Friday, September 28, 2012

"Consent" to One's Own Homicide?

We have previously talked in this space about the ethics of organ donation, and what the Church teaches about it.  We also talked about how the Church's teaching in this, as in so much else, is ignored, and questioned whether there can be such a thing as a moral vital organ transplant.  Item: vital organs are useless for transplant after the donor's death; and some unpaired vital organs, like the heart, cannot be taken without killing the donor.

Now comes another item from Staten Island, New York: after being fired as a transplant coordinator for the non-profit New York Donor Network, nurse practitioner Patrick McMahon claims, in an action for wrongful termination, alleges that the Network isn't even waiting for donors to fit the criteria-du-jour of brain death before pressuring hospitals to call a death on a potential organ donor.  McMahon alleges in his lawsuit that the Network pressured medical staff to declare patients brain dead; hounded the patients' families to consent to donation before brain death was declared; and that transplant procedures were initiated on patients notwithstanding that they showed signs of life.  He cites, among others, a case from November of last year, when he claims to have seen a transplant team administer a muscle paralyzing agent to a donor during a full organ harvest, because the woman was moving and jerking while they cut into her chest.  McMahon says that the procedure went forward in the face of his vehement objections.  In another case, McMahon says that the Network browbeat a doctor for refusing to declare a 19-year-old patient brain dead.  In two other cases, he says that patients had donor paperwork processed even though one showed brain activity in neurological tests, and the other showed responses in pain-stimuli tests.  McMahon claims that he was fired from his job days after approaching the Network's CEO with his concerns.

The Network, on the other hand, says that McMahon's allegations are baseless and insulting, denies that it plays any role in declarations of brain death, and cites its 35-year record of saving lives.

But the following questions are worth considering:

-- Does not the concept of "brain death" date back only to the immediate aftermath of the first successful heart transplant in 1967?

-- Are there not multiple definitions of "brain death"? 

-- Since death is the moment the soul leaves the body, how is it of any avail to administer life-preserving treatment to a corpse whose soul has departed?

-- Does not society increasingly consider many human beings to be more valuable dead than alive, especially before birth and near death?

-- Is it not true that society holds more and more that the ends justify the means, and that it is permissible to do evil in order to achieve good?

-- Is it in fact the removal of vital organs that proximately causes the death of the donor?  (Nota bene: you cannot lawfully consent to your own homicide, under either the natural law or the civil law.) 

-- Is the medical profession imbued with the true Spirit of Christianity, or with the grim spirit of materialism and utilitarianism?

-- If the answer to that last question is the latter, do I want to commit myself, in a helpless condition, to the hands of such a profession by consenting in advance to the harvesting of my organs?

The Catholic has a duty to seek the answer to temporal questions in the light of eternity.  

Even if he doesn't like the answer.

UPDATE: Further details on McMahon's lawsuit.


  1. Let's face it, there's lots of money in organ donation -- not for the families (It's illegal to sell organs.), but for the hospitals and organ services, that's a different story. Wherever you find heaps of money, you find people willing to do anything to get it. So, you have immoral industries exploiting people by: buying kidneys in the third world, hiring surrogate moms in India, buying women's eggs while keeping them in the dark about complications. Now, why aren't the champions of social justice like the nuns on the bus ever talking about these issues instead of saving the wetlands?

  2.,yes, I have a dog in this fight, because I am an organ recipient.
    The Catholic Church is not against organ donation. I have no idea where this things come from. The CCC clearly states that organ donation is a good thing, a generous and loving thing, when it is done according to protocol. (CCC 2296) Obviously, as with all things run by humans, things can go awry. This is not the case in general.
    I get really wary when I see peopel saying Catholics should be against organ donation, when the past two popes have spoken in favor of it, AND the CCC says it is to be encouraged.

  3. And as to "buying" kidneys--just because you can "buy" one doesn't mean it's going to work for you. Criteria for organ donation is very, very stringent. And organ services? What organ services? The Procurement agencies? In the US, they are non-profits.

  4. Emily, thank you for your comment. Here, in its entirety, is CCC 2296 on organ donation:

    Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as a expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.

    Notice that post-mortem organ donation is not praised or condoned without qualifications. This paragraph refers to donations that take place after death, and it also says that it is impermissible to bring about the death of a human being even in order to delay the death of other persons. The point is that the criteria for organ donation outlined in the CCC are not being followed. Unpaired vital organs are being taken from donors before death. This is made possible by the concept of "brain death," which is the medical profession's attempt to redefine death. Why redefine death? Because vital organs are no good for transplantation after death.

    If technology ever advances to the point where vital organs can be salvaged after the death of the donor -- meaning after the soul has departed the body (CCC 1016) -- that will be a different story. But until then, we have a serious problem. And now that we have the elastic concept of "brain death," there is little incentive to pursue that kind of technology.

    1. So...what qualifies death? If you're brain dead, you are being kept alive by machines. There is no higher function in the brain. A respirator breaths for you. Your hearts beats because of the oxygen your body is receiving.
      How are we to determine death? We have technology that can keep people "alive" interminably. Brain death is the best we have, medically, at this point.
      You're right--they are no good after death, to a point--organs can survive outside the body for about four hours, give or take.
      The brain death criteria has been around for about 20 years. So I'm pretty sure the people who wrote the CCC understood this was how it worked. Pope Benedict XVI said he supported organ donation in God and the World--again, when organ donation was as it is now.
      Of course there are qualifications. But I don't think they are talking about "brain death' as the issue. The issue is killing people specifically for organs, as we hear is being done in China, or the buying/selling of organs. UNOS in the United States specifically says that every possible medical measure is taken to save the life of a donor.
      And death HAS evolved over centuries. First it was you stopped breathing. Then it was when your heart stopped. Now it's brain death, because we can keep the heart going and the lungs going--the body going--with artificial technology. The Glasgow Coma Scale is one indicator of brain function. These are not willy-nilly medical decisions.
      In short: (and as I said, I'm biased) I find it really hard to be this jaded about brain death and organ donation. My donor has a massive brain aneurysm. She was brain dead. Her body functioned because of machines that were working for her, but there was no way her brain was EVER going to work again, no way she would ever function biologically without machines. In fact, to GET lungs, this is usually how people have to die, because if they die in a car crash, the lungs are usually compromised beyond use.
      So really, my question to you is: what's death? Do you condone the use of machines when it's CLEAR the brain is "offline" so to speak, and not coming back?

  5. I doubt the Church has ever changed her definition of death, which is the moment the soul leaves the body. How do we know the soul has left the body? If we don't know, then we must err on the side of life, lest we stain our hands with innocent blood. We cannot do evil that good may come.

    I dispute the idea that profound brain damage is a justification for calling a death. People do emerge from comas after years of being unresponsive. Signs of consciousness are detected in persons previously thought to be unconscious. Corpses do not carry and deliver live babies, yet there are cases of "brain dead" women doing just that. And then there is the case of the little boy who appeared in this space back on November 1, 2012 who lived for three years and 11 months without a brain. The doctors were sure that child would die within hours after birth, but he lived for years and was never hooked up to any machines. Cases like these prove that we are not nearly as wise as we think we are.

    A soul may be dormant or unable to interact with the outside world on account of profound brain damage, but as long as it is still there that person is still alive. If a person is still using his organs, and body functions are taking place, with or without machines, then the soul must be present. The body doesn't function without the soul. If the soul has left the body, then we have a corpse, and no amount of machinery is going to keep a corpse "alive."

    I am sorry that this issue touches your personal situation, but the fact is that atheism, materialism and pragmatic utilitarianism have infested the medical profession just as they have every other part of society. Doctors have gotten into the business of deciding that some lives are worth more than others, and that is a call that no mere mortal is qualified to make.