Denise J. Hunnell, MD

The erosion of ethics in organ transplantation: what’s a Catholic to do?

Denise J. Hunnell, MD
By Denise Hunnell MD

November 19, 2012 (Zenit.org) – Caleb Beaver died at age 16 on Christmas Day in 2011 due to a previously undiagnosed congenital malformation of his blood vessels. His devastated parents agreed to the donation of his heart, kidneys, lungs, liver, and pancreas. Several months later, his mother and father were able to meet with the grateful recipient of Caleb’s heart and hear their son’s beating heart in this new body.  While the meeting could not erase their grief, the meeting offered Caleb’s parents a small bit of consolation that his death had brought life to someone else.

Organ donation can certainly be a supreme act of generosity. Pope John Paul II endorsed organ transplantation in both his encyclical Evangelium Vitae as well as his 2000 address to the 18th International Congress of the Transplantation Society as a way to build up an “authentic culture of life”. However, Pope John Paul II was also careful to insist that this lifesaving technology must be governed by critical ethical principles in order to fulfill its life affirming potential.

The first principle is the donation must be voluntary and free of all coercion. That is why there can be no sale of human organs: the prospect of financial profit would put pressure on the poor to sell their organs for subsistence. A marketplace approach would also unfairly favor those who have the means to pay as organ recipients. Second, the human dignity of both the donor and the recipient must be respected. A potential organ donor must always be seen first as a human being and a patient deserving of optimal medical care. He should never be viewed as merely a cluster of organs waiting to be harvested. With this in mind, respect for human life from conception to natural death prohibits the removal of vital organs for transplant until after a patient has died.

The explosion in organ transplant technology has resulted in a tremendous shortage of available organs. Over 6,500 patients died in 2011 while they were waiting for an organ transplant. With so many patients facing death without a transplant, it is not surprising that a black market for human organs has emerged. Organ trafficking has become a major enterprise of organized crime in Latin America, Asia and the Middle East. Western nations in Europe as well as the United States are not immune from this exploitive trade. According to the European Society of Organ Transplantation, those most likely to sell their organs include the poor, the hungry, the socially marginalized, and illegal immigrants and refugees. Dr. Francis Delmonico, a Harvard transplant surgeon, estimates that 10% of all kidney transplants worldwide are performed with illegally trafficked organs. While many governments have enacted penalties for organ trafficking, few are aggressively seeking to eliminate the black market trade of human body parts.

Perhaps even more worrisome than the deplorable practice of buying and selling human organs are the trends emerging in mainstream medicine. Two of the principles outlined by Pope John Paul II, the expectation that a potential donor is viewed as a fully human patient first, and the requirement that a donor of vital organs be dead before the organs are harvested, have long been cornerstones of transplant programs. The shortages of available organs for transplant have motivated some to question the need for such standards.

Normally, patients are not evaluated as possible organ donors until after a decision to remove life sustaining medical care is made. This ensures that the decision to withdraw extraordinary means of support is made without coercion from the transplant team waiting for the patient’s organs. The United Network for Organ Sharing (UNOS), a nonprofit organization contracted by the United States Department of Health and Human Services (HHS) to administer the nation’s organ transplant program, is revising the requirements for organ donation programs in order to allow patients to be evaluated as potential organ donors before any decisions are made about the withdrawal of life sustaining measures. The first attempt by UNOS to revise the guidelines actually designated specific neurological diseases such as high level spinal cord injuries, muscular dystrophy, and Lou Gehrig’s disease as conditions to be flagged as potential organ donors on any admission to the hospital. This brought such an outcry from disability advocates that the current revision no longer recommends singling out specific diagnoses for organ donation. Instead, all patients will be evaluated as potential donors, and no consultation with families is required. In fact, UNOS states that it is unnecessary to obtain consent for organ donation from the next of kin or other health care surrogate if a patient has indicated they want to be an organ donor through something like a living will or a check in the organ donor box on their drivers license. This rush to label a patient as an organ donor effectively removes the protective barrier between patient care and preparation for organ donation, thus diminishing the trust between patients and their doctors.

Equally disturbing is the push to remove vital organs from living patients. Since the first transplants were done, there has been a lively debate over what constitutes death, and such discussions are still active today. Some advocate for criteria that rely on the presence or absence of cardiovascular circulation and define death as the absence of a beating heart. Others push for the absence of electrical brain activity to be the gold standard of death. Until recently, the issue was always centered on reaching maximum certainty that death has occurred before harvesting organs for transplant. Now the emphasis is shifting to making sure the patient is “close enough” to dead for transplant.

In their book Death, Dying, and Organ Transplantation, Drs. Franklin Miller and Robert Truog argue that it is not necessary to wait for death in patients who are voluntary organ donors and in whom death is imminent. In Canada, the Canadian Council for Donation and Transplantation markedly loosened the neurological criteria required for organ harvesting, leading critics to question whether the patients declared dead under the new liberalized criterion are really dead.

Standard protocols for donation after circulatory death typically require a two to five minute delay from the time heart function ceases to the time organs are removed. The new UNOS requirements discussed above remove any required waiting period before removing organs after the heart stops. Each transplant center is free to define circulatory death as it sees fit. As a utilitarian ethic becomes mainstream and donor death becomes optional, the need for certainty of death becomes superfluous.

Clearly, these developments are at odds with Catholic ethical principles. The Ethical Religious Directives for Catholic Health Care Services clearly state:

63. Catholic health care institutions should encourage and provide the means whereby those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for donation and research after death.

64. Such organs should not be removed until it has been medically determined that the patient has died. In order to prevent any conflict of interest, the physician who determines death should not be a member of the transplant team.

So what is a Catholic to do? As with other end of life decisions, it is important to designate a health care surrogate who will make sure your health care conforms to Catholic principles when you are unable to speak for yourself. In light of the increasing speed with which organs are removed from patients who have previously designated themselves as organ donors, it is wise to consider carefully the possible consequences of making your intentions to be an organ donor public through an advanced directive or a checked box on your drivers license. When possible, know your health care facility. Ideally, your hospital should be able to provide some assurance that any organ procurement protocol will assure quality care to the donor until the time of natural death and no vital organs will be removed before a patient is dead.

Organ transplantation, when done ethically, remains a heroic act of generosity.  This legitimate and life-saving practice must not be degraded by turning human organs into commodities, and turning seriously wounded or disabled persons into mere suppliers of organs.

Denise Hunnell, MD, is a Fellow of Human Life International, the world’s largest international pro-life organization. This article originally appeared on Zenit.org and is reprinted with permission.

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A protester rallies against Hobby Lobby, protesting against the Supreme Court decision Dan Holm/Shutterstock
Dustin Siggins Dustin Siggins Follow Dustin

DNC chairwoman exhorts constituents to boycott local Hobby Lobby store

Dustin Siggins Dustin Siggins Follow Dustin
By Dustin Siggins

The Supreme Court's Hobby Lobby decision was nearly two months ago, but the issue as hot as ever, as was demonstrated yesterday when Democratic National Committee chairwoman Debbie Wasserman Schulz, D-FL, urged constituents to boycott a Hobby Lobby store in her district.

In a press conference one lot away from the Hobby Lobby location in Davie, which opened in April, Wasserman-Schultz said that she wanted “people to know that this Hobby Lobby is here and they should vote with their purses and their pocketbooks, and women should not shop here."

"If you didn’t know this Hobby Lobby was here before, know it now and don’t shop here. They don’t deserve women’s business because they are the ones that all across the country have made it harder for women to get access to birth control,” she said.

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Wasserman-Schultz said that Hobby Lobby's corporate ownership "doesn’t support its employees” and “wants to be able to get in the personal business of their employees and make health care decisions and replace their own values, replace their employees’ health care decisions, with their values…."

She also criticized the Supreme Court's late June decision in favor of Hobby Lobby, which had sued the federal government over the Obama administration's HHS Mandate.

The Green family, which owns Hobby Lobby, say it violates their conscience to pay for coverage for the four abortifacients and potential abortifacients that the mandate required them to cover.

"The Supreme Court’s decision in the Hobby Lobby case was not only disappointing, it was dangerous," said the Democrat. "No boss should have the right to dictate and employee’s health decisions because [they] don’t belong in the bedrooms, doctor’s offices or pharmacies of their employees.

“A woman and her doctor know what’s best for their body. Not an insurance company. Not a politician. And certainly not a manager at a Hobby Lobby."

The Supreme Court's decision allowed closely held corporations to not fund coverage of contraception or abortion drugs and devices.

Wasserman-Schultz's office did not respond to multiple requests for comment.

Through a spokesperson, the Green family declined to comment about the Congresswoman's statements. 

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America is rejecting abortion because pro-lifers are having more children: study

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By Kirsten Anderson

According to a new Northwestern University study, American attitudes about abortion are trending more conservatively than other contentious social issues, a phenomenon the authors credit to the simple fact that pro-lifers have more kids.

“We find evidence that the abortion attitudes have lagged behind a liberalizing trend of other correlated attitudes,” the authors wrote. Using GSS data collected between 1977 and 2010, “We test[ed] the hypothesis that the comparatively high fertility of pro-life individuals has led to a more pro-life population.”

The authors wrote: “Support for abortion rights has turned flat after a period of increase following Roe v. Wade, and in recent years there are even indications of a reversal toward more restrictive attitudes. This U-turn is evinced particularly among younger cohorts, and is happening despite liberalizing trends in several ostensibly related issue domains.”

The authors speculated that the reason for the increase in pro-life attitudes among young people is that their parents had more children than their pro-abortion counterparts. When they examined the data, they found that pro-life individuals had, on average, 27 percent more children than those who considered themselves “pro-choice.”

Not only that, but pro-life parents appear to be much more likely to pass their views on to their children. The researchers found that the younger generation’s pro-life shift was too strong to be blamed solely on differences in fertility – meaning children of pro-abortion parents are rejecting their parents’ views.

“[E]ither pro-life beliefs are always more faithfully transmitted than pro-choice ones; or, there has been a cultural shift towards more pro-life beliefs that is being reflected in the parent-child correlations,” the authors wrote.

The study concluded that it wasn’t for the higher fertility rate among pro-life people, the nation as a whole would favor abortion by about five percentage points more than it does currently – and researchers predict the pro-life trend will continue.

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“Taken together, these findings suggest that fertility has had at least some part in leading the population in a more pro-life direction over time,” the authors wrote. “Further investigation into this pattern indicates that not only are abortion attitudes associated with fertility, but in proportional terms—which is what matters for cultural change—the gap is widening.”

“Fertility has declined for both pro-choice and pro-life groups over the past 30 years, but fertility has declined far less markedly for pro-life individuals,” they added. “Whereas pro-[life] individuals born before 1940 were only having about 1.2 children per one child born to a pro-choice parent, this ratio has grown to over 1.5 for those born in the mid to late 1970s. This pattern suggests that future cohorts may place an even stronger demographic drag on the liberalization of abortion attitudes.”

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A declaration that PP is an 'enemy of the Church' would mean that Catholics who work with, advocate for, or support Planned Parenthood, incur automatic excommunication. American Life League
Lisa Bourne

New campaign asks Pope Francis to declare Planned Parenthood an ‘enemy of the Church’

Lisa Bourne
By Lisa Bourne

The Catholic pro-life organization American Life League (ALL) is launching a campaign calling for the Catholic Church to declare Planned Parenthood an “enemy of the Church.”

Using prayer and education, ALL’s Defend the Family campaign seeks to expose the nation’s largest abortion provider for contribution to the destruction of human lives, as well as the family. 

The campaign, said Jim Sedlack, vice-president of ALL, is quite simply “a way of calling attention to the fact that this is a very bad organization.”

“Planned Parenthood is attacking the family, either by killing preborn children or by robbing the souls of the older children,” he said. 

A declaration that PP is an "enemy of the Church" would mean that Catholics who work with, advocate for, or support Planned Parenthood, incur automatic excommunication.

Such a declaration would not be unprecedented. Popes in the past have identified and condemned organizations that posed a grave threat to the Church, most recently Pope Pius XII in 1949 with Communism and Pope Clement XII in 1738 with Freemasonry.

While specifics would depend on the wording of the Papal pronouncement, Sedlak told LifeSiteNews if the Holy Father makes the declaration there would be no mistaking its intent.

“When the pope makes the declaration it becomes crystal clear,” Sedlak said. “There’ll be no shades of gray, it’ll be black and white, it’ll be clear to the world.”

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'Now is the time'

There are still people who are not fully aware of the extent of the societal damage inflicted by Planned Parenthood, said Sedlak, including members of the Church hierarchy. He said it’s important to emphasize the truth of what the abortion giant does.

“That’s why we’re focusing on the enemy,” said Sedlak. “When people really stop and focus on Planned Parenthood, they realize it’s the enemy.”

ALL cites Planned Parenthood’s targeting of children to sexualize them as a major cause of the destruction of the family and a fundamental reason for the Defend the Family campaign.

“They really push for getting young people into lives of sexual sin,” Sedlak said. “Young people who aren’t pulled into sexual activity do not provide a cent of income to Planned Parenthood, but young people who are pulled in provide millions of dollars to the Planned Parenthood empire.”

ALL compiled a comprehensive report on Planned Parenthood titled, “The Vatican can help save souls from Planned Parenthood,” as part of the Defend the Family campaign.

“The document builds the case,” said Sedlak. “Why Planned Parenthood, why now is the time.”

Sedlak told LifeSiteNews that for its part Planned Parenthood has always recognized that its greatest enemy is the Catholic Church, even working to have the Church lose its status at the UN.

“They fight anybody who wants to take sex away from the kids in any way possible,” Sedlak said. “That’s one reason why Planned Parenthood is the sex mafia.”

And when Sedlak uses the term "mafia," he means it literally, pointing out that the Holy Father condemned the mafia in his June 21, 2014, homily in Calabria, Italy, denouncing its, “Adoration of evil and contempt for the common good.”

“Planned Parenthood kills far more people than the mafia,” Sedlak said.

Also underscoring the need for the Vatican to act on declaring Planned Parenthood an enemy of the Church, is the convening of the Extraordinary Synod on the Family this October in Rome, which will lead into the general synod in 2015.

Sedlak told LifeSiteNews that these, along with the 2015 World Meeting of Families in Philadelphia, are events that ALL will rally around to raise awareness of the Defend the Family campaign.

Preliminary response to the campaign has been very positive, he said.

Sedlak told LifeSiteNews that the “Vatican can help save souls from Planned Parenthood” report was so well received upon initial presentation to Vatican officials, that ALL was asked to translate it into three more languages.

“The support we’ve gotten from talking to bishops has been overwhelming,” Sedlak said.

Prayer is priority #1

The Defend the Family campaign consists first and foremost of prayer, Sedlak told LifeSiteNews.

“Our approach is that we need prayer support,” he said. “The only way that we’re going to succeed is through prayer to the Blessed Mother; the only way it will succeed is if God wants it to succeed.”

Participants are asked to say regular prayers after Mass, to offer prayers for the pope and to initiate communication with local bishops about the dangers that Planned Parenthood poses to the faithful.

Sedlak also added that The Defend the Family campaign is for everyone, not just Catholics.

He said pro-life supporters of all faith traditions are invited to contact ALL for assistance in encouraging their religious denomination or church leader to declare Planned Parenthood an enemy.

In addition to prayers for the campaign, ALL is asking people to sign and submit ALL’s Declaration of Encouragement to the Holy Father, enroll in the Spiritual Bouquet for the Holy Father and to share ALL resources on Planned Parenthood.

Information, links and resources are available on the campaign website, defendthefamily.org.

Sedlak told LifeSiteNews that ALL is giving the success of the Defend the Family campaign up to God.

“This is all happening in God’s time, and so far he’s been blessing us mightily,” Sedlak said. “And we’re going to go wherever God takes us.”

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