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.


Advertisement
Featured Image
Gilles Paire / Shutterstock.com
Ben Johnson Ben Johnson Follow Ben

,

African denounces Western elites pushing population control in his country

Ben Johnson Ben Johnson Follow Ben
By Ben Johnson

An op-ed in one of the leading publications in Uganda has denounced the promotion of IUD use and other long-acting reversible contraceptives (LARCs) in the nation as a colonialist form of population control.

An article published in New Vision, which bills itself as “Uganda's leading daily,” and which was posted online after being translated into broken English, contradicts the frequent claim that there is a desperate cry from Africans and brown people generally to provide the “unmet need” for contraception in the Third World.

Programs to convince African women to use the IUD or other forms of contraception “are projects of multibillion international agencies distributing them under the guise of helping the poor countries to control birth rates,” Stephen Wabomba wrote.

The use of the IUD leads to an increase in “the spread of STIs/HIV/AIDS, infections or increased rates of Pelvic Infection Diseases (PID),” and other maladies, he said. The IUD, which is inserted into the uterus and may work for years at a time, offers no protection against sexually transmitted diseases and often does not prevent fertilization.

Western governments and NGOs are very much “aware of the side effect[s] but still force them on us through sensational marketing strategies by claiming that there is unmet need” for contraception “in Uganda,” he wrote.

He instead suggested the use of Natural Family Planning methods as the “best alternative” for married couples, as well as increased “funding of chastity and abstinence education in Uganda.”

Click "like" if you are PRO-LIFE!

He called on every citizen of Uganda “to stand up and be counted as a lover of life” and become a “protector of the voiceless and defenseless unborn children being aborted every day.”

Wabomba is heeding his own advice by acting as director of the Pregnancy Help Center in Jinja, the second largest city in Uganda. The town of 87,000 is perched on the shores of Lake Victoria.


Advertisement
UN flag waving on the wind
Shutterstock.com
Guilherme Ferreira Araújo

UN tells Chile and Peru to legalize abortion

Guilherme Ferreira Araújo
By Guilherme Ferreira Araújo

On July 7 and 8, the United Nations Human Rights Commission (UNHCR) discussed Chile’s abortion laws and issued a report asking for liberalization of those laws.

According to the report, Chile “should establish exceptions to the general prohibition of abortion, contemplating therapeutic abortion and in those cases in which the pregnancy is a consequence of a rape or incest.”

Chile is one of the few countries that prohibits abortion in all cases.  So far, the country has managed to stand against internal and external pressure to legalize abortion.

But during her campaign, President Michele Bachelet promised to make the legalization of abortion a priority.  Indeed, last May she stated that her intention was to reopen the debate so that the government could approve therapeutic abortion before the end of this year.  The U.N. report also said that Chile “should make sure that reproductive health services are accessible to all women and adolescents."

One of the reasons the UN is using to pressure Chile’s government to change their abortion laws is the high number of clandestine abortions allegedly taking place in Chile. The UNHRC points to “official data” showing 150,000 annual clandestine abortions. However, not only is it impossible to corroborate that figure, but other sources show that this number could be exaggerated by a factor of 10.  According to an article published in the Chilean news publication, Chile B, the annual number of clandestine abortions in Chile may vary between 8,270 and 20,675.

Inflating the number of illegal abortions and maternal mortality is a common tactic of the pro-abortion movement’s effort to legalize the deadly practice. Dr. Bernard Nathanson, founder of the National Abortion Rights Action League (NARAL), famously admitted the tactic after becoming pro-life.

“We claimed that between five and ten thousand women a year died of botched abortions,” he said. "The actual figure was closer to 200 to 300 and we also claimed that there were a million illegal abortions a year in the United States and the actual figure was close to 200,000. So, we were guilty of massive deception."

Chile has also been used as a prime example that legalized abortion does not reduce maternal mortality.

A study published in 2012 by Plos One Institute found that since 1989 when Chile banned abortion, there has been an annual decrease in maternal death. That study, and others compiled and published by the Chilean MELISA Institute strongly challenge the myth that abortion is safe or even necessary to increase maternal health.

Click "like" if you are PRO-LIFE!

Notwithstanding the empirical data, the United Nations is also hard at work to pressure Chile’s neighbor to the North, Peru, to liberalize its own abortion laws.  In the case of Peru it is the Committee on the Elimination of Discrimination Against Women (CEDAW) that has issued the report, not the UNHRC.  CEDAW representatives examined Peru’s case on July 1 and suggested that Peru should legalize abortion in case of rape and severe abnormalities of the unborn child.

The organism suggested that the government eliminate all laws that punish women who abort and asked that Peru “urgently” adopt a law to fight violence against women, a notion often used as a euphemism for legalizing abortion.  

The CEDAW commission presented the conclusions of the report on July 22 and put special emphasis on the abortion issue. This happens despite the strong opposition to abortion in Peru. A recent survey showed that 79 percent of Peruvians support the Catholic Church’s position on abortion.

The CEDAW pressure on Peru is not new. In 2011, after the UN sanctioned Peru for denying an abortion to a teenager, Carlos Polo, Director of the Population Research Institute’s Latin American office, stated that the UN organism doesn’t have the right to force Peru to approve abortion.


Advertisement
Featured Image
People ask me all the time, “How do you live with your past?” My answer is silly, but it is a true story. Youtube screenshot
Abby Johnson Abby Johnson Follow Abby

I helped so many women abort their babies. Now how do I live with that?

Abby Johnson Abby Johnson Follow Abby
By Abby Johnson
Abby Johnson business card Planned Parenthood

I have many memories of my time with Planned Parenthood. I spent eight years of my life there. Some memories are good, some are not. But they are contained in my mind. It’s easy to forget them. I have forgotten so much about my time there in just four and a half short years. 

I found my old business card the other day. That is a tangible memory for me. It made me think of the day that I heard I had been promoted to direct the clinic. I was so happy…hugging and jumping up and down with my supervisor. She was so proud of me.

I thought about the day I moved everything into my new, big office. I put pro-choice stickers all over my file cabinet. I called my parents to share the news. They were, of course, proud of me, but hated my work. I can’t imagine how conflicted they were in their minds and hearts. Human resources sent me my new paperwork. There was my new title, my new and amazing salary. 

A few days later, my new business cards came. I remember putting them in my new business card holder on my desk. I filled up the business card holder that I kept in my purse. I had already become used to hearing myself say my new title.

I was proud of myself. I was proud of the hard work I had put in to earn that new title. I worked so many hours, sacrificed so much time from my family. But I knew it would be worth it. And now I had the job title to prove it.

I remember proudly passing out my new business cards to anyone that would take one. Being pro-choice was not just a movement to me; it was a lifestyle. I wholeheartedly embraced that lifestyle and loved being a part of it. 

These tangible reminders that I occasionally find are sometimes hard to work through. I remember receiving the records from my medication abortion. That tangible reminder of my past was difficult to manage. I look at my “Employee of the Year” award that I received from Planned Parenthood and think back to the night I received it. I ended up putting that old award on my desk as a reminder of where I came from and how much my life has changed. Seeing that plaque no longer brings back those tangible memories. 

Follow Abby Johnson on Facebook

One of the reasons I was so taken aback when finding my old business card was not just because it was a reminder of how proud I had been to run an abortion clinic…something I find deplorable now. It was because of the things I took part in while I had that big title.

The memories of handing women small monetary checks in order to pay for their silence after we had left them with a serious infection after their abortion. The memories of watching women bleed out on our abortion table and being instructed not to call the ambulance because we didn’t want to let the pro-lifers know that we had a medical emergency. The memories I have of “joking” about the babies that died in our facility by abortion. The memories I have of training our abortion facility employees on the “normalcy” of abortion and how to convince women that abortion is the best choice for them.

Part of being a former abortion clinic worker is learning how to deal with your past sin. It may be the lady who came to your clinic for an abortion that you bump into at the store. It could be standing in front of your former abortion facility and remembering all of the damage your words and actions did to so many women. It could be finding that old business card that reminds you of the pride you felt when you became the director of an abortion facility. 

People ask me all the time, “How do you live with your past?” My answer is silly, but it is a true story. 

One day I was watching the kid’s movie “Kung Fu Panda” with my daughter. In the film there is a wise, old tortoise named Oogway. He is talking to one of his students who is frustrated with his current situation. Oogway asks his student, “Do you know why today is called the present? Because it is a gift.”

That little line by an animated tortoise hit me like a ton of bricks. Today is a gift. There is absolutely nothing we can do with our past. And there is very little we can do to control our future. We live NOW. We serve NOW. We choose to move on from our past NOW. 

I don’t know what your past sins are. And I don’t know how frequently you are reminded of them. But as someone who has to face their past sins on pretty much a daily basis, I can tell you that you can be free from their burden. Being reminded of your past doesn’t mean that you have to live with constant grief. It simply means that you have been given the opportunity to transform your past into something positive…maybe you can help others make different choices than you did, maybe you can help others heal from the same struggles that you lived through. I don’t know what you are being called to do, but as the saying goes, “God can turn our mess into a message.” 

Carrying around past burdens doesn’t help us in any way. Know that you can be forgiven. Accept that forgiveness. Use your life to help others. The present is indeed a gift.

Follow Abby Johnson on Facebook


Advertisement

Customize your experience.

Login with Facebook