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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Two Congressmen confirm: National 20-week ban on abortion will come up for a vote shortly

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By Dustin Siggins

WASHINGTON, D.C., April 17, 2015 (LifeSiteNews.com) – A bill to end abortion in the United States after 20 weeks will move forward, and it will have the strong support of two leading pro-life Congressmen, the two Republicans told LifeSiteNews.com at the eighth annual Susan B. Anthony List Campaign for Life Summit on Thursday.

Rep. Chris Smith, R-NJ, told LifeSiteNews and the National Catholic Register that ongoing House discussions on H.R. 36, the "Pain Capable Unborn Child Protection Act," will result in a pro-life bill moving forward.

"Very good language" is being put together, Smith told The Register. He told LifeSiteNews that he fully anticipated being able to support the final bill, because the House Republican caucus "wouldn't have something that would be unsupportable. Our leadership is genuinely pro-life."

In 2013, the "Pain Capable Unborn Child Protection Act" easily passed through the House of Representatives, only to be stalled by a Democratic-controlled Senate. This year, an identical bill was halted by Rep. Renee Ellmers, R-NC, and other Republicans -- surprising and angering pro-life leaders who thought its passage was assured. That bill, H.R. 36, is now being rewritten so it can be voted on by the full House, though its final wording remains uncertain.

Some fear that the House leadership will modify the bill to mollify Ellmers. She and others objected that the bill allows women to abort a child after 20 weeks in the case of rape – but only if they report that rape to the authorities.

Pro-life activists say removing the reporting requirement would take abortionists at their word that the women whose children they abort claimed to be raped. Congresswoman Ellmers has publicly stated the House leadership is considering such a proposal.

Jill Stanek, who was recently arrested on Capitol Hill as part of a protest to encourage Republicans to pass H.R. 36, said that would be "a loophole big enough for a Mack truck."

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Congressman Smith said the bill will come to the floor shortly. "The commitment to this bill is ironclad; we just have to work out some details," Smith said.

He also noted that, while a vote on the 20-week ban has been delayed for nearly three months, "we did get the No Taxpayer Funding for Abortion Act passed, and that would have been in the queue now, so we just reversed" the order of the two bills.

Congressman Smith spoke to both outlets shortly after participating in a panel at the Summit.

Another speaker was Rep. Steve King, R-IA, who also supports the 20-week ban.

"I can't think of what” language that is actively under consideration could make him rethink his support for the bill, King said. He also told attendees that the nation was moving in a direction of supporting life.

The outspoken Congressman declined to answer further, noting "that's asking me to anticipate an unknown hypothetical."

The annual Campaign for Life Summit and its related gala drew other high-profile speakers, including presidential candidate Senator Rand Paul, potential presidential hopeful Senator Lindsay Graham, and Republican National Committee Chairman Reince Priebus.  

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"Someone who doesn’t flinch at the dismemberment of babies is not going to flinch at the dismemberment of some evangelical baker’s conscience."
Jonathon van Maren Jonathon van Maren Follow Jonathon

Pro-lifers are winning. So now they’re coming for our cupcakes?

Jonathon van Maren Jonathon van Maren Follow Jonathon
By Jonathon van Maren

As I travel across Canada (and at times the United States) speaking on abortion and various facets of the Culture of Death, one of the things I hear often is a hopelessness, a despair that the West is being flattened by the juggernaut of the Sexual Revolution. There is a feeling among many people that the restriction of religious liberty, the continued legality of abortion, and the redefinition of marriage are inevitable.

This is, of course, one of the most prominent and successful strategies of the Sexual Revolutionaries—create an aura of inevitability while concurrently demonizing all those who oppose their new and mangled “progress” as Neanderthals on the cusp of being left behind by History. That inevitability becomes a self-fulfilling prophecy, because many people don’t realize that the various battles in the Sexual Revolution actually all correlate to one another—that what we are seeing now is the end game of an incredibly vast and well-planned cultural project.

It is because we miss many of these connections that we often cannot see, with clarity, how the culture wars are actually unfolding. I read with great interest a recent column by Rev. Douglas Wilson, eloquently titled “With stirrups raised to Molech.”

“We are now much occupied with the issues swirling around same sex mirage,” he writes, “but we need to take great care not to get distracted. Why have the homosexual activists gone all in on this issue? Why is their prosecutorial zeal so adamant? We went, in just a matter of months, from ‘let’s let individual states’ decide on this, to federal judges striking down state statutes, followed up hard by official harassment of florists, bakers, and photographers. Why the anger, and why the savage over-reach? And do they really think we couldn’t remember all the things they were assuring us of this time last year?”

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It’s a compelling question, and one that I’ve heard many Christians puzzling over recently. Why do the advocates of the Sexual Revolution despise those who disagree with them so viciously? It is partly because their cultural project does not, as they claim, consist of “living and let live.” It is about compulsory acceptance of any and all sexual behaviors, with tax-payer funding for the rubbers and pills they need to ensure all such behaviors remain sterile, and extermination crews to suction, poison, and dismember any inconvenient fetuses that may come into being as the result of casual coitus.

The ancient mantra “the State has no business in the bedrooms of the nation” has long been abandoned—the emboldened Sexual Revolutionaries now demand that politicians show up at their exhibitionist parades of public indecency, force schools to impose their so-called “morally neutral” view of sexuality on children, and force into silence those who still hold to traditional values.

Rev. Wilson, however, thinks that this loud and vicious war on conscience may be about even more than that. The pro-life cause, he notes, has been very successful in the Unites States. The abortion rate is the lowest it has been since 1973. Hundreds of pro-life laws are passing on the state level. The abortion industry has been successfully stigmatized. True, the successes are, for pro-lifers, often too feeble and not nearly adequate enough in the face of such unrestrained bloodshed. Nevertheless, the momentum has turned against the Sexual Revolutionaries who have championed abortion for decades—their shock and anger at the strength of the pro-life movement evident in pro-abortion signs at rallies that read, “I can’t believe I still have to protest this s**t.”

It is because of the pro-life movement’s success, Wilson muses, that the Sexual Revolutionaries may be coming at us with such fury. “If a nation has slaughtered 50 million infants,” he writes, “they are not going to suddenly get a sense of decency over you and your cupcakes. Now this explains their lack of proportion, and their refusal to acknowledge the rights of florists. Someone who doesn’t flinch at the dismemberment of babies is not going to flinch at the dismemberment of some evangelical baker’s conscience. This reveals their distorted priorities, of course, but it also might be revealing a strategy. Is the homosexual lobby doing this because they are freaking out over their losses on the pro-life front? And are they doing so in a way intended to distract us away from an issue where we are slowly, gradually, inexorably, winning?”

It’s a fascinating perspective. It’s true—and has always been true historically—that when one group of human beings is classified as nonhuman by a society as nonhuman and subsequently butchered, the whole of society is degraded. No nation and no culture can collectively and systematically kill so many human beings without a correlating hardening of the conscience. But on the pro-life front, there has been decades of fierce resistance, hundreds of incremental victories, and a renewed energy among the upcoming generation of activists. For the Sexual Revolutionaries who thought the battle was over when Roe v. Wade was announced in 1973, this must be a bitter pill to swallow indeed.

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Lisa Bourne

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‘Prominent’ Catholics attacking Archbishop Cordileone are big donors to Pelosi and pro-abort Democrats

Lisa Bourne
By Lisa Bourne

Note: To sign a petition supporting Archbishop Cordileone, click here

SAN FRANCISCO, CA, April 17, 2015 (LifeSiteNews.com) -- Big donors to the Democrat Party and pro-abortion Nancy Pelosi are among those publicly harassing San Francisco Archbishop Salvatore Cordileone for protecting Catholic identity in the area’s Catholic high schools.

A big-ticket full-page ad ran April 16 in the San Francisco Chronicle attacking the archbishop and calling Pope Francis to oust him for his efforts to reinforce Catholic principles in the schools.

A number of prominent San Francisco-area residents identifying as Catholic are signatories of the ad, and several are wealthy donors to Democrat entities and pro-abortion politicians, Catholic Vote reports.

Federal Election Commission records indicate Charles Geschke, Adobe Systems chairman and previous head of the Board of Trustees at the University of San Francisco, gave more than $240,000 to Democrat groups, as well as $2,300 to Nancy Pelosi and $4,000 to John Kerry, both politicians who claim to be Catholic but support abortion and homosexual “marriage.”

Also on the list is political consultant and businessman Clint Reilly, who gave nearly $60,000 to Democrat organizations, along with $5,000 to Barack Obama, whose administration vehemently promotes abortion and homosexual “marriage” and has continually opposed religious liberty. Reilly gave $4,600 to Pelosi as well.

Another individual in the ad attacking the archbishop who also gave big campaign donations to California pro-abort Democrats was Lou Giraudo, a former city commissioner and business executive who contributed more than $24,000 to Nancy Pelosi, $6,000 to Dianne Feinstein and $4,300 to Barbara Boxer.

Nancy Pelosi herself challenged the archbishop for his stance on Catholic teaching last year when she tried to pressure him out of speaking at the March for Marriage in Washington D.C., claiming the event was “venom masquerading as virtue.”

The archbishop responded in a letter that he was obliged “as a bishop, to proclaim the truth—the whole truth—about the human person and God’s will for our flourishing ... especially the truth about marriage as the conjugal union of husband and wife.”

The April 16 ad attacking Archbishop Cordileone was the latest in an ongoing assault since the archbishop took steps in February to strengthen Catholic identity in the schools and clarify for faculty and staff in handbooks and contract language the long-standing expectation that they uphold Church principles. 

It said Archbishop Cordileone has “fostered an atmosphere of division and intolerance” and called on Pope Francis to remove him.

“Holy Father, Please Provide Us With a Leader True to Our Values and Your Namesake,” the ad said. “Please Replace Archbishop Cordileone.”

The Confraternity of Catholic Clergy (CCC), a national association for priests and deacons, condemned Archbishop Cordileone’s harassers in a statement, saying the archbishop “teaches in conformity to the Catechism of the Catholic Church.”

“The character assassination and uncharitable venom being cast upon a bishop merely defending the doctrines of his religion is appalling and repugnant,” the CCC said. 

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“It is totally inappropriate, improper and unjust for the media and others to vilify and brutally attack him when he is doing precisely what an ordained minister and pastor of souls is obligated to do,” the group stated, “namely, speak the truth in season and out of season.”

Those behind the attack ad said the proposed handbook language was mean-spirited, and that they were “committed Catholics inspired by Vatican II,” who “believe in the traditions of conscience, respect and inclusion upon which our Catholic faith was founded.”

The Archdiocese of San Francisco denounced the ad upon its release, saying it was a misrepresentation of Catholic teaching and the nature of the teacher contract, and a misrepresentation of the spirit of the Archbishop.

“The greatest misrepresentation of all is that the signers presume to speak for “the Catholic Community of San Francisco,” the archdiocese responded. “They do not.”

The CCC pointed out that just as physicians are expected to be faithful to the Hippocratic Oath, bishops, priests, and deacons are expected to be faithful to the Church, its teachings and its authority, “since their objective is the salvation of souls, not a popularity contest.” 

In openly declaring their support for Archbishop Cordileone, the group urged the media and others to show “prudence, civility, and fair-mindedness” toward those with whom they disagree.

“He took an oath to be faithful to the Gospel,” the Confraternity stated of Archbishop Cordileone, “and in the words of the disciples in the New Testament, ‘better to obey God than men.’”

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