the treatment necessary to treat a brain tumor and before you were pronounced dead, you were "as good as dead." Fast forward to now, how is life support of a brain dead person different in kind? I don't see it.

S

Pope Pius XII and Pope John Paul II both said the Church has no competency in determining death.

Elijah

Yes, Kevin, brain function is indeed a gray matter. :P

Pseudomodo

Gray is the SI unit of the absorbed dose of ionizing radiation, corresponding to one joule per kilogram.

It's GREY!!!

Michael

Machine dependence does not make a person dead; if so, anyone dependent on a ventilator, pacemaker, or other mechanical device to live would be already dead. To say that "brain dead" people will die soon is a "prognosis" of impending death, not a "diagnosis" that death has already occurred. "Brain dead" individuals are functioning as unified organisms (as Alan Shewmon, pediatric neurologist at UCLA, has convincingly shown), though many of their powers are impaired. They are not dead. Many brain dead patients have EEG activity (I can furnish references upon request) and have continuing hypothalamic function. Thus, removing unpaired vital organs from such patients is manslaughter and is morally wrong. It is unfortunate that the Roman Catholic Church continues to support brain death criteria, which is utterly inconsistent with its opposition to abortion. Its position on this issue is, in my judgment, hypocritical.

Pope Pius XII unfortunately left it up to the physician to define death--yet the definition of death is a philosophical issue, and the criteria for death is an issue involving both philosophy and medicine. In any case, brain death criteria are based on both bad philosophy and bad medicine.

Brian

Thus, removing unpaired vital organs from such patients is manslaughter and is morally wrong. It is unfortunate that the Roman Catholic Church continues to support brain death criteria, which is utterly inconsistent with its opposition to abortion. Its position on this issue is, in my judgment, hypocritical.

When does anyone remove organs from brain dead but still alive people? I believe that the Church's teaching is not that we can kill brain dead people, but that no one can be forced to keep themselves alive by artificial means - it's against their dignity. If a person would cease to be alive without the aid of a ventilator or other devices and they cannot speak for themselves, it is up to the their family to make that decision.

I think your pacemaker example is a little over the top. That would fall into the same category as a feeding tube, it assists a working heart that has problems beating regularly just as a feeding tube assists a working digestive system even though the person has problems eating solid food.

That pretty much takes me to the extent of my knowledge on the subject, hopefully someone else can provide more detail.

Michael

When organs are removed from a person declared dead by "brain death" criteria, the person's heart is still beating until it is stopped during organ donation surgery. This is no secret and is standard practice in organ transplantation. The "brain dead" person has a functioning circulatory system, and the respiratory system works in the way that counts for unity--that is, the ventilator provides oxygenated air, but oxygen and carbon dioxide exchange takes place in the lungs and other tissues of the body as a whole.

Many people confuse the issues of allowing to die with removing organs from brain dead people. I have no problem with allowing a terminally ill person to die via removing a ventilator or feeding tube. In those cases the paralysis of muscles required for ventilation or the inability to eat are due to the disease process, and removing artifical means of support allows the disease process to run its course. Removing unpaired vital organs, such as the heart or liver, on the other hands, directly causes death--obviously removal of the heart or liver is not part of the disease process (usually the heart is stopped by a potassium solution before it is removed). Thus, it does count as manslaughter--it is certainly not allowing to die. I think many people are so blindly in favor of organ transplantation that they ignore the real "right to life" issues involved in the debate over brain death--and the organ transplant industry, which has the full support of the media, only presents the rosy side of transplantation. For all his faults and false positions, Peter Singer is right on one point: the "sanctity of life" ethic really died in 1968 with the acceptance of the Harvard "brain death" criteria for human death. Singer asks where the pro-life movement was in 1968. I wonder too.

Brian

As far as I know all organ donors choose to be. They've reached the point where they will not recover and donate their organs to save other peoples lives. Maybe I'm over-extrapolating, but by your logic the soldier who falls on a grenade to save his buddies is sinning. "No one has greater love than this, to lay down one's life for one's friends."

Michael

That, at least, admits that organ donors--at least those declared dead by brain-based criteria--are alive before organ donation surgery--how else could they "lay down their lives." The problem is that doctors are killing patients for their organs. The patient giving prior permission (as in an organ donor card) is irrelevant for the morality of a practice that violates the fundamental ends of medicine, one of which is to "do no harm." Killing a patient is objectively harming that patient, even if, via a utilitarian argument, it is "for the benefit of another." Robert Truog has argued that organ donation kills the brain dead patient, but he argues that it's a form of justified killing. For a utilitarian such as Truog to argue this point is not surprising, and is consistent with his fundamental premisses. For a Catholic to argue for doctors killing patients, no matter how noble the reason, is surprising.

Brian

Michael,

You've reached the edge of my medical knowledge, hopefully someone else can pickup the discussion. If they take the organs out while the body is still alive, then I agree with you that it kills the person. While the body is alive the soul is there, there's no way for the soul to be somehow separated because their brain dead leaving behind a souless, yet living body.

I don't necessarily think this violates the doctor's oath to do no harm. The person has already suffered an irrecoverable injury and would die without artificial life support. They have already chosen to donate their organs. They've chosen freely to give up their life to save another life who will hopefully have many years to live. I'm an organ donor, learning that I will still be alive if they take out my organs doesn't change that decision for me.

I will agree with you that there is the possibilty for this practice be abused. But that is the fault of the doctors, not the person who has selflessly chosen to give away his organs. In becoming an organ donor you put your trust in the doctors to do what's best both for you and the people receiving your organs.

D. W. Evans, M.D.

I have read your exchange with Michael on this topic Brian. As you agree that you would be still alive after being diagnosed "brain dead", you would be asking a doctor to be your executioner by asking him (prospectively) to remove your heart while in that state - albeit for the benefit of another. I could not do that and I fully agree with Michael that no other doctor should do it either. The doctor's role is to heal and to alleviate suffering. Once he becomes known as willing to kill - or even to harm his patient for the sake of some third-party interest - his status changes, with potentially disastrous consequences for the fundamental doctor-patient relationship based, as it is and must be, upon trust. David

Brian

Dr. Evans,

I hope that the medical community allows you to conscientiously object to performing such procedures.

I'm also still not convinced that organ donation is objectively wrong. You've got two people: one who is kept alive solely by machines and stated his will to give up his organs in such a situation and one who will eventually die without a transplant. You can end up with two dead people, or one dead person and one healthy, living one. I'm sure that if you were in a situation with two dying people in your operating room and only had the means to save one, you wouldn't choose to save neither so that you wouldn't neglect one. Admittedly, organ transplant is more difficult than this example because it involves performing actions that directly cause the death of a person, but I'm not convinced that it's wrong.

Just so I know where you're coming from, do you believe people have the right to make DNR requests? Or that whoever is legally responsible for making decisions for a brain dead person has the right to remove them from life support?

Bernice Jones


I have learned much about “brain death.”

I was shocked when I read about a “patient” who was dependant on machines, referred to as “artificial means,” to aid in providing all of the necessary functions to sustain life. Yes. Even a ventilator was used. Hydration and nutrition were necessary also. An array of different drugs were administered, even pain medication and paralyzing drugs. This patient had been prepped for OR. Soon to undergo surgery in a sterile environment with physicians and nurses waiting, the “patient’s” vital signs were checked. The EKG as well as all other tests proved to be normal. The vital organs, all eleven systems, were functioning. This assessment of the “patient’s” overall physical health is crucial prior to any surgery. This “patient’s” vital signs were recorded and a healthy young man, as the records confirm, was ready for the surgical procedure to begin.

Normal, standard procedures, I am told, for surgery. Yet, the records indicate what happened next wasn’t what many physicians or nurses would consider normal whatsoever.

In the process of excising many vital organs, including this young man’s beating heart, this “patient” was killed. What do I mean when I say “killed?” KILLED! A “flat line” appears on the monitor screen, the same monitor that had previously validated every sign of this young man’s life. The young man, this “patient,” was now truly dead.

What I refer to as a ‘normal’ surgical procedure conducted by ‘normal’ physicians and nurses are those dedicated to protecting and preserving their “patient’s” life. Under no circumstance would they do anything to harm their “patient.” This young man’s vital signs, having been assessed by those of the ‘healing arts,’ would have confirmed life and hope. These physicians see life and extended to the patient, out of love, compassion and mercy. Everything within their professional capacity, every means made available to protect and preserve the “patient’s” life is aggressively sought and graciously offered. Hope and life are spoken.

This young man, the “patient,” had a head injury and was pronounced “brain dead.” There are those who call themselves physicians and yet, are blinded to vital signs when pronouncing this fictitious, lethal death sentence and condemn one to death. The monitor dances in unison to every beat of the heart, the pulse and oxygen level is numerically recorded and all are visible on the screen. Bodily excretions are routinely measured as the urine is displayed visibly in a bag as it hangs along side the “patient” on the bed. Yet, no hope is offered, rather, death is spoken.

For some of you it must be quite entertaining to have intellectual debates concerning “brain death,” as obviously, few are educated on this subject matter and for no other reason do I see it necessary to debate this any longer. As most everyone knows now, “brain death” cannot and has not been scientifically validated as it is scientifically impossible to do. “Brain death” is legal and for this reason and this reason only, the debate is comfortably and openly debated.

Equally obvious is the ignorance regarding God’s word, His every command, precept and His sovereignty. Sadly, for as many years as “brain death” has remained at the center of heated debates, a most controversial subject matter, nothing has been done to stop this deadly hoax and uphold our Lord’s word until most recently.

“Brain death,” this deadly hoax, is over.

“The lack of knowledge” is the core of this issue as the moral decay; having pursued moving God’s moral boundaries, inch-by-inch, year-by-year in cultivating a “culture of death” has been the agenda and for some, actively pursued. There wasn’t anything innocent about this blatant attempt to eradicate God as the One and Only Who holds the key to life and death.

God is unmoved. God will not be mocked.

The controversy stops in the operating room with the cavity of the “organ donor” gaping open as body fluids spill onto the floor. The body now cold, white and lifeless, void of movement. It seems that all understand true death at this point and I am sure, without a doubt, no one will challenge me having made this statement.

I take an uncompromising stand for life. The human person is God’s masterpiece. With creation God spoke all things into being especially His precious, the human person. With His hands He gently formed each one so unique and so wonderfully. Each person, in His Image and Likeness, He created. In the womb, His Holy, secret place, He molds and establishes the person. His highest value is equally and graciously established in each as He cradles them within the body of our mother. Each one He breathes into the nostrils His “breath of life” and the unity of body and His Spirit become one.

The human person, regardless of the age, physical or mental condition is holy. One’s altered state will not alter God’s decree. The body, even lifeless, remains to be the temple of His Holy Spirit. The human person is not to be mutilated, alive or dead.

The “babbling,” the mumbo-gumbo used surrounding the term “brain death” in an attempt to confuse doesn’t amuse God. Stop it!

Opened before Him is the Book of Life and with His hand He carefully wrote each name of those called to His throne to live and dwell with Him for an eternity. This was done prior to His creating the foundation of the earth and with every beat of your heart and every breath you take, He beckons you. This time, your life, is precious to Him. Don’t waste a minute on foolishness.

The universe, all heaven and earth depict the work of His hands. The sea obeys His voice, the storms seek His permission and the seasons change upon His command. Effortlessly God orchestrates the harmonious and continual movement of His creation. Yet, nothing does He treasure more than you.
All of this, all of His beautiful, perfect creation is the reflection of our powerful, mighty God. From the depth of His heart in love did He create all of this for you.

He is the Father of TRUTH and the Creator of all knowledge, the scale of all measure, and the foundation of all justice. “I AM,” says the Lord.

He engraved His word on the heart of man, consummated His word in the “Rock” of our salvation, His Son, our Lord and Savior, Jesus Christ and no one dares to argue with Him for “it is written.” His every word will endure forever and not one will return to Him void.

As a donor mother, I have learned much about “brain death.” I have sought “good instruction” and have received it.

“Try to find out what is pleasing to the Lord.” Ephesians 5:10

Yes. This is your Divine appointment, your time allotted by the Lord God Almighty to humbly submit to Him. You have been allowed a time to choose and bow before Him under His grace, this provision of undeserved mercy He extends to all mankind. Jesus poured out His pure blood for you to enable you to walk with Him and enter the Holy of Holies through the door, Jesus Christ. May your tongue profess Jesus Christ as Lord and with every breath you take and every beat of your heart may you serve Him.

No one can defy Him as all will make this ultimate decision. “Choose life” our Lord said. Which god will you serve?

We must return to our Holy Father God, to our Judeo-Christian teaching and honor Him as our King of Kings, Lord of Lords!

“I AM” says the Lord God Almighty!


Petros

I have been reading articles from both sides of the brain death debate. It is clear to me that this issue cannot be settled by scientists. Even if the Church does not have the competency to involve in the technical details of determining death, at least she should answer some philosophical problems that can be found in both sides of the debate.

To me, the most stringent criteria for determining brain death probably give very good indication that treatment could be discontinued to allow nature to take its course. I don't think there is any controversy in that. The controversy arises when organ transplantation is involved.

Frankly, I'm not impressed by the amount of mental gymnastics one needs to exercise to justify vital organ transplants on brain dead persons. What happens on the operating table, as described very well by Bernice, is so against our intuitive notion of what it means to be dead that only surgeons or people with a Ph.D. in philosophy can truly believe that brain death is death.

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