There are some occasions in which it is clearly permissible, for example when a person has a pair of organs, only one of which is really necessary. One can be removed to transplant to another person, such as a kidney transplant. There are other cases in which it is permissible, for example when the organ can be taken when the person is clearly already deceased, such as eye corneal transplants.
However, it is manifestly immoral to kill a person to take one of their organs, although that person would have died on his own within a short period of time. It is never permissible to kill one person just to help another. Only God has power over life and death.
The problem arises because once a person has really died and his cardiac and respiratory functions have ceased for several minutes, then his organs will be damaged in such a way that they cannot be used for organ transplants. Hence the organs must be removed first.
The big dispute presently concerns when a person is alive or dead. This involves the concept of brain death. The medical profession generally considers that when a person has been proven to be brain dead, for example by a flat EEG or by the absence of respiration when the respirator has been turned off, then he must be considered to be dead, despite the fact that his cardiac and respiratory functions are being artificially maintained. Consequently, it is permitted, so they say, to remove any or all organs from a person who is still breathing and whose heart is still beating, so long as they are proven to be brain dead. This has actually become big business, and a "living corpse" like this is worth probably more than $80,000 for its internal organs.
This practice is not only disgustingly inhuman. It is manifestly anti-God and immoral. Death is the moment at which the soul leaves the body. This is known only to God, the creator of life. While a person is still breathing, even artificially, and while his heart is still beating, he has many signs of life. His body is being maintained in life by the circulation of blood. He is still a human being. It is true that if his brain is dead he will never think again, and he will not have the reflexes and reactions that depend upon brain function. However, this does not mean that he is not alive. It just means that there is a permanent irreparable impairment to his human activities. It is not for man to decide that he is not a man and that he is not alive. Consequently, he must be treated as a living person. Hence no essential organs can be removed until well after all respiration and cardiac action have ceased.
"Cadaveric" transplantation is a misnomer, and is used to describe the removal organs from a person who has been declared brain dead, but who is being kept alive by artificial means.
Note that the pope’s address is not a statement of the Church’s Magisterium , and that it makes no definitions or clear statements on Faith or morality. I will pass over the humanistic and naturalistic tone of this discourse, which speaks of the dignity of the human person, but not of the salvation of souls. I would, however, like to bring up the crucial statement in this document, which the pope uses to justify his personal opinion that it is licit to harvest organs from brain dead people, who are being alive by artificial means, in order to treat medical conditions by transplantation. This statement is this: "the criterion adopted in more recent times for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sounds anthropology." (§5)
The pope’s very hesitant statement is quite simply wrong. The Church teaches that reason can prove with certitude the spirituality and the immortality of the human soul (Ds 2766 and 2812). This means that the soul is not bound to any organ of the body, including the brain. The soul is not dead or absent just because the brain is incapable of functioning, short of a miracle. Death is in fact the separation of the soul from the body. As the pope himself correctly points out, the precise moment of death "is an event which no scientific technique or empirical method can identify directly" (§4). It is for this reason that a priest can conditionally administer the sacrament of Extreme Unction for up to an hour after a person has been medically declared dead.
The pope’s argument is that we can accept the neurological criteria of death have replaced the cardio-respiratory criteria, namely the cessation of heart and lung activity for a period of time beyond which it is no longer possible to revive them. It is true that the neurological criteria give the moral certitude that the person will die when the cardio-respiratory life support systems are removed. However, they give absolutely no certitude that the person is already dead, in the true sense of separation of soul and body. Moral certitude of this is only possible when corruption takes place, as sure proof that human life is no longer present in the corpse. However, as long as respiration and cardiac function are maintained, albeit artificially, the tissues and cells of the body will certainly stay alive and nourished, and the body remains one organism, with one being, that is to say one soul. Corruption is the only sure sign that the unity of the being is lost, and that consequently the immortal soul is separated from the body. Once corruption sets in and death is certain, it is certainly permissible to use organs for experimental and other uses, provided that there is a proportionally grave reason. However, since corruption involves a disintegration of the tissues and organs, they cannot then be used for transplantation purposes.
How can it be said that with certitude, that the human soul is no longer present in an apparently live body whose brain is dead? And if the human soul is in all probability present, how can the removal of organs necessary for life be justified? The moral certitude that the brain dead person will die in any case is irrelevant. He is presently, to all appearances and in all likelihood still alive, and the removal of organs necessary for life could be the direct cause of his death? Surely to be responsible for this is a sin against the fifth commandment. Surely man cannot claim this right to kill another person simply because of the benefit that could accrue to a third person. This is utilitarianism, considering man as a means to an end.
Consequently, the medical diagnosis of brain death can not be considered as giving the medical profession the right to declare a person as dead quite simply. Furthermore, it is not permissible to accept organs necessary for life, such as the heart, lung, or liver, removed from a person in such a state. It is consequently my opinion that the present day practice of "cadaveric" transplantation is immoral and illicit, and it is not permitted for a Catholic to authorize his or another’s donation or even to accept organs harvested in this way.
In fact, the definition of "brain death" may have come into use in place of the traditional signs of death partly because of the desire to "harvest" organs for transplants into others. Many physicians themselves will admit that they know of cases were a person has been dubiously declared "brain dead" because an organ recipient is waiting. By the time traditional death is clear, the organs are no longer "harvestable." Thus, some say that organ donation may have been a foot in the door to a secularized, rather than a Catholic, morality.
Fr. Peter R. Scott
