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 ( – 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 and is reprinted with permission.

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Today’s chuckle: Rubio, Fiorina and Carson pardon a Thanksgiving turkey

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By Steve Jalsevac

A little bit of humour now and then is a good thing.

Happy Thanksgiving to all our American readers.

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Building of the European Court of Human Rights.
Lianne Laurence


BREAKING: Europe’s top human rights court slaps down German ban on pro-life leafletting

Lianne Laurence
By Lianne Laurence

STRASBOURG, France, November 26, 2015 (LifeSiteNews) – The European Court of Human Rights ruled Thursday that a German regional court violated a pro-life activist’s freedom of expression when it barred him from leafleting in front of an abortion center.

It further ruled the German court’s order that Klaus Gunter Annen not list the names of two abortion doctors on his website likewise violated the 64-year-old pro-life advocate’s right to freedom of expression.

The court’s November 26 decision is “a real moral victory,” says Gregor Puppinck, director of the Strasbourg-based European Center for Law and Justice, which intervened in Annen’s case. “It really upholds the freedom of speech for pro-life activists in Europe.”

Annen, a father of two from Weinam, a mid-sized city in the Rhine-Neckar triangle, has appealed to the Strasbourg-based European Court of Human Rights at least two times before, Puppinck told LifeSiteNews.

“This is the first time he made it,” he said, noting that this time around, Annen had support from the ECLJ and Alliance Defense Fund and the German Pro-life Federation (BVL). “I think he got more support, better arguments and so I think this helped.”

The court also ordered the German government to pay Annen costs of 13,696.87 EUR, or 14,530 USD.

Annen started distributing pamphlets outside a German abortion center ten years ago, ECLJ stated in a press release.

His leaflets contained the names and addresses of the two abortionists at the center, declared they were doing “unlawful abortions,” and stated in smaller print that, “the abortions were allowed by the German legislators and were not subject to criminal liability.”

Annen’s leaflets also stated that, “The murder of human beings in Auschwitz was unlawful, but the morally degraded NS State allowed the murder of innocent people and did not make it subject to criminal liability.” They referred to Annen’s website,, which listed a number of abortionists, including the two at the site he was leafleting.

In 2007, a German regional court barred Annen from pamphleteering in the vicinity of the abortion center, and ordered him to drop the name of the two abortion doctors from his website.

But the European Court of Human Rights ruled Thursday that the German courts had "failed to strike a fair balance between [Annen’s] right to freedom of expression and the doctor’s personality rights.”

The Court stated that, “there can be no doubt as to the acute sensitivity of the moral and ethical issues raised by the question of abortion or as to the importance of the public interest at stake.”

That means, stated ECLJ, that “freedom of expression in regard to abortion shall enjoy a full protection.”

ECLJ stated that the court noted Annen’s leaflets “made clear that the abortions performed in the clinic were not subject to criminal liability. Therefore, the statement that ‘unlawful abortions’ were being performed in the clinic was correct from a legal point of view.”

As for the Holocaust reference, the court stated that, “the applicant did not – at least not explicitly – equate abortion with the Holocaust.”  Rather, the reference was “a way of creating awareness of the more general fact that law might diverge from morality.”

The November 26 decision “is a quite good level of protection of freedom of speech for pro-life people,” observed Puppinck.

First, the European Court of Human Rights has permitted leafleting “in the direct proximate vicinity of the clinic, so there is no issue of zoning,” he told LifeSiteNews. “And second, the leaflets were mentioning the names of the doctors, and moreover, were mentioning the issue of the Holocaust, which made them quite strong leaflets.”

“And the court protected that.”

Annen has persevered in his pro-life awareness campaign through the years despite the restraints on his freedom.

“He did continue, and he did adapt,” Puppinck told LifeSiteNews. “He kept his freedom of speech as much as he could, but he continued to be sanctioned by the German authorities, and each time he went to the court of human rights. And this time, he won.”

ECLJ’s statement notes that “any party” has three months to appeal the November 26 decision.

However, as it stands, the European Court of Human Rights’s ruling affects “all the national courts,” noted Puppinck, and these will now “have to protect freedom of speech, recognize the freedom of speech for pro-lifers.”

“In the past, the courts have not always been very supportive of the freedom of speech of pro-life,” he said, so the ruling is “significant.”

As for Annen’s pro-life ministry, Pubbinck added: “He can continue to go and do, and I’m sure that he does, because he always did.”  

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A vibrant church in Africa. Pierre-Yves Babelon /
Pete Baklinski Pete Baklinski Follow Pete

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‘Soft racism’: German Bishops’ website attributes African Catholics’ strong faith to simplemindedness

Pete Baklinski Pete Baklinski Follow Pete
By Pete Baklinski

GERMANY, November 26, 2015 (LifeSiteNews) --  The only reason the Catholic Church is growing in Africa is because the people have a “rather low level” of education and accept “simple answers to difficult questions” involving marriage and sexuality, posited an article on the official website of the German Bishops' Conference posted yesterday. The article targeted particularly Cardinal Robert Sarah of Guinea, the Vatican's prefect of the Congregation for Divine Worship and ardent defender of Catholic tradition.

First Things blogger Leroy Huizenga, who translated a portion of the article, criticized the article's view as “soft racism.”

In his article, titled “The Romantic, Poor Church,” editor Björn Odendahl writes: 

So also in Africa. Of course the Church is growing there. It grows because the people are socially dependent and often have nothing else but their faith. It grows because the educational situation there is on average at a rather low level and the people accept simple answers to difficult questions (of faith) [sic]. Answers like those that Cardinal Sarah of Guinea provides. And even the growing number of priests is a result not only of missionary power but also a result of the fact that the priesthood is one of the few possibilities for social security on the dark continent.

Huizenga said that such an article has no place on a bishops’ conference website. 

“We all know that the German Bishops' Conference is one of the most progressive in the world. But it nevertheless beggars belief that such a statement would appear on the Conference's official website, with its lazy slander of African Christians and priests as poor and uneducated (Odendahl might as well have added ‘easy to command’) and its gratuitous swipe at Cardinal Sarah,” he wrote. 

“Natürlich progressives could never be guilty of such a sin and crime, but these words sure do suggest soft racism, the racism of elite white Western paternalism,” he added. 

African prelates have gained a solid reputation for being strong defenders of Catholic sexual morality because of their unwavering orthodox input into the recently concluded Synod on the Family in Rome. 

At one point during the Synod, Cardinal Robert Sarah urged Catholic leaders to recognize as the greatest modern enemies of the family what he called the twin “demonic” “apocalyptic beasts” of “the idolatry of Western freedom” and “Islamic fundamentalism.”

STORY: Cardinal Danneels warns African bishops to avoid ‘triumphalism’

“What Nazi-Fascism and Communism were in the 20th century, Western homosexual and abortion ideologies and Islamic fanaticism are today,” he said during his speech at the Synod last month. 

But African prelates’ adherence to orthodoxy has earned them enemies, especially from the camp of Western prelates bent on forming the Catholic Church in their own image and likeness, not according to Scripture, tradition, and the teaching magisterium of the Church. 

During last year’s Synod, German Cardinal Walter Kasper went as far as stating that the voice of African Catholics in the area of Church teaching on homosexuality should simply be dismissed.

African cardinals “should not tell us too much what we have to do,” he said in an October 2014 interview with ZENIT, adding that African countries are "very different, especially about gays.” 

Earlier this month Belgian Cardinal Godfried Danneels, instead of praising Africa for its vibrant and flourishing Catholicism, said that African prelates will one day have to look to Europe to get what he called “useful tips” on how to deal with “secularization” and “individualism.” 

The statement was criticized by one pro-family advocate as “patronizing of the worst kind” in light of the facts that numerous European churches are practically empty, vocations to the priesthood and religious life are stagnant, and the Catholic faith in Europe, especially in Belgium, is overall in decline.

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