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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Pope tells Girl Scouts to oppose ‘ideologies’ against God’s design for marriage

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By Thaddeus Baklinski

ROME, June 30, 2015 (LifeSiteNews) – Pope Francis told Girl Scout and Girl Guide leaders from across the globe last week that it is essential they promote respect for marriage and family according to God’s design.

The pope’s remarks came as both the international organization, World Association of Girl Guides and Girl Scouts, and Girl Scouts USA face criticism over support for abortion, homosexuality, transgenderism, and contraception.

"It is very important today that a woman be adequately appreciated, and that she be able to take up fully the place that corresponds to her, be it in the Church, be it in society,” Pope Francis said in his address on the morning of June 26, prior to the U.S. Supreme Court’s decision imposing same-sex “marriage” on the country.

In the face of ideologies that seek to destroy the truths about marriage and family, he said, the formation of girls through Guiding "is absolutely determinant for the future."

"We are in a world in which the most contrary ideologies are spreading to the nature and design of God on the family and on marriage. Therefore, it is a question of educating girls not only to the beauty and grandeur of their vocation of women, in a just and differentiated relation between man and woman, but also to assume important responsibilities in the Church and in society," Pope Francis said.

The pope spoke during a private audience at the world meeting of the International Conference of Catholic Guides (ICCG), which took place in Rome from June 25-30.

Stressing that among educational movements Guiding has played a pivotal role in the faith formation of young women, the pope said, "Education is, in fact, the indispensable means to enable girls to become active and responsible women, proud and happy of their faith in Christ lived in every day life. Thus they will participate in the building of a world permeated by the Gospel."

“To Live the Joy of the Gospel as a Guide” was the theme for the ICCG meeting in Rome, with the stated purpose of reaffirming and strengthening the organization's 50-year-old history within the Catholic Church.

Among the participants at the ICCG meeting in Rome were Girl Scouts USA (GSUSA) CEO Anna Maria Chávez and National President Kathy Hopinkah Hannan.

In a statement, Chavez maintained that faith is “at the heart of Girl Scouts, and is woven into everything the organization does to inspire girls to take action to make the world a better place.”

However, the US Conference of Catholic Bishops has cautioned that some aspects of the Girl Scouts pedagogy go against Catholic teaching and doctrine.

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A report by the USCCB focused on three issues:

  1. GSUSA's relationship with groups like Planned Parenthood and international affiliate World Association of Girl Guides and Girl Scouts (WAGGS);
  2. GSUSA's views on issues related "to human sexuality, contraception, and abortion";
  3. and various materials and resources GSUSA has that have "inappropriate content."

With regard to WAGGGS, the report notes that while this group claims it does not formally back abortion and "reproductive rights," language on its website leaves no doubt that such support exists, as well as support for contraceptive use.

Numerous pro-life and pro-family groups have organized boycotts of Girl Guide cookies in protest of the organization's embrace of feminist politics and activism.

The pope's address to the ICCG meeting, translated into English by Zenit, is available on the Zenit website here.

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St. Peter Damian
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St. Peter Damian (1049): what Church MUST do in response to rampant homosexuality among clergy

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By Steve Jalsevac

June 29, 2015 (LifeSiteNews) – The rise of the power and influence of homosexual priests, bishops and cardinals, as well as influential laity, has been a major factor in the growing chaos within Catholicism over the past 60 years. This disorder within the Catholic Church has had a negative impact on the entire world because of the resulting decline in the positive influences that Catholicism has had on civilization for many centuries.

To think that what is happening now is new, however, betrays an ignorance of history. In 1049, when St. Peter Damian wrote his treatise, Book of Gomorrah (Liber Gomorrhianus), to Pope Leo IX, homosexuality and sexual perversion in general were far more openly rampant within the clergy than today.  This horrendous state of affairs is what the Saint addressed in his appeal to the Pope for urgently needed reforms.

We often hear from sleepy, comfortable, cowardly, timid or cultural Catholics, and especially from clergy who are directly implicated in homosexuality, that we should never criticize priests, bishops and especially the Pope. Supposedly, that is a greater sin than that of the heretics and sexual perverts facilitating great personal suffering and sending souls to Hell without anyone doing what is necessary to either convert or stop them.

St. Peter Damian was not so foolish as to listen to such nonsense denying God His justice at a time when the Church appeared to be in its death throes. He understood the grave duty to be blunt about the dangers and sinfulness, to not minimize the catastrophe that would come if strong actions were not quickly taken and to demand corrective actions. And yet, he also emphasized that all of this must be done with charity and Christian hope for the persons involved in the moral corruption. Their conversion was above all hoped and prayed for, rather than their condemnation for eternity.

An Italian translated version of the Book of Gomorrah has recently been published. An English version carefully translated by one of our LifeSite journalists will also soon become available.

On Feb. 11 of this year the Rorate Caeli website published excerpts from the introduction by Professor Roberto de Mattei to the Italian version.

Following are some paragraphs from that introduction that I hope will jar awake some of the faithful, especially considering what is going on now in the United States as a result of the mad Supreme Court decision and the moral chaos around the Synod on the Family regarding Church sexual teachings.
 

Excerpts from the Introduction:

St. Peter Damien (1007-1072) Abbot of the Fonte Avellana Monastery and subsequently Cardinal/Bishop of Ostia, was one of the most outstanding figures of Catholic reform in the XI century. His Liber Gomorrhianus, appeared around 1049, in an age when corruption was widely spread, even in the highest ranks of the ecclesiastical world.

In this writing, addressed to Pope Leo IX, Peter Damien condemns the perverted habits of his time in a language that knows no false mercy or compromises. He is convinced that of all the sins, the gravest is sodomy, a term which includes all the acts against nature and which want to satisfy sexual pleasure by separating it from procreation. “If this absolutely ignominious and abominable vice is not immediately stopped with an iron fist – he writes – the sword of Divine wrath will fall upon us, bringing ruin to many.”

There have been times in (the Church’s) history when sanctity pervades Her and others when the defection of Her members cause Her to collapse into darkness, appearing almost as if the Divinity has abandoned Her.

Peter Damien’s voice resounds today, as it did yesterday, with encouragement and comfort for those, like him, who have fought, suffered, cried and hoped, throughout the course of history.

He did not moderate his language, but kept it fiery to show his indignation. He was fearless in voicing an uncompromising hatred for sin and it was precisely this hatred that rendered his love burning for the Truth and the Good.

Today, at the beginning of the third millennium of Christ’s birth, priests, bishops and Episcopal conferences are arguing for married priests; they are placing in doubt the indissolubility of the marriage bond between man and woman and at the same time, accepting the introduction of laws for homosexual pseudo-marriage. Sodomy is not being thought of as a sin that cries to God for vengeance but is diffused in seminaries, colleges, ecclesiastical universities and even inside the Sacred Walls of the Vatican itself.

Liber Gomorrhianus reminds us that there is something worse than moral vice practiced and theorized. It is the silence that should speak, the abstention that should intervene, the bond of complicity that is established among the wicked and of those, who with the pretext of avoiding scandal are silent, and, by being silent, consent.  

Graver still, is the acceptance of homosexuality by churchmen, thought of as a “positive” tension towards the good, worthy of pastoral care and juridical protection and not as an abominable sin. In the summary Relatio post disceptationem of the first week’s work in the Synod of Bishops in October 2014, a paragraph affirmed that: “homosexual persons have gifts and qualities to offer the Christian community”, with an invitation to the Bishops “…are we capable of welcoming these people, guaranteeing them a fraternal space in our communities?”

This scandalous statement was removed from the final report, but some bishops and cardinals, inside and outside the Synod Hall, insisted on the appeal to look for the positive aspects of a union against nature, going as far as hoping for “a way to describe the rights of people living in same-sex unions.”

St. Peter Damian as a simple monk, and with greater reason as a cardinal, did not hesitate in accusing even the Popes of that time for their scandalous omissions. Will the reading of the book Liber Gomorrhianus instill the spirit of St. Peter Damien in the hearts of some prelates or laypeople, by shaking them out of their torpor and force them to speak and act?

Even if abysmally far from the holiness and prophetic spirit of St. Peter Damien, let us make his indignation against evil, ours, and with the words that conclude his treatise we turn to the Vicar of Christ, His Holiness, Pope Francis, presently reigning, so that he may intervene and bring an end to these doctrinal and moral scandals: “May the Almighty Lord assist us, Most Reverend Father, so that during the time of Your Apostolate, all of the monstrosity of this vice be destroyed and the state of the Church, presently supine, may wholly rise up again in all its vigour.”

The book can be found in Italian here. 

(Note: the name of the saint is spelled Damian in English and Damien in Italian and French. In Fr. Mattei's quotes is it spelled Damien)

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Phil Lawler

So now is it ‘hate speech’ to deplore the Obergefell decision?

Phil Lawler
By Phil Lawler

June 30, 2015 (CatholicCulture.org) - The ink was barely dry on last week’s Supreme Court ruling when Father James Martin, SJ, began scolding Catholics who were, from his decorous perspective, too strident in denouncing the decision.

"No issue brings out so much hatred from so many Catholics as homosexuality," Father Martin told his Facebook followers. He repeated the same message several times throughout the day, warning commenters that they must not indulge in “homophobia” and suggesting that someone who questioned whether we were all expected to sing “Kumbaya” was illustrating his point. So is sarcasm now prima facie evidence of hatred?

In my own surfing through the internet, reading scores of posts on the Obergefell decision, I can honestly say that I did not see a single message, a single comment, that struck me as hate-filled. Perhaps Father Martin’s email traffic is qualitatively different from mine. Or perhaps—far more likely, I’m afraid—he sees “hatred” where I see only vehement disagreement.

Is it possible to be angry about the Obergefell decision, to consider it a travesty of justice and a betrayal of the Constitution, without being viewed as a hater? Wait; let’s turn that question upside-down. Is it possible to see all serious disagreement with the decision as hate-speech, without celebrating the outcome of the Obergefell case?

I ask the latter question, you see, because if Father Martin was upset by the Supreme Court ruling, his dismay did not show through on his Twitter feed. He recommended three columns reacting to the decision: one by a fellow Jesuit, recounting how his grandmother could not marry her lesbian partner; another by the gay New York Times columnist Frank Bruni, celebrating the decision; the third by the gay activist/blogger Andrew Sullivan, also celebrating.

The recommendation for Andrew Sullivan’s piece was particularly striking because of the title: “It Is Accomplished”—an explicit reference to the words of Jesus Christ on the Cross. Father Martin, who was horrified by so much of what he read on Friday afternoon, let that blasphemous headline pass without comment. His demand for the use of temperate language, and for avoiding comments that others would find offensive, was applied to only one side of the post-Obergefell debate.

And that’s likely to be the party line for politically-correct Catholics in the wake of this momentous decision. We are allowed to disagree with the Supreme Court, politely, but not too forcefully. Any strident denunciation of the ruling or its logic might be interpreted as hate-speech, which of course is unacceptable. As the secular left clamps down on religious expression—and we’ve already been served notice that the crackdown is coming-- the Catholic left will worry aloud that, yes, some strong public expressions of religious beliefs are distasteful.

The influence of this approach, with its keen anxiety to avoid provocation, has already been evident in the statements released by some American bishops in response to the ruling. Archbishop Gregory says that he disagrees with the Court, but if you don’t know why he disagrees before you read his statement, you’re not likely to be any better informed when you’re finished. Cardinal Wuerl reminds us that we must hate the sin but love the sinner; he neglects to mention what the sin is. And Archbishop Cupich gives no indication at all that he disagrees with the Supreme Court ruling.

We have a long uphill struggle facing us as we seek to restore a proper understanding of marriage, to revive appreciation for the natural law, and to undo this wretched judicial decision. We cannot expect success if we go into the battle unarmed. If we begin the debate by saying that we must not offend our adversaries—even after our adversaries have declared our most fundamental beliefs to be offensive—we are doomed to failure.

We already know how the battle will unfold, because the campaign to crush resistance to same-sex marriage is already underway. The militant left will choose vulnerable targets—a pizza-parlor here, a baker there—and vilify them as “haters.” People who have been trained to see “hatred” in any firm disagreement will nod in solemn approval as the alleged offenses are harshly punished. And so juggernaut will keep rolling, gaining momentum, until it reaches us.

There is an alternative. We can speak the truth. Yes, certainly we should avoid making unduly provocative statements. But since we are trying to provoke reactions, we cannot pull all our punches.

More to the point, if we’re going into battle—and we are—we need to know who’s on our side, and who’s working against us.

This article was originally published on CatholicCulture.org and is re-published with permission.

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