Thursday 25 November 2010

'Vital-Organ Transplants' - 'Brain Stem Death' conceptually suspect and clinically dangerous'


                              Saint Panteleimon the Hermit (284 - 304)   

Recently in the Orcadian, our weekly local newspaper, the Scottish Executive published a large advertisement  promoting the human ‘organ donor’ scheme, and asking for more donors, ‘prepared to give the gift of life to others’. In the same paper, NHS Orkney published a half-page article endorsing its support for the Scottish Executive in promoting the scheme, and also asking for new donors, who could be as young as 13 years of age.  Both these items also mentioned that as there were insufficient donors to meet demand, a system of ‘presumed consent’ was being considered, whereby consent would be presumed for everyone unless there was clear evidence in writing to the contrary.

On reading these articles I was reminded that the question of ‘presumed consent’ had raised its head about three years ago, when the Prime Minister of the day, Gordon Brown, had suggested that this might be a suitable means of increasing the supply of usable human organs for transplant purposes. I remembered that at that time I was concerned about the ethics of organ transplants, and particularly so when it came to ‘presumed consent’, and I hasten to add that I am now even more concerned.


                                      Saint Luke - Guercino (1591-1666)

 I must say straight away that I am not any sort of doctor or medical person, and that my sole claim to fame is a First Aid certificate acquired nearly 50 years ago! However it is possible to glean considerable information from professional and trustworthy sources through official websites, which when balanced with the Church’s pronouncements on the subject, and mixed with a portion of common sense, enables one, I think, to have a reasonably balanced  view of the matter. I hasten to add that I have great sympathy for the sick, and I have generally great respect for the medical profession, and admiration for the continuing advancement in medical knowledge and technology when used ethically and morally for the good of humanity.

 As far as this post is concerned, it is necessary to make the distinction between   ‘transplants of vital organs, such as the heart, lungs and liver’, and  ‘transplants of lesser organs, tissues, and body parts’, and I must emphasise that  this post is only concerned with the former category, for it is in these cases that vital organs are removed from a live donor.

When this matter arose three years ago, I sent an email to the Guild of Catholic Doctors, requesting information on the nature and ethics of ‘organ transplants’ - particularly in relation to  the teaching of the Catholic Church,  to which I received the following reply;
  

From:  Guild of Catholic Doctors
To: Brian Crowe
 Sent: Thursday, January 10, 2008 8:17 PM
Subject: Re: organ transplants

Some organs are taken from very recently dead patients.  Most are taken from was is termed 'heart beating donors'.  These are donors who have been declared medically 'brain dead' and are kept 'alive' on life support machines until the organs are taken.  Obviously there is then the discussion to be had on what is the definition of death.  I am not sure which articles you have been reading but we have published some divergent views on this.  
 
The Church has not ruled on this.  In most matters the church, quite rightly, clearly lays down the moral principles, but then bows to science on technical matters, which are the remit of science. There is never conflict between truth, so if the science is valid and true (in the sense of being in agreement with the moral truth), the church will accept it. (See Pope John Paul II in his encyclical 'Faith & Reason')  In the 'old' days it was easy to tell when someone died - their heart stopped.  With modern science that is no longer a valid criterion for death as it is possible to get the heart going again and keep organs alive (including a removed heart, which continues beating) for some considerable time after what was previosly defined as death.  Para 2296 of the Catholic Catechism supports the principle of organ donation and also laying down the moral principles.  A significant number of our membership are transplant surgeons and physicians.
 
It is possible to remove one of the two kidneys from a healthy living donor, and now with surgical advances it is possible to remove half a liver from a healthy living donor.  The half left in the patient will regenerate to its normal size with a short period as will the half that is put into the new recepient.
 
I hope that helps
 
Signed Dr. ……………….
 

           
I was grateful for this reply but in truth, it raised as many questions as it answered. I followed this up at the time with an email to a certain member of the Scottish hierarchy, but received no reply. It may well be that my message failed to reach the intended recipient, but whatever the reason I heard nothing, and the matter receded into my mental 'in-tray' where it has since remained. It was only the recent publicity in the ‘Orcadian’ that reminded me of this outstanding correspondence, and persuaded me to look again at the details.




       Christ Raising Lazarus from the Dead - Studio of Tintoretto (1518-1594)

Reading the original reply from the Guild of Catholic Doctors, it appears that Catholic doctors themselves hold divergent views on the morality of organ transplants, a divergence based primarily on the question of ‘point of death’.  As I understand it, the crucial factor is that for a ‘vital organ’ transplant to have a chance of succeeding, the vital organs  viz. heart, lungs or liver,  have to be removed whilst the donor is still alive.  Inevitably in the process, the donor will die. Clearly to deliberately and knowingly cause the death of a donor by removing his/her vital organs for transplant purposes, is ‘murder’ and must be wrong. 

It seems that over recent years, medical science has defined (some say invented) an hitherto undocumented human condition, now defined as ‘brain death’ or/and ‘brain stem death’.  Surprisingly, or perhaps not, it is at this stage that vital organs such as the heart, lungs, and liver, are removed from a donor. For some doctors, the ‘brain death’ or ‘brain stem death’ diagnosis legitimises the  removal of vital organs from  donors, although many other doctors do not share this view. I find this seriously disturbing, and wanting to find out more, recently visited several websites dealing with this subject.
                
                                   ****************

Assuming that what I have found is truthful, and I have no reason to doubt it, the reality is shocking and worse than I could have believed. One particular site, that of Dr Paul A Byrne MD, past President of the Catholic Medical Association (USA), is totally condemnatory of so-called ‘brain death’,  which he describes as a cynical ploy to deceive; he also condemns ‘organ transplants’, which effectively destroy the life of the donor, because to be usable, organs have to be removed from a live person, who then dies as a direct result. Another site ‘The Life Guardian Foundation' (www.thelifeguardian.org)  incorporates much information on this subject, including a frank article by Dr Byrne MD in which his logic and conclusions appear indisputable. This website also includes an harrowing account of the devastating experience of a mother in the USA, whose 18/19 year old son accidentally shot himself in the head, and was taken to hospital where, in spite of positive medical  prognosis, it appeared that little real effort was made to save him. Instead, after various  medical 'procedures', he was certified ‘brain dead’ and his vital organs were then removed. It transpired that at some time in his short life, the young man had altruistically agreed to be a donor, which apparently was known to the hospital authority when he was admitted.
                                               
                                               ******

Below is a short extract from the Life Guardian website:-


 'CRITICAL INFORMATION CONCERNING "BRAIN DEATH" AND ORGAN TRANSPLANTATION'
 
For over forty years there has been a deadly code of silence pertaining to "brain death." Behind closed doors a controversy raged. Many of those in the medical field opposed this reinvention of death. The controversy continues.              
             "Brain death" was invented for the sole purpose of organ transplantation, living human medical experimentation, and a means in which measures to sustain life could be legally withdrawn. It was the first legal form of euthanasia in the US. This deadly code of silence has been broken.
               It is time to inform the Public of the Truth... (end of quote)
                             
                               **********************
 

                      The Anatomy Lesson - Rembrandt (1606-1669)

In the UK the Royal College of Physicians reported in 1976 and 1977, rejecting the whole ‘brain death’ criterion as scientifically worthless, and adopting the notion of 'irreversible brain stem dysfunction' as an indicator of death.
                                                 BUT
‘The UK ‘brain stem death’ standard for the diagnosis of death on neurological grounds ignores evidence of persisting life and function in other parts of the brain, and has never been accepted in the USA – where the irreversible cessation of function of the entire brain, specifically including the brain stem (‘whole brain death’), is required'. The US President’s Council on Bioethics has recently described the UK standard as “conceptually suspect” and “clinically dangerous”.(Wikipedia -  Controversies in the Determination of Death : a White Paper by the President's Council on Bioethics. Washington, DC December 2008. www.bioethics.gov)
          
                                    ***************
 ‘Organ donation’ is big business on a world-wide scale. Would-be recipients pay sometimes huge sums of money for organ transplants.  Donors, often from poor communities in the Third World, are driven by desperate financial need, to sell kidneys and lesser organs, for pitifully meagre sums of money. Although these  body parts are not in the donor 'category' that we are considering, one can appreciate the substantially higher  'market value' of vital organs, and the temptation to find donors at whatever cost, financial or moral.
‘Big business’ means big money, and we know that ‘money is the root of all evil’- no idle saying.  Regrettably but almost inevitably, where there is big business there is  corruption.
 

In many European countries, everybody is automatically considered to be an organ donor unless there is evidence to the contrary in writing. This principle of 'presumed consent' is being actively promoted in those countries in which it is not yet enshrined in law, which includes the UK.
I suspect that the European Parliament in Brussels, with its record of  anti-life legislation, and its own liberal and humanist agenda,  has much to do with the almost 'pro-active' promotion of this scheme, which appears so laudable and yet is shrouded by misinformation and suspicion of deception.

Of course it is right to remember the many principled, selfless,  and caring doctors and nurses, who take a stand against un-ethical practices, who honour and dignify their profession, and whose priority is always the good and well-being of their patients.


                                             The Pieta - Luis de Morales (1509-1586)

The evil of ‘vital organ transplants’, based on the premise that it is essentially murder to remove 'vital organs' from a live donor who will inevitably die as a result, in order that these organs be transplanted into a recipient to keep them alive, seems clear on rational and common-sense grounds alone. With regard to the condition of 'brain death' or 'brain stem death' - used to justify the morality of 'vital organ transplants', how can it be possible for a person to be alive and dead at the same time, or to be partly dead? It is like squaring the circle, an impossibility. At any one time we are either alive or we are dead, there is no in-between stage.  Please see the website of Dr Paul A Byrne MD, who writes so clearly and authoritatively on this and other related matters. 


http://www.renewamerica.com/columns/byrne 
          

St Thomas Aquinas (1225-1274) - philosopher and theologian            

With increasing pressure from local and government organisations, the ‘organ donor’ scheme is insidiously worming its way into the ‘things we ought to be doing’ charts. I doubt that many donors are aware of the full implications of their decision, particularly if the donor is a child of only 13 years of age. This appears particularly likely when considering the simple, and some might say inspired, design of the on-line donor application form (see below) which not only fails to differentiate between 'vital organs' and 'other organs and tissue', but in 'Section A' lumps them all together as one.
 
      St Philip Benizi(1233-1285)-Superior of the Servite Order.

When visiting the ‘NHS blood and tissue’ website, I found the ‘on-line’ application form  for potential organ donors, a copy of which I have pasted below:-
                                 
THE ON-LINE APPLICATION FORM FOR ORGAN DONOR
I want to donate the following for transplantation after my death:
A  any of my organs and tissue
                    OR
B  my
 kidneys   heart   liver   small  bowel
 eyes   lungs   pancreas   tissue

The first significant point of note is in the first line, namely the words  ‘after my death’; and the next point is the inclusion of heart, liver, and lungs, each with its own tick-box, in Section B below.
It is inconceivable that the wording ‘after my death’ is a mistake, or that the ‘heart’, ‘liver’ and ‘lungs’ have been included by mistake. But we know from eminent medical authorities, that these particular vital organs can only be usable if taken from a live donor, they are useless if taken from a donor already dead

 The question has to be asked:-                 
 ‘How can the NHS  invite potential donors to donate their heart, liver, or lungs, after their death, when  to be usable, they have to be removed before they die?’ 

Theoretically the relevant reply would seem to be that death is officially recognised when  ‘brain cell death’ is confirmed, legitimising the removal of vital organs, whilst at the same time ensuring that the heart remains beating and the body still functions, until such time as the vital organs are physically separated from the body, when the body then dies (as understood in pre 'brain cell death' days!) Although of course, it was already dead, wasn't it?

Some might well think that the wording used in the donor application form is seriously misleading, and represents justifiable grounds for accusing the NHS donor authorities of gross misrepresentation. There certainly appears a case to answer!  


    Saint Giuseppe Moscate (1880-1927)- Italian doctor and scientist

We know that many doctors and other medical and scientific experts, including the US President’s Council on Bio-Ethics (see above), do not accept the UK criteria for ‘brain cell death’, the latter describing it as ‘conceptually suspect and clinically dangerous’. Yet it is used today in the UK presumably with the backing of  powerful influences in the medical and scientific world, apparently without any effective public criticism or suggested action.
                                 
 
        Saint Martin de Porres (1579-1639) - Dominican Lay Brother

 There is a particular drive to increase the numbers of young ‘organ donors’, as apparently young organs are more likely to be successfully transplanted than those from older donors. During September and October this year, the ‘Organ-donor’ road-show visited 14 University campuses in the UK, using the ‘Superhero’ theme, with the addition of a female companion.’ and obtained a total of  5,472  new signatories.
 .

                  Blessed Niels Stensen (1638-86) -anatomical scientist
                                                                                        
Even as I write, I get the feeling that I will be accused of meddling in medical matters, which are not my business.
Yet it is my business as it is everyone's business, for it is my life or my wife's life or my children's lives or anybody's life that could be at risk. To me there appear genuine grounds for suspecting that all is not quite what it seems, and that fine words disguise the shadow of evil. I'm sure that there is good will and intention in many people involved in the ‘donor scheme’, but there are others perhaps who have their own agenda;  ambition, money, career, social advancement, or whatever, who are prepared to go along with the evil principle that 'the end justifies the means'. We know that deception is an art in which Satan, the master of all deceit, excels, especially so in matters of life and death.

We pray for loud and authoritative guidance on this matter from our Church, and ask that it will be sooner rather than later.
                 
                        Our Lady of Good Counsel of Genazzano

‘Our Lady of Good Counsel, pray for us, and guide and protect our Holy Father, Pope Benedict XVI’
‘Saints Cosmas and Damien, pray for us’