Bulletin Q&A Article, published 5-21-23:
I am renewing my driver’s license and considering joining the organ donor registration. What is the Church’s position on organ donation after death?
Paragraph #2296 of the Catechism states: “Donation of organs after death is a noble and meritorious act and is to be encouraged as a manifestation of generous solidarity. It is not morally acceptable if the donor or those who legitimately speak for him have not given their explicit consent.” So, at first blush, it seems like signing up for an organ donor registry is a good thing. But there is a concern about the determination of when death occurs. The same paragraph of the Catechism continues: “It is furthermore morally inadmissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.”
Organs may not be removed prior to death. But how is death determined, and who makes the decision? This is where the problem lies. Many valuable organs, such as the heart and liver, can survive for very short times without blood flow at normal body temperatures. And so there is pressure to remove these organs while the heart is still beating, and the doctors involved look to maintain life artificially when they consider brain death to have occurred.
In a 1989 address to a pontifical group working on the determination of the moment of death, St. Pope John Paul II said: “When does what we call death take place? This is the crux of the problem. Essentially what is death? … it is not easy to arrive at a definition of death understood and accepted by all.” He goes on: “The problem of the moment of death has serious practical implications, and this aspect is also of great interest to the Church. In fact, a tragic dilemma seems to arise. On the one hand, there is the urgent need to find replacement organs for patients who would otherwise die or at least not recover. In other words, it is conceivable that in order to escape certain and imminent death, a patient needs to receive an organ which could be provided by another patient, perhaps his neighbor in the hospital, but on whose death there is still a doubt.”
The Church has given some guidance to health care workers on the determination of death. “It is a well-known fact that for some time certain scientific approaches to ascertaining death have shifted the emphasis from the traditional cardiorespiratory signs to the so-called neurological criterion. Specifically, this consists in establishing, according to clearly determined parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum, and brainstem). This is then considered the sign that the individual organism has lost its integrative capacity.” (New Charter for Health Care Workers, #116, Pontifical Council for Pastoral Assistance to Health Care Workers 2017)
In the end it is a tough call. Organ donation is “a noble and meritorious act” if one can assure the proper guidelines for determining death are established and followed. But can this be assured in a society where the culture of death seems to be prevailing in a push for euthanasia? St. John Paul said in his address: “Even the application of the most assured principles is not always easy, because the contrast between opposing requirements obscures our imperfect vision and, consequently, the perception of absolute values which do not depend on our vision or our sensibility.”