By Daniel Payne
CNA Staff, Nov 5, 2024 / 08:00 am
A recent news report out of Kentucky revealed a slim but pointed risk regarding organ donation, one that underscores a key Church teaching about how the process of gifting one’s organs must play out.
Congressional testimony in September revealed a 2021 incident in which a man named TJ Hoover was declared brain dead and a medical team was assembled to harvest his organs. In the operating room, however, Hoover was found to still be alive. Multiple medical officials quit over what they described as a traumatic experience.
“Several of us that were employees needed to go to therapy,” one worker told National Public Radio. Government authorities are investigating the incident.
What does the Catholic Church say about organ donation?
The Catholic Church states that organ donation is an acceptable and even morally laudable practice. The Catechism of the Catholic Church says that organ transplants “are in conformity with the moral law,” though only “if the physical and psychological dangers and risks to the donor are proportionate to the good that is sought for the recipient” (No. 2296).
Organ donation after death, meanwhile, “is a noble and meritorious act and is to be encouraged as an expression of generous solidarity.” However, the circumstances around organ donation must be in line with Catholic moral teaching.
Joe Zalot, the director of education at the National Catholic Bioethics Center (NCBC), told CNA in an interview that St. John Paul II, Pope Benedict XVI, and Pope Francis have all spoken favorably about organ donation.
Francis has described it as an “expression of universal fraternity that binds all men and women,” while John Paul II described organ donation as “a genuine act of love.”
Zalot pointed out that there are really two types of organ donations.
“One is with a paired organ, like a kidney,” he said. “We have two kidneys. If my brother has kidney failure, and he needs a transplant, and I’m a match, so long as I consent, I can give him my kidney.”
The more prominent issue, he said, is the donation of vital organs, which by definition an individual cannot live without.
“The Church is okay with vital organ donation,” Zalot said. “But you have to have moral certainty that the person [giving the organs] is actually deceased.”
“The Church doesn’t say how exactly you do that. It’s a medical question,” Zalot said. “But you have to have moral certainty that the person has died in order to extract his or her vital organs.”
Debate over ‘brain death’
A prominent debate among both physicians and moral theologians is the classification of “brain death,” a medical designation that indicates complete loss of brain function, including the involuntary mechanisms by which the brain sustains life.
Brain death is a “very, very hot issue” among Catholic ethicists, Zalot said. New brain death guidelines issued last year by a major neurological society were criticized by more than 150 Catholic ethicists and theologians over concerns that patients might incorrectly be pronounced “brain dead” and subsequently have their organs removed while still alive.
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The U.S. Conference of Catholic Bishops (USCCB) and the NCBC, meanwhile, last year criticized a proposed rewriting of the definition of “brain death” by the Uniform Law Commission, arguing that the revision would “replace the standard of whole brain death with one of partial brain death,” thus broadening the criteria for organ harvesting.
The suggestion that “partial brain death is sufficient for vital organ retrieval” could dissuade individuals from becoming donors themselves, the groups argued.
The catechism further stipulates that it is “not morally admissible directly to bring about the disabling mutilation or death of a human being” for purposes of organ harvesting, “even in order to delay the death of other persons” (No. 2296).
The Catholic Church has taught for many centuries that the body will ultimately be resurrected in glorified form, mandating the respectful treatment of human remains after the soul has departed.
“When death occurs, you have the separation of soul and body,” Zalot said. “The body dies and the soul lives on. But we have a duty to treat the body with respect.”
Considerations in light of the resurrection of the body
One aspect of organ donation rich for theological consideration is how donating one’s organs upon death might be considered in light of the Catholic belief of the resurrection of the body.
Father Terrence Ehrman, CSC, a professor of systematic theology at the University of Notre Dame, told CNA the question ”points to the great mystery of the Resurrection.”
Asked how donating one’s organs might be considered in light of the ancient Catholic teaching of bodily resurrection, Ehrman noted that there’s “not much in Scripture and tradition about what actually a resurrected body is.”
“There’s very little we have about what this resurrected existence is like,” he admitted. But the Church teaches that “there is this connection with our bodies. They’re who we are, they’re not just a part of us.”
He noted that one’s body changes radically over one’s lifetime, though one is plainly still inhabiting the same body.
“What makes me the same person today that I was yesterday or 50 years ago?” he said. “I’m the same person. I’m the same identifiable organism. I have the same body in one sense. But it’s different in many ways.”
“The matter [making up a body] can be very different,” he said. But “the Church is clear that we’re going to be raised in the same body.”
Catholic theologians and philosophers have long debated questions of bodily integrity and continuity, such as if someone is buried at sea and is consumed by a fish, Ehrman noted.
But the “new reality” implied by bodily resurrection suggests that one’s unique, personal body will ultimately be made whole in some way, he said.
“I think the same thing applies to questions about organ donation,” he said. “Maybe we don’t need to think of it in the way that we get the same exact matter back. We rather get the same body back, one that’s identifiable as us.”
Zalot, meanwhile, said the Church’s proscriptions on organ donation are informed by its comprehensive teachings on the dignity of the human person and respect for the human body.
The faithful are still enjoined to respect the body even after organ donations have been performed, Zalot said.
Organ donation is “a great gift,” he said. “But after a person is a vital organ donor — once the heart or other organs are removed — the same rule applies, treating the body with respect.”
