Denise J. Hunnell, MD

Opinion

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

Denise J. 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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Pro-life group asks: Pray for abortionists who sell baby body parts

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February 11, 2016 (LifeSiteNews) - This Lent, a pro-life group would like you to pray for an abortionist - specifically, an abortionist who facilitates the sale of unborn babies' body parts.

The Pro-Life Action League is asking for people to pray for three people in particular throughout the 40 days of Lent. All three were caught on video by the Center for Medical Progress.

Dr. Deborah Nucatola appeared in the first video released last July, sipping red wine and stabbing her salad as she discussed the dismemberment of aborted children, including where to “crush” their bodies for a "less crunchy" technique.

The second is Dr. Mary Gatter, who appeared in the second undercover video, haggling over the prices Planned Parenthood expected to receive for the aborted children's organs and tissue. At one point, she joked that she wants the revenue to pay for “a Lamborghini.”

And the third is Planned Parenthood CEO Cecile Richards, who was also caught in the first video praising Dr. Nucatola.

Despite the shocking evidence uncovered by CMP, Richards has insisted her organization did not receive any profit for what she dubs its "fetal tissue donation program." She apologized only for Dr. Nucatola's "tone." She has since said that Planned Parenthood will not receive any remuneration for babies' body parts.

"These three architects of Planned Parenthood’s baby parts scheme have devoted their lives to the destruction and exploitation of human life in the name of ‘choice,’" said Eric Scheidler, executive director of the Pro-Life Action League. "If we won’t pray for them, who will?”

He asked Christians to pray for these three abortion industry profiteers - and for Richards, who is a post-abortive woman - in order to fulfill Jesus Christ's commandment in the Bible, “Love your enemies, and pray for those who persecute you” (St. Matthew 5:44).

“In God’s eyes, what abortion has done to these three women may be worse than what they’ve done to unborn children, who now rest in our Lord’s loving arms," Scheidler said.

For most Catholics, Lent began yesterday on Ash Wednesday, and lasts 40 days.



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Texas AG faces ethics probe for defending conscience rights of natural marriage supporters

Lisa Bourne

AUSTIN, Texas, February 11, 2016 (LifeSiteNews) – The attorney general of the state of Texas is facing an ethics investigation for having affirmed the constitutional religious freedom of state workers to decline to issue marriage licenses to same-sex couples if it goes against their religious beliefs.

Attorney General Ken Paxton took steps to address the issue of conscience protection in his state before and after last June's Supreme Court's Obergefell decision imposing same-sex "marriage" on all 50 states, first issuing a statement the day prior clarifying that Texas law recognizes the definition of marriage as between one man and one woman and recommending that state officials wait for direction from his office should the High Court move to redefine marriage.

Paxton then issued a statement two days after the ruling, his office allowing county clerks and their employees to retain religious freedoms that may allow accommodation of their religious objections to issuing marriage licenses to same-sex couples, and said as well that justices of the peace and judges would similarly retain religious freedoms.

Click "like" if you want to defend true marriage.

A month later, a group of some 200 attorneys filed a complaint asserting that Paxton's position encouraged officials to violate the U.S. Constitution and break their oaths of office, according to ABC News.

The complaint was dismissed at first by the Office of Chief Disciplinary Counsel of the State Bar of Texas, but it was reinstated February 2 by a state Supreme Court-appointed appeals board, which contended that the complaint alleges a "possible violation" of professional conduct rules.

The appeals board decision to reinstate the case does not mean Paxton violated professional ethics, according to the ABC report, but does require him to respond to the complaint in conjunction with the investigation.

"The complaint has always lacked merit," said Paxton spokeswoman Cynthia Meyer, "and we are confident the legal process for resolving these complaints will bear that out."

Paxton was among several state officials across the U.S. who moved to ensure conscience protection in the immediate aftermath the Obergefell ruling, at times garnering the ire of homosexual activists.

Last July, South Dakota's attorney general granted permission to county clerks with conscientious objections to opt out of issuing marriage licenses to same-sex couples as long as another clerk in the office would issue the license. 

Rowan County, KY clerk Kim Davis was jailed last fall for refusing to issue marriage licenses to same-sex couples because it violated her religious values.

In a highly contentious case, Davis had asked for a religious accommodation allowing her office to issue altered licenses to homosexuals without her name on them, which was eventually granted by Kentucky's Governor Matt Bevin. However, the ACLU sued, seeking to force Davis to issue the old forms with her full name on them. A federal judge rejected the suit earlier this week.

Last year, homosexual activists sent harassing messages, including threats of violence, to Oklahoma State Senator Joseph Silk and his family after the Republican legislator sponsored a bill that would have given the state's business owners the freedom to follow their religious convictions in regard to homosexual "marriage."

Paxton faces penalties varying between a reprimand and disbarment resulting from the ethics complaint. The Texas attorney general is also facing securities fraud charges.



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This pro-abortion billionaire may run for president

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NEW YORK, February 11, 2016 (LifeSiteNews) - He's an upwardly mobile, socially liberal billionaire whose political affiliation has changed numerous times over the years. He's teased numerous presidential campaigns in the past, but this time he's talking like he's serious. And no, he's not who you think he is.

Michael Bloomberg, who served three terms as mayor of New York City, has confirmed to media sources that he is considering running for president as an independent in 2016.

Bloomberg told told the Financial Times this week that he finds American political "discourse and discussion distressingly banal and an outrage and an insult to the voters," and that he's “looking at all the options."

The 73-year-old tycoon was a registered Democrat before switching parties to run in the less contested Republican primary in 2001. He became a registered independent in 2007.

As mayor, Bloomberg governed as a social liberal who strongly supported abortion and the LGBT political agenda.

In 2011, Bloomberg signed a controversial gag order directed at crisis pregnancy centers. A year later, he endorsed Barack Obama's re-election, saying that abortion-on-demand is part of "the world I want to leave my two daughters, and the values that are required to guide us there."

After leaving office, he received Planned Parenthood's Global Citizen Award at its annual gala on March 27, 2014.

That's the same year Bloomberg Philanthropies announced a $50 million undertaking to expand "reproductive health," including a major partnership with Planned Parenthood-Global to overturn pro-life laws in four nations: Nicaragua, Sengal, Uganda, and Burkina Faso.

Jeb Bush sat on the board of the philanthropy, which also strongly supports Common Core educational standards, at the time.

Mayor Bloomberg played a pivotal role redefining marriage in New York state, giving the four Republican state senators who voted for New York’s same-sex “marriage” bill the maximum campaign contribution allowed by law. One retired and a second lost his primary fight.

His strong emphasis on health regulations, such as attempting to ban soft drinks larger than 16 ounces, did little to enhance his popularity and were deftly parodied by Sarah Palin. (A state court struck down the proposed regulation.)

His $50 million gun control crusade dissipated after his cause failed in state after state.

The financial heft he could bring into the race, as well as his quirky politics, has tempted Bloomberg to enter presidential politics in the past. He considered a presidential run in 2008 and thought more strongly about a third party bid in 2012, after hosting the inaugural convention of the “No Labels” movement in New York City in 2010, but he backed off each time after not seeing a viable path to victory.

With an estimated fortune of $39 billion, he has said he would be willing to spend more than $1 billion on his campaign in 2016 - but he would only enter the race if the Republican Party nominates Donald Trump or Ted Cruz, and the Democratic Party nominates Bernie Sanders.

He called Jeb and Hillary Clinton "two quality” candidates and "the only two who know how to make the trains run." Jeb reciprocated last month, telling CNN that Bloomberg is "a good person, and he’s a patriot and wants the best for the country.”

At least one of his competitors is eager to see Mike run. "I hope he gets into the race," Donald Trump told Greta Van Susteren on Fox News Wednesday night. "I'd love to compete against him...I would love to see Michael in the race."

That is likely because polling shows Bloomberg would draw most of his support from the Democratic candidate. "Although he is characterized as the New York counterpunch to Trump, Mayor Mike Bloomberg is more the nemesis of Bernie than he is of Donald," said Tim Malloy, assistant director of the Quinnipiac University Poll.

Bernie Sanders would defeat both Trump and Cruz in a head-to-head match, according to Quinnipiac. But if Bloomberg entered the race, he would win 15 percent of the vote largely from Sanders, giving Trump a one-point victory in the popular vote (and narrowing Cruz's loss to one point).

However, he could throw a major wrench in the Democrats' electoral college total, according to columnist Pat Buchanan.

"Not only would Bloomberg lose the Big Apple, his statewide vote would come mostly from the Democratic nominee, giving Republicans the best opportunity to carry the Empire State since Ronald Reagan coasted to re-election in 1984," wrote Buchanan, who served as White House communications director during Reagan's second term.

“It’s not beyond imagining that he could get in and have an effect on the race,” Sen. Sheldon Whitehouse, D-RI, told The Hill.

Perhaps sensing this, numerous Democrats - including Senators Claire McCaskill and Jeanne Shaheen - have thrown cold water on a Bloomberg presidential run.

Democratic National Committee chairwoman Debbie Wasserman Schultz, a Florida congresswoman, said this week that an independent Bloomberg candidacy "won't be necessary" - because the Democrats already represent social liberals.

"I really think when he takes a good hard look, he will conclude that the issues that are important to him...[have] a natural home among our Democratic candidates," she said. "And so, I think Michael Bloomberg's agenda is well cared-for and advanced among our Democratic candidates, and his candidacy, I think he will find, won't be necessary.""

His entrance into the race would be a true injection of "New York values" - making him the third or fourth New Yorker in the race - alongside fellow billionaire Trump from Queens, the Brooklyn-born Sanders, and onetime New York Senator Hillary Clinton.

Annie Linskey, a reporter for the Boston Globe who once worked for Bloomberg, told Fox News on Monday that there is "about a four" percent chance that Bloomberg will run.



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