Reconsideration of ‘brain death’ criteria could affect ethics of organ donation

Boston, Mass., Aug 17, 2008 / 23:00 pm

An article in the New England Journal of Medicine (NEJM), questioning the criteria of “brain death” and “cardiac death” especially in relation to organ donation, could affect the validity of ethical arguments approving the practice of organ donation at a person’s apparent death.

The NEJM article’s authors, Harvard Medical School professor Dr. Robert D. Truog and National Institutes of Health bioethics department faculty member Dr. Franklin G. Miller, argue that “as an ethical requirement for organ donation, the dead donor rule has required unnecessary and unsupportable revisions of the definition of death,” LifeSiteNews.com reports.

Saying that the scientific literature does not support the criteria which consider “brain death” and “cardiac death” to be actual death, the authors argue that the donation of vital organs taken from living human beings should not be considered unethical.

“The uncomfortable conclusion to be drawn from this literature is that although it may be perfectly ethical to remove vital organs for transplantation from patients who satisfy the diagnostic criteria of brain death, the reason it is ethical cannot be that we are convinced they are really dead,” they write.

Drs. Troug and Miller suggest that ethical requirements of organ donation should not insist on dead donors but should consider organ donation “in terms of valid informed consent under the limited conditions of devastating neurologic injury.”

Unlike Troug and Miller, most moral ethicists consider the death of the donor as the event making it ethical to remove vital organs for transplant. They argue that removing vital organs from a living donor would constitute actively killing a person.

This is the generally accepted Catholic view.

In an August 29, 2000 address to the 18th International Congress of the Transplantation Society, Pope John Paul II emphasized that unpaired vital organs can be removed only after death, “from the body of someone who is certainly dead.”

Troug and Miller’s doubts about the ethical criteria used to justify organ donation have prompted some critics of organ donation to call for the cessation of the practice in Catholic hospitals.

“The setting out of these facts should by all rights lead to a cessation of complete removal of any vital organ at Catholic hospitals," said Dr. John Shea, a medical consultant to LifeSiteNews.com.