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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Lisa Bourne

‘You can’t have’ marriage equality ‘without polygamy’

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By Lisa Bourne

July 3, 2015 (LifeSiteNews) – Motivated by the U.S. Supreme Court ruling legalizing homosexual “marriage,” a Montana polygamist has filed for a second marriage license, so he can be legally wed to two women at once.

"It's about marriage equality," said Nathan Collier, using homosexual advocates’ term to support marriage redefinition. "You can't have this without polygamy."

Collier, who has has appeared on the TLC reality show Sister Wives with his legal wife Victoria, and his second wife Christine, said he was inspired by the dissent in the Supreme Court decision.

The minority Supreme Court justices said in Friday’s ruling it would open the door to both polygamy and religious persecution.

“It is striking how much of the majority’s reasoning would apply with equal force to the claim of a fundamental right to plural marriage,” wrote Chief Justice John Roberts.

Collier and his wives applied for a second marriage license earlier this week at the Yellowstone County Courthouse in Billings, a report from the Salt Lake Tribune said.

Collier, who was excommunicated from the Mormon Church for polygamy, married Victoria in 2000 and had a religious wedding ceremony with Christine in 2007. The three have seven children between them and from previous relationships.

"My second wife Christine, who I'm not legally married to, she's put up with my crap for a lot of years. She deserves legitimacy," Collier said.

Yellowstone County officials initially denied the application before saying they would consult with the County Attorney and get him a final answer.

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

Bigamy, the holding of multiple marriage licenses, is illegal all 50 states, but Collier plans to sue if his application is denied. Officials expect to have an answer for him next week.

While homosexual “marriage” supporters have long insisted legalization of same-sex unions would not lead to polygamy, pro-life and family advocates have warned all along it would be inevitable with the redefinition of marriage.

“The next court cases coming will push for polygamy, as Chief Justice John Roberts acknowledged in his dissent,” said Penny Nance, president of Concerned Women for America, after the Supreme Court ruling. “The chief justice said “the argument for polygamy is actually stronger than that for ‘gay marriage.’ It’s only a matter of time.”

In a piece from the Washington Times, LifeSiteNews Editor-in-Chief and the co-founder of Voice of the Family John-Henry Westen stated the move toward legal polygamy is “just the next step in unraveling how Americans view marriage.”

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Chris Christie: Clerks must perform same-sex ‘marriages’ regardless of their religious beliefs

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By Ben Johnson

TRENTON, NJ, July 3, 2015 (LifeSiteNews) – Chris Christie is not known for nuance. This time, he has turned his fiery personality loose on county clerks and other officials who have religious objections to performing same-sex “marriages.”

In a tone usually reserved for busting teachers' unions, Christie told clerks who hold traditional values, “You took the job, and you took the oath.” He would offer no exemption for an individual whose conscience would not allow him to participate in a union the vast majority of the world's religions deem sinful.

“When you go back and re-read the oath it doesn’t give you an out. You have to do it,” he said.

He told a reporter that there “might” be “individual circumstances” that “merit some examination, but none that come immediately to mind for me.”

“I think for folks who are in the government world, they kind of have to do their job, whether you agree with the law or you don’t,” the pugnacious governor said.

Since the Supreme Court voted 5-4 to legalize homosexual “marriage” last Friday, elected officials have grappled with how to safeguard the rights of those who have deeply held religious beliefs that would not allow them to participate in such a ceremony.

Christie's response differs markedly from other GOP hopefuls' responses to the Supreme Court ruling. Mike Huckabee, for instance, has specifically said that clerks should have conscience rights. Louisiana Gov. Bobby Jindal signed an executive order granting such rights and ordered clerks to wait until a pending court case was fully adjudicated before any clerk issues a marriage license to a homosexual couple.

Christie gave up a legal appeal after a superior court judge struck down his state's voter-approved constitutional marriage protection amendment. New Jersey is the only state where such a low court overturned the will of the voters.

The decision to ignore conscience rights adds to the growing number of Christie's positions that give conservatives pause.

The natural locus of support for a Christie 2016 presidential run is the Republican's socially liberal donor class, for personal as well as political reasons. His wife works on Wall Street, and some of the GOP's high-dollar donors – including Paul Singer – have courted Christie for years.

However, this year Jeb Bush, Marco Rubio, and to a lesser degree Scott Walker have eclipsed Christie as the preferred candidates of the boardroom donors – who sometimes prefer Democrats to Republicans.

Christie also used language during a speech before the Republican Jewish Coalition last year, which concerned some major GOP donors.

Christie is reportedly spending this weekend with Mitt Romney and his family at Romney's New Hampshire home. Romney declined to enter the 2016 race himself and may be able to open his donor list to Christie's struggling campaign.

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After having a girl with Down syndrome, this couple adopted two more

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By Ben Johnson

LINO LAKE, MN, July 3, 2015 (LifeSiteNews) – For most people, having five biological children would have been enough. In fact, for many Americans, large families are treated as a scandal or a burden.

But one family made the decision, not just to have a large family, but to give a home to some of the most vulnerable children in the world: Girls born overseas with Down syndrome.

Lee and Karen Shervheim love all seven of their children, biological or otherwise. Undeterred by having twin boys – Daniel and Andrew, 18 – they had Sam four years later.

They now have three daughters who are all 11 years old. All three have Down syndrome.

And two of them are adopted.

About the time their eight-year-old son, David, was born, Lee and Karen decided to adopt a child with Down syndrome to be a companion to their daughter, Annie.

They made the further unexpected choice to adopt a child from Eastern Europe with the help of Reece's Rainbow, which helps parents adopt children with Down syndrome.

“Between my wife and I, we couldn’t get it out of our heads,” Lee told the Quad City Press. “So many children need families and we knew we could potentially do something about it.”

After originally deciding to adopt Katie, they spent six weeks in Kiev, visiting an orphanage in nearby Kharkov. While there, they decided they may have room in their heart, and their home, for another child.

When they saw a picture of Emie striking the same pose as their biological daughter in one of their photographs, they knew they would come home with two children.

Both girls were the same age as their Annie. She would not lack for companionship, as they worried.

Lee said after the Ukrainian government – finally – completed the paperwork, they returned to the United States, when the real challenges began.

“The unvarnished truth,” Lee told the Press, is that adopting the Russian-speaking special needs children “was really disruptive to our family. They came with so many issues that we had not anticipated.”

After teaching them sign language and appropriate behavior, they moved to Lino Lake, Minnesota and found a new support group in Eagle Brook Church. There they found personal assistance and spiritual solace.

Every year in the past seven years has been better and better, they say.

“I think my girls can do almost anything they want to do,” he said, “and that’s what I want to help them become.”

The family's devotion is fueled by their faith, and it informs the sense of humor Lee showed in a tweet during the 2014 midterm elections:

It takes a special person to believe in the potential of the “mentally retarded,” as they were once labeled. Today, 90 percent of all babies diagnosed with Down syndrome in the womb will be aborted. The percentage is higher in some countries. Some have even spoken of "a world without people with Down syndrome."

Their God, and their experience, tell them that every child has infinite worth and potential, Lee told local media, and he would encourage anyone to follow his footsteps and adopt a Down syndrome child – or two.

“The message is that it really doesn’t matter where you started or where you came from,” Lee said. “There are endless opportunities for everyone, whether they have disabilities or not. They deserve a shot.”

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