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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Cardinal Gerhard Ludwig Müller, prefect of the Vatican's Congregation for the Doctrine of the Faith
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Vatican pressing forward with reform of US feminist nuns: Cardinal Müller

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By Thaddeus Baklinski

Cardinal Gerhard Ludwig Müller, prefect of the Congregation for the Doctrine of the Faith, says the Vatican is pressing forward with plans to reform the U.S.-based Leadership Conference of Women Religious (LCWR).

In an interview published in the Vatican newspaper L’Osservatore Romano, the cardinal said that the reform of the LCWR, which was undertaken after an assessment of the group found serious doctrinal problems, will be carried out with the goal of helping them "rediscover their identity.”

“Congregations have no more vocations and risk dying out," Müller said. "We have first of all tried to reduce hostility and tensions, partly thanks to Bishop Sartain whom we sent to negotiate with them; he is a very gentle man. We wish to stress that we are not misogynists, we are not women gobblers! Of course we have a different concept of religious life but we hope to help them rediscover their identity.”

Moreover, the cardinal said that problems specific to the LCWR are not a reflection of all the women religious in the US.

"We need to bear in mind that they do not represent all US nuns, but just a group of nuns who form part of an association,” Müller said.

“We have received many distressed letters from other nuns belonging to the same congregations, who are suffering a great deal because of the direction in which the LCWR is steering their mission.”

Cardinal Müller's remarks confirmed the assertion he and the Holy See’s delegate to the LCWR, Archbishop Peter Sartain of Seattle, made in an address to LCWR officials in Rome on April 30, that the theological drift the feminist nuns are taking constitutes a radical departure from the foundational theological concepts of Catholicism.

The Holy See “believes that the charismatic vitality of religious life can only flourish within the ecclesial faith of the Church,” Müller said in the address.

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“The LCWR, as a canonical entity dependent on the Holy See, has a profound obligation to the promotion of that faith as the essential foundation of religious life. Canonical status and ecclesial vision go hand-in-hand, and at this phase of the implementation of the Doctrinal Assessment, we are looking for a clearer expression of that ecclesial vision and more substantive signs of collaboration,” he stated.

The LCWR has openly defied the mandate of reform intended to bring their organization into line with basic Catholic doctrine on the nature of God, the Church, and sexual morality.

Among the CDF’s directives, to which LCWR has strenuously objected, is the requirement that “speakers and presenters at major programs” be approved by Archbishop Sartain. This, Müller has explained, was decided in order to “avoid difficult and embarrassing situations wherein speakers use an LCWR forum to advance positions at odds with the teaching of the Church.”

The LCWR has invited speakers to their Annual Assembly such as New Age guru Barbara Marx Hubbard, and Sr. Laurie Brink, who is particularly noted for flagrantly denying the Divinity of Christ and telling the sisters that to maintain their “prophetic” place in society they need to “go beyond” the Church and even “go beyond Jesus.”

In one of the first public statements of his pontificate, Pope Francis affirmed that the investigation and reform of the LCWR must continue.

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Brian Fisher

Birth mothers: real heroes of the pro-life movement

Brian Fisher
By Brian Fisher
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What does it mean to be brave? Is it the doctor who dedicates himself to improving the health of a third-world nation? Is it the woman who faces her third round of chemotherapy to fight the progression of cancer? Is it the teacher who forgoes the comforts of a suburban school to reach minorities in the inner city? All of these are examples of bravery demonstrated in exceedingly challenging circumstances. And our society longs for stories of bravery to inspire us and fill us with hope.

As someone who works day in and day out with those on the front lines of helping rescue babies from abortion, I’m no stranger to stories of bravery. I see courage every day in the eyes of the men and women who sacrifice their time and energy to help women facing unplanned pregnancies. I see it every time a young mom — despite being pressured by her parents or significant other to get an abortion — chooses LIFE. And perhaps more profoundly than in any other situation, I see it when an expectant mom with no relational support, job, or income chooses to place her baby for adoption rather than abort her son or daughter.

This was Nicky’s situation.

When Nicky found herself pregnant with her boyfriend’s child, her life was already in shambles. During her 26 years, Nicky had already given birth to and surrendered sole custody of a little girl, committed several felonies, lived in her car, lost several jobs, and barely subsisted on minimum wage. So when she met up with an old boyfriend, Brandon, Nicky believed she was being given a second chance at happiness. “Our first year together was beautiful. We were getting to know each other and deciding if we would stay together forever.” Unfortunately, a positive pregnancy test result changed everything.

“When I told him I was pregnant, Brandon sat down on the bed, looked me in the eyes, and told me to ‘get an abortion’.” Nicky says those three little words changed everything for her. “I became depressed living with someone who wanted his child ‘dealt with.’”  Like thousands of women every day, Nicky began searching online for information on abortion, hoping her boyfriend would eventually change his mind. Through our strategic marketing methods, Online for Life was able to guide Nicky to a life-affirming pregnancy center where she received grace-filled counsel. “The woman I sat with was beyond wonderful. She helped me to just breathe and ask God what to do….And so I did.”

Nicky left the pregnancy center that day with a new resolve to choose life for her child, even though she still wasn’t sure how she’d financially support a child. “I was alone with just $10 in my pocket…and without any type of plan for what I was going to do.” So Nicky relied on the support of the staff she met at the life-affirming pregnancy center. With their help and through a chain of fortunate events, Nicky was put in contact with the couple who would eventually become her daughter’s adoptive parents.

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After meeting this couple face to face and coming to terms with her own desperate situation, Nicky conceded that the best thing for her unborn child would be to place her in someone else’s loving home. She told Brandon about her plans and he agreed that adoption would give their child the best chance at a happy and secure future. He even returned home to help Nicky prepare for the birth of their child. “The weeks leading up to my delivery were filled with a mixture of laughter, tears, protectiveness and sadness,” Nicky recalls. But one sentiment continued to be shared with her. “Brave…so brave.” That’s what everyone from the life-affirming pregnancy center to the adoption agency to the birthing center kept calling Nicky. “The nurses kept coming up to me and telling me they were honored to care for and treat someone like me.” After several weeks of preparation, Nicky finally gave birth to a healthy baby girl, and she made the dreams of a couple from the other side of the country come true.

Nicky’s adoption story continues to be riddled with a strange combination of pain and joy. “I cry every day, but I know my baby, who came out of a very bad time, ended up being loved by people from across the country.” When asked what message she’d like to share with the world about her decision to give up her child for adoption, Nicky responds, The voice of the mother who gives up a baby for adoption isn’t heard. We need to change that.”

To learn more about Online for Life and how we’re helping to make stories like Nicky and her daughter’s story a possibility, please visit OnlineforLife.org.

Author, speaker, and business leader Brian Fisher is the President and Co-Founder of Online for Life, a transparent, metric-oriented, compassion-driven nonprofit organization dedicated to helping rescue babies and their families from abortion through technology and grace.

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New York farmers stop hosting weddings after $13,000 fine for declining lesbian ceremony

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By Dustin Siggins

New York farmers Robert and Cynthia Gifford, who were ordered last week to pay $13,000 for not hosting a same-sex "wedding," say they are closing that part of their operation.

"Going forward, the Giffords have decided to no longer host any wedding ceremonies on their farm, other than the ones already under contract," said Alliance Defending Freedom (ADF) lawyer James Trainor. ADF represented the Giffords in their legal fight against New York's non-discrimination law.

Last week, the Giffords were ordered to pay a $10,000 fine to the state of New York and $3,000 in damages to a lesbian couple, Jennifer McCarthy and Melisa Erwin, who approached them in 2012 about hosting their "wedding." The Giffords, who are Roman Catholic, said their religious convictions would not let them host the ceremony, but that McCarthy and Erwin could hold their reception on their property.

Unbeknownst to the Giffords, the lesbian couple recorded the two-to-three minute conversation. After declining to hold the reception on the Giffords' farm, on which they live and rent property, the lesbian couple decided to make a formal complaint to the state's Division of Human Rights.

Eventually, Judge Migdalia Pares ruled that the Giffords' farm, Liberty Ridge Farm, constitutes a public accommodation because space is rented on the grounds and fees are collected from the public. The Giffords argued that because they live on the property with their children, they should be exempt from the state law, but Pares said that this does not mean their business is private.

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Trainor told TheBlaze that the Giffords' decision to end wedding ceremonies at Liberty Ridge “will hurt their business in the short run," but that was preferable to violating their religious beliefs.

“The Giffords serve all people with respect and care. They have hired homosexual employees and have hosted events for same-sex couples,” he said.

However, "since the state of New York has essentially compelled them to do all ceremonies or none at all, they have chosen the latter in order to stay true to their religious convictions," Trainor explained to LifeSiteNews. "No American should be forced by the government to choose between their livelihood and their faith, but that’s exactly the choice the state of New York has forced upon the Giffords."

"They will continue to host wedding receptions," said Trainor.

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