Vatican in "Firestorm" over Brian Death Criteria for Organ Transplants

By Hilary White ROME, November 24, 2008 ( ) - Dispute within the Vatican on the approval of so-called “brain death” criteria for organ transplants remains sharp, according to a senior Vatican correspondent. Sandro Magister, a leading Italian journalist and expert on the Vatican,…

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IMHO, if the Vatican recognizes Brain Death as true death, it should also recognize brain emergence as the true beginning of human personhood (i.e. not fertilization). It makes no sense for the loss of brain function to indicate the absence of the soul (separation of the soul from the body) without the presence of brain function indication the presence of the soul (unity between a soul and body).

I don’t think it said that brain death was “true death,” it is just the prudential point where there is enough certainty of death, that one will not be taken from a person who is able to continue to live. As for the beginning of life, there is no real extraordinary means needed to keep the child alive. Ordinary life in the womb for a embryo and fetus is capable of sustaining life, even if a considerable number may not make it to term.

Just, because you come up with that reasoning, does not mean that it is the reasoning the Church has come up with follows that logic. Your reasoning may not refute the Church’s argument.

If I am understanding you right, then I don’t think that’s correct (the brain death part)

To what does the expression “brain death” refer?

“Brain death” refers to the medical judgment that a person is dead by using “neurological criteria”. Properly diagnosed, “brain death” refers to the complete cessation of all organized neurological activity throughout the entire brain, including the cerebrum, cerebellum, and brain stem. At this point, the body irrevocably ceases to function as a unified whole. The appropriate Phraseology here is “the determination of death using neurological criteria.”

Is it appropriate to use neurological criteria to determine death?

The customary criteria for determining death are “cardio-pulmonary,” i.e., death is declared after breathing and heart-beat cease. Technological advancements in critical care, however, have made continued circulation and respiration possible through mechanical means even after brain function has ceased.

The use of neurological criteria for the determination of death is legitimate according to the Catholic Church. Pope John Paul II approved this approach in an address he gave to the 18th International Conference of Organ Transplant Specialists in August 2000. Neurological criteria consist of four key signs: coma or unresponsiveness, absence of cerebral motor responses to pain in all extremities, absence of brain stem reflexes, and apnea. Pope Pius XII and Pope John Paul II both said the Church has no competency in determining death; this properly belongs to medical science.

May I receive organs for transplant from those declared dead using neurological criteria?

Yes, a faithful Catholic may receive organs from a donor who is declared dead by neurological criteria. A faithful Catholic may also make provisions for the donation of his own organs in the event of his death whether it is determined by cardio-pulmonary or neurological criteria.

Why does the use of neurological criteria remain controversial?

As mentioned above, when a person suffers total loss of brain function, the heart may continue to beat with the assistance of mechanical ventilatory support. In such cases, this artificial support may cause the victim to appear alive visually and to the touch. Medical evidence, indicated by the four signs listed above, shows that this is not the case. In short, there is no reason for controversy. The use of neurological criteria makes certain that life has ceased.

Why does the Church accept this definition of death?

This is not a new definition of death but rather of the use of new signs to determine that death has occurred. The Christian understanding of death has always been that it is the separation of the soul from the body. The Catholic Church looks to the medical community to determine the biological signs that indicate with moral certainty that this event has already occurred. In recent years, medical research has indicated that the irreversible loss of brain function provides a firm indicator that death has already occurred.

What does Catholic theology say about this definition of death?

Neurological criteria are compatible with Catholic teaching that a human being is a substantial union of body and rational soul. When all brain function is completely and irreversibly lost, this may be taken as a reasonable indicator that the rational soul is no longer present.

Does the use of “brain death” criteria cause the death of the patient?

The use of brain death criteria does not cause the death of the patient, but only assesses whether that death has already occurred. This is analogous to the way that cessation of heartbeat and respiration have traditionally been used to make that assessment.

Why do some say that taking organs from those declared dead by neurological criteria is a form of homicide?

Such comments are irresponsible. Those who make such statements wrongly believe that a person is still alive because the corpse appears to be alive from the effect of oxygenated blood continuing to be pumped through the body by mechanical means. Those who reject the use of neurological criteria for the determination of death claim that a patient declared dead by this method is killed for his organs. Such comments overlook the important distinctions mentioned above, and are in tension with sound Catholic teaching.

In medical practice, a physician who is not on the organ transplant team must declare death to avoid any potential conflict of interest. However, it must be emphasized, that the neurological criteria must be rigorously and consistently applied and a judgment made of total brain death before a person is declared dead.

How does the media add to the confusion over this matter?

The media is often imprecise in the way that they say that a patient who is brain dead “had life support removed, and died.” Obviously, one who is dead cannot die again. Reporting such as this shows a careless imprecision in the use of language and a general ignorance about neurological criteria for ascertaining death.


I don’t think your argument has merit. If complete brain death indicates with reasonable moral certitude the absence of life,** it does not follow** that a living organism which has not **yet **developed brain structures is therefore not alive.

As an example, a corpse doesn’t breathe, and prolonged absence of respiration is good evidence of death. But a fetal child also does not breathe for a prolonged period, but is manifestly alive.

The difference between brain death and brain emergence is that after brain death, no brain will emerge; whereas before brain emergence, a brain will emerge.

The principle which accounts for the future emergence of the brain is life*.


Well I think my arguement still holds. Granted, it doesn’t do a good job of refuting your arguement, other than to say, they’re different circumstances and may not have commensurate reasonings.

Your analogy is wrong b/c the evidence is the fetal child is consuming oxygen. Without oxygen it would die. Many grown people consume oxygen in unusual ways and they are still alive too.

And what follows would not be moral certitude of absence of life versus absolute certitude of absence of life but moral on both sides of the time line. It wasn’t crystal clear in what you wrote :slight_smile:

The difference between brain death and brain emergence is that after brain death, no brain will emerge; whereas before brain emergence, a brain will emerge.

Brain death is loss of activity in specific areas of the brain. Very rarely, normal activity is restored after brain death. This tells me that brain death is NOT a valid criteria for a definition of death theologically contrary to the bioethics center. I think what needs to change or evolve is not the definition of death but the idea that taking a life is always and everywhere wrong. We already have exceptions for self-defense, capital punishment, and war. As the world changes and science uncovers new things previously not imagined, our theology needs to change too. I believe brain death is NOT true death. However if the patient has consented, I believe it is not murder (unjustified homicide) to use his body for organ donation. In end of life issues also, we should take into account health care costs. It is also hypocrisy to insist a hospital must artificially indefinitely feed a person while not insisting that people have a duty to feed the hungry with all their disposable income. Living High Letting Die makes the argument that we should do precisely that (I have not read the book). But IMO, neither is a duty.

I do happen to believe some form of brain emergence is the beginning of the presence of a human person – which is a THEOLOGICAL category, not the modern biology which takes God out of the equation and considers man to be just another animal species. And it’d be convenient to accept brain death as true death and argue that that means brain emergence of some kind is true human personhood – but as I said I cannot accept brain death is true death theologically when it has been EMPIRCALLY proven false by the rare cases. These were not some divinely caused resurrections. These are just yet unexplained events – meaning brain death is a sham IMO. Not that everyone who buys into it knows it is a sham, but IMO some are spreading the idea to encourage organ donations – a noble goal, one I support, but not by the means of what are in my opinion, falsehoods.

Thank Goodness I read the link :slight_smile: From the thread title I thought the Vatican had a new policy for eliminating Brians :smiley:

That doesn’t harm the analogy – I was speaking of breathing.

Exactly! Then you admit that the fetal child is alive, because it needs oxygen, but as yet has not developed brain function. So, again, I say your original argument is unsound.

The difference in brain activity between a fetal child and a truly dead corpse is that in a fetal child, if all goes normally, brain activity will develop, whereas in a brain dead corpse, if it is truly brain dead, **no brain activity is ever possible.

Not according to my understanding. If normal activity is restored it wasn’t brain death. Brain death, if it be true brain death, is irreversible.

That is a different topic. I took issue with your argument that brain emergence should indicate the union of body and soul, just as brain death indicates their separation. If the fetal child will develop a brain, it is manifestly alive, and therefore has a living body. All living bodies have souls.

It is fine if you don’t accept brain death as a valid criteria for the death of a person. But your reasoning that *if *one were to accept brain death as the criteria for death that one must accept brain emergence as the criteria for life is flawed, and I hope I have shown why.


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