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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Iowa GOP rep: ‘Nothing worse’ than homeschoolers telling us how to vote

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By Ben Johnson

ANKENY, IA, May 4, 2015 (LifeSiteNews.com) – In a private e-mail exchange with a concerned parent, Republican state legislator Josh Byrnes of Iowa said there is “nothing worse than homeschool parents” making their views known on public school policy.

The statement came as Jeff Moorman took exception to a pending bill allegedly dealing with “bullying,” the “Bully Free Iowa Act of 2015” (HSB 39).

The proposal would allow school districts to monitor students outside of school hours and punish – or contact law enforcement officials and state bureaucratic agencies over – any communication it deems “bullying” – even if that behavior takes place inside a private residence or on social media. Some of these complaints may be filed without first notifying parents.

School administrators could accuse a child of bullying if any comment dealing with “sexual orientation” and “gender identity” – as well as a broad swath of categories encompassing everything from “behavior, friendship or relationship with others” to “political party preference, political belief...or any other distinguishing characteristic” – created a “hostile school environment.”

Parents are concerned this would lead to teachers and public education union employees launching surveillance of students' Facebook or Twitter accounts for stray comments about homosexuality or transgender status.

“This bill infringes on parental rights” and allows teachers to “invade [a] student's rights and privacy,” Moorman, who is part of the educational watchdog group Iowa for Student Achievement, told State Rep. Byrnes, R-Osage. Moorman said the proposal grants school officials “overreaching authority.”

Rep. Byrnes replied by asking, “Which Ankeny school are your kids part of?”

After Moorman answered his question, Byrnes wrote, “That’s good. I was making sure you didn’t h[om]e school.”

“Nothing worse than homeschool parents trying to tell us legislators how to run public schools when they don’t use them themselves,” State Rep. Byrnes wrote.

Moorman provided the e-mails to the blog Caffeinated Thoughts. The full exchange may be read here.

“Nowhere in the language of the bill does it restrict the school’s scope to just students enrolled in their school district,” wrote Shane Vander Hart, who broke the story. “Homeschooling parents have reason to be concerned.”

He also blasted Byrnes' dismissal of homeschoolers' right to have a voice in the legislative process. “Actually, there’s nothing worse than a state legislator demonstrating he lacks the maturity and temperament to serve in his current office,” he added. “It seems that the fact that homeschooling parents are taxpayers and that in itself gives them the right to weigh-in on any bill – education policy or otherwise.”

The state teachers union supports passage. Jean Hessberg, a spokeswoman for the Iowa State Educational Association, said the union would oppose any provision requiring the school district to report anti-gay or transgender “bullying” to the victims' parents, since they may not know their children were having sex with members of the same sex or choosing to identify as members of the opposite sex.

The bill's supporters are a hybrid of Republicans and Democrats. Despite the strong political backing of Iowa Gov. Terry Branstad, a Republican, it has failed to pass the state legislature after numerous attempts. 

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Half of Ohio’s abortion clinics closed due to pro-life laws, abortions down 9%: report

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By Dustin Siggins

COLUMBUS, OH, May 4, 2015 (LifeSiteNews.com) -- Pro-life laws have dropped the number of abortion facilities in Ohio by nearly 50 percent since 2011, and the number of abortions is down nine percent, the Associated Press reports in a new review. 

Seven out of 16 abortion facilities have closed or stopped providing abortions since 2011. An eighth is embroiled in a legal fight, which makes the nation's seventh-largest state second only to Texas in terms of abortion clinics closed in recent years.

The reduction may be affecting the number of abortions done in Ohio, which have dropped 8.9 percent -- from 25,473 in 2012 to 23,216 in 2013, according to the AP.

Since 2011, Ohio Gov. John Kasich and the GOP-controlled legislature have passed a number of pro-life measures. They include, but are not limited to, laws preventing abortion after a baby can survive outside the womb, and requiring women to listen to fetal heartbeats and have ultrasounds prior to an abortion.

Pro-life legislators in Ohio have continued to push pro-life bills, such as one that would ban abortions when heartbeats can be detected, which happens as early as six weeks.

Click "like" if you are PRO-LIFE!

The president of Ohio Right to Life says that it's not just pro-life laws that are making a difference. Women are choosing life, according to Mike Gonidakis, because of the work by pro-life groups to help them and their children. "It's a combination of a lot of things," Gonidakis told the AP, citing access to health care for the poor and counseling at crisis pregnancy centers. "Our society's changing. More and more women are choosing life."

“Women deserve better than abortion," Heartbeat International president Peggy Hartshorn told LifeSiteNews. "Pregnancy centers like those we support provide the facts about a baby’s development and about the many serious physical and psychological dangers of abortion. We set the standard for true compassion and support for women because the life of a mother and her baby are worth more than the bottom line.”

The executive director of Ohio's NARAL chapter, Kellie Copeland, says women are having to drive further, sometimes out of state, to get an abortion. She told the AP that the lack of clinics often creates circumstances where women can't get abortions because they cannot get an appointment until after the state's legal limit.

Copeland also says that the difference between the number of abortion clinic closures and the drop in abortions shows women in the state want to have abortions, and that "these laws have all been about creating these false hurdles for clinics to have to jump through."

Hartshorn, however, said comments like Copeland's are "telling."

"The very same special-interest groups who once claimed their goal was to make abortion ‘safe, legal and rare’ are now settling for merely ‘legal,'" she said. "Abortion facilities that are closing their doors are doing so because they are putting women’s health and safety at risk. While these highly profitable abortion businesses are unable to comply with laws enacted to protect the health of women, grassroots pregnancy help organizations are offering these very same women a safe—and legal—environment where they are able to make the healthiest choice for everyone involved in an unexpected pregnancy.”

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Walt Heyer

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‘Too many end in suicide’: The dark history of gender ‘reassignment’

Walt Heyer
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May 4, 2015 (ThePublicDiscourse.com) -- Bruce Jenner and Diane Sawyer could benefit from a history lesson. I know, because I suffered through “sex change” surgery and lived as a woman for eight years. The surgery fixed nothing—it only masked and exacerbated deeper psychological problems.

The beginnings of the transgender movement have gotten lost today in the push for transgender rights, acceptance, and tolerance. If more people were aware of the dark and troubled history of sex-reassignment surgery, perhaps we wouldn’t be so quick to push people toward it.

The setting for the first transgender surgeries (mostly male-to-female) was in university-based clinics, starting in the 1950s and progressing through the 1960s and the 1970s. When the researchers tallied the results and found no objective proof that it was successful—and, in fact, evidence that it was harmful—the universities stopped offering sex-reassignment surgery.

Since then, private surgeons have stepped in to take their place. Without any scrutiny or accountability for their results, their practices have grown, leaving shame, regret, and suicide in their wake.

The Founding Fathers of the Transgender Movement

The transgender movement began as the brainchild of three men who shared a common bond: all three were pedophilia activists.

The story starts with the infamous Dr. Alfred Kinsey, a biologist and sexologist whose legacy endures today. Kinsey believed that all sex acts were legitimate—including pedophilia, bestiality, sadomasochism, incest, adultery, prostitution, and group sex. He authorized despicable experiments on infants and toddlers to gather information to justify his view that children of any age enjoyed having sex. Kinsey advocated the normalization of pedophilia and lobbied against laws that would protect innocent children and punish sexual predators.

Transsexualism was added to Kinsey’s repertoire when he was presented with the case of an effeminate boy who wanted to become a girl. Kinsey consulted an acquaintance of his, an endocrinologist by the name of Dr. Harry Benjamin. Transvestites, men who dressed as women, were well-known. Kinsey and Benjamin saw this as an opportunity to change a transvestite physically, way beyond dress and make-up. Kinsey and Benjamin became professional collaborators in the first case of what Benjamin would later call “transsexualism.”

Benjamin asked several psychiatric doctors to evaluate the boy for possible surgical procedures to feminize his appearance. They couldn’t come to a consensus on the appropriateness of feminizing surgery. That didn’t stop Benjamin. On his own, he began offering female hormone therapy to the boy. The boy went to Germany for partial surgery, and Benjamin lost all contact with him, making any long-term follow-up impossible.

The Tragic Story of the Reimer Twins

The third co-founder of today’s transgender movement was psychologist Dr. John Money, a dedicated disciple of Kinsey and a member of a transsexual research team headed by Benjamin.

Money’s first transgender case came in 1967 when he was asked by a Canadian couple, the Reimers, to repair a botched circumcision on their two-year-old son, David. Without any medical justification, Money launched into an experiment to make a name for himself and advance his theories about gender, no matter what the consequences to the child. Money told the distraught parents that the best way to assure David’s happiness was to surgically change his genitalia from male to female and raise him as a girl. As many parents do, the Reimers followed their doctor’s orders, and David was replaced with Brenda. Money assured the parents that Brenda would adapt to being a girl and that she would never know the difference. He told them that they should keep it a secret, so they did—at least for a while.

Activist doctors like Dr. Money always look brilliant at first, especially if they control the information that the media report. Money played a skilled game of “catch me if you can,” reporting the success of the boy’s gender change to the medical and scientific community and building his reputation as a leading expert in the emerging field of gender change. It would be decades before the truth was revealed. In reality, David Reimer’s “adaptation” to being a girl was completely different from the glowing reports concocted by Money for journal articles. By age twelve, David was severely depressed and refused to return to see Money. In desperation, his parents broke their secrecy, and told him the truth of the gender reassignment. At age fourteen, David chose to undo the gender change and live as a boy.

In 2000, at the age of thirty-five, David and his twin brother finally exposed the sexual abuse Dr. Money had inflicted on them in the privacy of his office. The boys told how Dr. Money took naked photos of them when they were just seven years old. But pictures were not enough for Money. The pedophilic doctor also forced the boys to engage in incestuous sexual activities with each other.

The consequences of Money’s abuse were tragic for both boys. In 2003, only three years after going public about their tortured past, David’s twin brother, Brian, died from a self-inflicted overdose. A short while later, David also committed suicide. Money had finally been exposed as a fraud, but that didn’t help the grieving parents whose twin boys were now dead.

The exposure of Money’s fraudulent research results and tendencies came too late for people suffering from gender issues, too. Using surgery had become well-established by then, and no one cared that one of its founders was discredited.

Results from Johns Hopkins: Surgery Gives No Relief

Dr. Money became the co-founder of one of the first university-based gender clinics in the United States at Johns Hopkins University, where gender reassignment surgery was performed. After the clinic had been in operation for several years, Dr. Paul McHugh, the director of psychiatry and behavioral science at Hopkins, wanted more than Money’s assurances of success immediately following surgery. McHugh wanted more evidence. Long-term, were patients any better off after surgery?

McHugh assigned the task of evaluating outcomes to Dr. Jon Meyer, the chairman of the Hopkins gender clinic. Meyer selected fifty subjects from those treated at the Hopkins clinic, both those who had undergone gender reassignment surgery and those who had not had surgery. The results of this study completely refuted Money’s claims about the positive outcomes of sex-change surgery. The objective report showed no medical necessity for surgery.

On August 10, 1979, Dr. Meyer announced his results: “To say this type of surgery cures psychiatric disturbance is incorrect. We now have objective evidence that there is no real difference in the transsexual’s adjustments to life in terms of job, educational attainment, marital adjustment and social stability.” He later told The New York Times: “My personal feeling is that the surgery is not a proper treatment for a psychiatric disorder, and it’s clear to me these patients have severe psychological problems that don’t go away following surgery.”

Less than six months later, the Johns Hopkins gender clinic closed. Other university-affiliated gender clinics across the country followed suit, completely ceasing to perform gender reassignment surgery. No success was reported anywhere.

Results from Benjamin’s Colleague: Too Many Suicides

It was not just the Hopkins clinic reporting lack of outcomes from surgery. Around the same time, serious questions about the effectiveness of gender change came from Dr. Harry Benjamin’s partner, endocrinologist Charles Ihlenfeld.

Ihlenfeld worked with Benjamin for six years and administered sex hormones to 500 transsexuals. Ihlenfeld shocked Benjamin by publicly announcing that 80 percent of the people who want to change their gender shouldn’t do it. Ihlenfeld said: “There is too much unhappiness among people who have had the surgery…Too many end in suicide.” Ihlenfeld stopped administering hormones to patients experiencing gender dysphoria and switched specialties from endocrinology to psychiatry so he could offer such patients the kind of help he thought they really needed.

In the wake of the Hopkins study, the closure of the flagship Hopkins clinic, and the warning sounded by Ihlenfeld, advocates of sex change surgery needed a new strategy. Benjamin and Money looked to their friend, Paul Walker, PhD, a homosexual and transgender activist they knew shared their passion to provide hormones and surgery. A committee was formed to draft standards of care for transgenders that furthered their agenda, with Paul Walker at the helm. The committee included a psychiatrist, a pedophilia activist, two plastic surgeons, and a urologist, all of whom would financially benefit from keeping gender reassignment surgery available for anyone who wanted it. The “Harry Benjamin International Standards of Care” were published in 1979 and gave fresh life to gender surgery.

My Experience with Dr. Walker

I myself suffered greatly to come to terms with my gender. In 1981, I sought out Dr. Walker to ask him, the man who wrote the standards of care, for help. Walker said I was suffering from gender dysphoria. A mere two years after both the Hopkins study and the public statements of Ihlenfeld drew attention to the increased suicide risk associated with gender change, Walker, even though he was completely aware of both reports, signed my approval letter for hormones and surgery.

Under his guidance, I underwent gender reassignment surgery and lived for eight years as Laura Jensen, female. Eventually, I gathered the courage to admit that the surgery had fixed nothing—it only masked and exacerbated deeper psychological problems. The deception and lack of transparency I experienced in the 1980s still surround gender change surgery today. For the sake of others who struggle with gender dysphoria, I cannot remain silent.

It is intellectually dishonest to ignore the facts that surgery never has been a medically necessary procedure for treating gender dysphoria and that taking cross-gender hormones can be harmful.  Modern transgender activists, the descendants of Kinsey, Benjamin, and John Money, keep alive the practice of medically unnecessary gender-change surgery by controlling the flow of published information and by squelching research and personal stories that tell of the regret, unhappiness, and suicide experienced by those who undergo such surgery. Negative outcomes are only acknowledged as a way to blame society for its transphobia.

Transgender clients who regret having taken this path are often full of shame and remorse. Those who regret their decision have few places to turn in a world of pro-transgender activism. For me, it took years to muster the courage to stand up and speak out about the regret.

I only wish Dr. Paul Walker had been required to tell me about both reports when I consulted him: the Hopkins study showing surgery did not alleviate severe psychological problems, and Ihlenfeld’s observation of the continuing transgender unhappiness and high incidence of suicide after hormones and surgery. This information might not have stopped me from making that disastrous decision—but at least I would have known the dangers and pain that lay ahead.

Walt Heyer is an author and public speaker with a passion to help others who regret gender change. Through his website, SexChangeRegret.com, and his blog, WaltHeyer.com, Heyer raises public awareness about the incidence of regret and the tragic consequences suffered as a result. Heyer’s story can be read in novel form in Kid Dakota and The Secret at Grandma’s House and in his autobiography, A Transgender’s Faith. Heyer’s other books include Paper Genders and Gender, Lies and SuicideReprinted with permission from The Witherspoon Institute

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