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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The Romanian Orthodox Church's Patriarchal Cathedral in Bucharest Wikimedia Commons
Bogdan Stanciu

Romanian news outlet sanctioned for discrimination in attacking pro-life initiative

Bogdan Stanciu
By Bogdan Stanciu

BUCHAREST, Romania -- A decision of CNCD, Romania's Council Against Discrimination, has recently become definitive, recognizing the right to dignity of all Orthodox Christians in the country.

Last year, PRO VITA Association - Bucharest branch, one of the main nonprofits in Romania defending life, family and religious liberty, filed an official complaint with the Council, showing that a blog post dated May 17, 2013 and hosted on the Adevarul.ro platform prejudiced the image of Christian Orthodox believers.

The article, signed "Alex Dumitriu," challenged the support given by the Romanian Orthodox Church to the “One of Us” European initiative, which required a ban on public funding for the destruction of embryos during research and medical procedures.

The blog post described the Romanian Orthodox Church as an “anti-human, criminal and anti-life organization, whose purpose is spreading suffering and abjectness, mysticism and ignorance for their own profit.”

The applicant argued that these allegations created a degrading and hostile atmosphere for Orthodox Christians in Romania, thus harming a whole community.

The Council agreed that the affirmations in the article referred to both the clerics and the simple believers and discriminated against the Christian Orthodox community. It concluded it was discrimination, infringing upon the right to dignity granted to persons of Christian Orthodox confession.

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The council cited the European Convention on Human Rights, which states that freedom of expression is not an absolute right in Europe, carrying with it duties and responsibilities. Also, the Adevarul.ro platform was fined a symbolic sum of 2,000 RON (approximately 445 EUR).

It is for the first time in Romania that a media institution is sanctioned for discriminating against Christians.

As a brand, the Adevarul newspaper has continued the tradition of a title established in the 19th century, but after 1989 it took over the infrastructure and human resources of the recently-deceased communist newspaper Scanteia, the official propaganda channel of the Romanian Communist Party. Today it has also developed Adevarul.ro, an online platform that is one of the most popular media channels in Romania.

Adevarul.ro has recently made it a habit of harassing the Romanian Orthodox Church with almost daily frequency, presenting negative aspects in the church and tendentious articles of opinion about this institution and about Creationism and Christianity in general, in what looks more and more like an ideological guerrilla warfare.


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Paul Russell

Nitschke heads a suicide cult that must be stopped

Paul Russell
By Paul Russell

Following The Australian's news story today about another young life lost that was related to Philip Nitschke and the Exit organisation, senior journalist, Angela Shanahan says that Nitschke and Exit must be stopped.

Shanahan opens: 

PHILIP Nitschke, contrary to his claims as an advocate of euthanasia for the terminally ill, is the chief mover of something resembling a suicide cult.

The case histories of Lucas Taylor, 26, and Joe Waterman, 25, who committed suicide after being in contact with Nitschke’s group, Exit, leave little doubt of that.

Lucas Taylor was the subject of the other article in today's paper while Joe Waterman's story was covered earlier in the ABCs 7:30 Report that created the original furore leading to the medical board suspending Nitschke's practicing licence today.

Covering the information Judi Taylor found on her son's computer after his death the story adds: 

His heartbroken mother realised that her son was not the only young person on this site. Nor was anyone on the site interested in the motivation for his thoughts of suicide, nor in helping Lucas to overcome his feelings.

“They were only interested in the ‘endgame’,” she said, including detailed advice about where and when and how to go about it.

Again, this destroys any pretence that Nitschke and Exit are only involved in advising sick and dying people about how to commit suicide. This is a macabre and clandestine death industry. Hope joins with Angela Shanahan in calling for this organisation to be stopped and is joined now in our call for a National Inquiry into Exit and other euthanasia organisations by the mothers of both of the young men mentioned in this article.

Shanahan closes by saying: Nitschke’s claim of political persecution is risible. He and his organisation must be stopped.

Reprinted with permission from NoEuthanasia.org.au.


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Hilary White Hilary White Follow Hilary

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Leaving the Matrix: what is the cost of conversion?

Hilary White Hilary White Follow Hilary
By Hilary White

What do you do when you decide to leave a sexually disordered lifestyle? What do you do, when all the people you have contact with, all your friends, even your family, have accepted and embraced a way of living and thinking about life that you have realized is harmful, psychologically and morally destructive, and which you know you must leave? What is the cost of conversion?

We can easily get caught up in the tumult of the ever-escalating legal, political, and cultural war against the traditional worldview and anthropology, so much that we forget that the “issue” is about real, individual human beings and how they should, concretely, order their lives. We culture warriors must remember that what we are asking people to do is difficult, that it can incur huge sacrifice and loss and will often require enormous upheaval and change. We are asking people to leave not only a “lifestyle” of sexual activity, but an entire world, populated with family, friends, co-workers, colleagues, and an entire global culture that embraces and aggressively promotes it.

I include not only the experience of leaving the “gay lifestyle,” but of leaving a worldview, a cultural paradigm that accepts and promotes sexual license of any kind in general. It is more than the questions surrounding the so-called “ex-gay” movement, and more than the issue of living chastely in an increasingly sexually obsessed world.

How ought a person who experiences same-sex attraction react when it begins to dawn on him that, for whatever reason, he cannot continue to live according to the world’s paradigm? We know how the homosexualist movement says he ought to react, and we know that the secular world (nearly all the world, therefore) is in more or less complete agreement. He should reject such self-negating thoughts. He should embrace his “orientation” and start to seek out same-sex sexual relationships, and carry on in the way that they tell us life is now normally lived.

He should engage in sexual encounters with various people, sometimes setting up “relationships” for varying lengths of time, breaking up, moving on, finding someone else, perhaps cohabitating, and maybe, some day, “settling down” with one person, either in “marriage,” or not, as the mood strikes. This is what the world now presents to us as normal. Nearly every television show and movie set in our times says this is just how people live nowadays. 

It is only too easy for those of us who live out here in The Real to forget how totally different our lives are from that of the majority of our fellow men. We shout, “jump!” because we see a whole other lush, green and happy world, but they see nothing but the shadows on the cave wall.

But those few of us left who think this is not a very good way to live, that it is morally and psychologically destructive, have in large part to forge our own way in life, figure out a set of rules and standards to live by alone, all the while fighting the pressure to conform. Even for those of us not plagued by sexual feelings towards people of the same sex it isn’t easy.

It is particularly not easy for those of us who have decided later in life to try to embrace a different path, but who had previously followed the world’s advice, and who had never known any other way of living. What does it take to totally change a worldview, a method of organizing one’s life and all social relationships? How hard is it to reinvent a way of life that the world has not only abandoned, but aggressively rejected and condemned?

The cost will usually be, at least, the loss of nearly all one’s friends, sometimes even very close friends. Very often it will include alienating, sometimes permanently, one’s own family. Since the Sexual Revolution’s paradigm has now been embraced by three or four or more generations, it will often mean alienation from parents and siblings.

It will sometimes mean the loss of good relations with co-workers and colleagues, and sometimes even the loss of jobs and careers. I know a man, a previously highly respected author, who was totally rejected by the entire literary establishment of his home country, a heavily secular nation, when he embraced Catholicism, including its sexual moral teachings. He told me that he expected he would never be published again outside the Catholic niche press. None of his previous friends would speak to him and for the first two years his mother had refused to take his calls.

He had been asked again and again why, if he felt he had to become a Christian, he could not have become an Anglican. And why this “sudden obsession” with “outdated” and “retrograde” sexual morality? He said that, in essence, he was treated as he would have been in the 19th century had he “come out” as a homosexual. Chastity, in other words, is the new perversion.

It is a momentous decision to leave that world, and people who make that transition compare it to leaving the Matrix: a painful, shocking and revelatory experience of a totally new and previously unguessed-at world that can leave the person disoriented, feeling as though he is now living in a kind of “parallel universe” in which he is alone and alienated from friends and family and fellow citizens.

There is an increasing number of us “converts” to a more morally sane life, who often find that once we have made the transition we are alone again. And even when we find others, a new community and friends – usually in a church – we learn that we must keep the door to the past closed. It’s not that we fear rejection, far from it, and it is not even a matter of shame.

But we understand that in a civilized society, no one wants to hear about barbarity, and we learn that to keep our past life closely in mind is to allow it to continue to rule the present. Close friends will know about our past, but, outside the most intimate circles it is passed over silently. We have reinvented ourselves and moved on, but the price is sometimes to become people with no past. To be wholly remade, it is necessary to leave behind the person we were.

It works. I can say that it is possible to be radically morally rebuilt, that one can reconstruct an entire personality, consciously dismantle past habits of thought and approach to life and replace them with better ones. The damage from the previous life, whether physical or psychological, can be permanent, but it is possible to construct a way of living that is morally and psychologically and physically healthy, and reorder a life in such a way that the damage does not rule your present. 

But it’s expensive. For me, it started when I was still living in British Columbia. I felt something new beginning in my mind and felt a yearning spring up that could not be satisfied by anything I’d experienced… the usual convert’s tale.

I’d been aware all my life that the kind of world we lived in, and the kind of life we lived in it, was somehow just not right. I loved old films and television shows that depicted a totally different way of living. I was close to my grandparents and wondered why we no longer lived that way. When I moved to the mainland in my early 20s, I somehow started going to Mass again, and that was when the real struggle began. I knew full well that the way I lived and thought about life was deeply at odds with the Church.

But I was alone. None of my friends were Catholic and none of them could begin to understand what it was I had begun to talk about. And I had made no friends at the large inner city parish I attended. I had tried to join a few things, and had volunteered a bit, but I could see that I had nothing in common with them. It seemed as though these people lived in another universe, one I could not even want to enter. A priest suggested I get involved in the pro-life movement, and I rejected this idea out of hand as totally absurd.

I thought I could only ask God for help. I prayed for “Catholic friends.” This brought no change, so I scaled down and said, “All right then, just one. Just one Catholic friend.” In the end, I simply got up and left one day. I’ve written elsewhere that I just got in a car and went “on holiday” out east, and never returned. When I landed in the far-eastern Canadian town where I was to undertake my own radical conversion, I only stopped there because I had run out of continent.

And it was there I discovered a whole new world, a moral universe of whose existence I had been previously totally ignorant. I met my “Catholic friends,” and was able to start the painful task of first deconstructing and then rebuilding my entire worldview, my character, my beliefs, my total understanding of life, the universe, and everything.

“Painful”? I barely survived. It took a year but I emerged a new kind of person in a new kind of world that I had never suspected existed. I met a group of other people who had undergone the same experience and we traded war stories. We agreed that it was like living in a parallel universe, and we bonded over the loss of previous friendships and family relationships. We helped each other, this little group of Catholic refugees on the rain-washed East Coast, to figure out a way to live in a world to which we no longer belonged. 

We talk about the programs set up by various individuals and groups that propose to help people, (mainly men) leave the homosexual lifestyle. We defend the right of psychotherapists to offer healing and help for people who have been damaged by their own choices and by the violence and sins of others. We lobby our Parliaments, we write articles, we even argue in comment boxes on the internet. We sometimes get brave and give talks and engage in public debates where we confront our ideological opponents in public venues. In all this, we rightly speak against the New Paradigm that the world has embraced and we urge people to reject it. It’s a form of evangelization.

But I think we need to keep in mind, while we are doing this good work, that what we are asking people to do, concretely, is momentous. Indeed, from the point of view of heaven, it is of cosmic significance. In less exalted terms, however, we are asking something almost unimaginably difficult of people ensnared in a way of living and thinking that they may not even completely understand themselves.

So much of our anti-culture, our death-culture, has been simply absorbed unconsciously, so much of it has been fed to us with our Fruit Loops and Saturday Morning Cartoons from earliest childhood, that we often have no way of knowing anything else exists. We have become people trapped in Plato’s Cave, knowing only the vaguest shadows of reality.

It is only too easy for those of us who live out here in The Real to forget how totally different our lives are from that of the majority of our fellow men. We shout, “jump!” because we see a whole other lush, green and happy world, but they see nothing but the shadows on the cave wall.

Ultimately, the Matrix is not only unreal, it is designed to make men miserable, but in such a way that they are hardly aware of being miserable. It not only enslaves, but tortures its victims. There is a reason that suicide, divorce, drug use, violent crime, self-harm, eating disorders, depression, … misery, in short, have grown to such colossal proportions in our societies.

If I may make a suggestion, maybe we could start writing and talking about how much better it is to live in The Real. How much happier it is possible to be when living a morally integrated life of self-control, not being pushed around either by lust or by the merciless demands of a lust-worshipping culture...a life of real freedom, in other words. It might help make the jump less frightening.


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