Protecting Life and the Gift of Donation: Organ Donation Inquiry

The current Victorian Parliamentary Inquiry into the “Options and Mechanisms to Increase Organ Donation in Victoria” has been seeking submissions to inform its investigation of ethical, community and legal measures which will assist in increasing the rates and efficiency of organ donation in the State.

It is worth noting that there seem to be deep emotional and ethical concerns which prevent Australians, many of whom approve of organ donation in theory, from agreeing to donation for themselves or their deceased family members.

The Catholic moral teaching and theology, particularly since Pope John Paul II articulated his great “theology of the body” teachings, has a special concern for the representation, treatment and protection of the human body. It is in the light of this reverence for the body, that Servant of God John Paul II also said that ethically conducted organ donation could be a uniquely noble act since it: “is not just a matter of giving away something that belongs to us but of giving something of ourselves…” (Address to the Congress on Organ Transplantation, 2000).

In Catholic teaching, the human body is a “sacred site.” It has a sacramental quality in the living person and serves as a “memorial” of the person after death. That is why Catholic liturgy and prayer has such a long tradition of consecrating tombs and burial grounds, of prayers around coffins, of honouring the relics of saints and of blessing the deceased body.

That is also why the Church further insists that all citizens (whether medical professionals or members of the public) should be vigilant that two crucial ethical aspects of organ retrieval and donation be protected, developed and promoted legislatively, organisationally and culturally.
The cornerstone is the inherent dignity and integrity of each and every human life—whether that of the organ donor or the would-be recipient. Resting on this is the second and fragile good which is that organ donation is and must remain a voluntary, generous and personal gift of “the body” from the donor to the recipient.

The first moral issue is that vital organs can only be removed for transplantation once the death of the patient has been reliably and “irreversibly” diagnosed. It is also important that the family of the deceased be able to “see” and sense that this is not simply an abstract or nominal benchmark. There is a danger that medical teams and laws will give into the strong pressure to increase organ supplies, lowering the bar on the determination of death.

The Church supports the current legal definition of death which rests upon the final loss of heart beat and subsequent circulation or upon criteria which determines the loss of TOTAL brain activity (and therefore indicates the irreversible loss of integration in the life and body of the person).

In contrast to this, some doctors and philosophers are arguing that a permanent loss of consciousness or severe upper brain damage should qualify as a bench mark for "personal" or "social" death of the patient, even though the patient is alive in every other physical sense of the word. This is alarming.

Catholic reverence for the body in relation to organ donation is similar to the Catholic emphasis on the importance of reverence, commitment and “informed consent” in relation to sexual giving of the body.

Pope Benedict XVI suggested this link in his address to the International Congress of Organ Transplantation (7th November, 2008) saying: “informed consent is a precondition of freedom so that the transplant can be characterized as being a gift and not interpreted as a coercive or abusive act.”

A Catholic ethical position would oppose any system or culture which assumed that organs could be “taken”, punitively removed (as occurs in some cases with Chinese political prisoners) or which obtains organs by offering undue commercial or social incentives. Organs should not be treated as commodities. Pope Benedict XVI was very clear at the 2008 Congress: “The possibility of organ sales, as well as the adoption of discriminatory and utilitarian criteria, would greatly clash with the underlying meaning of the gift that would place it out of consideration, qualifying it as a morally illicit act”.

It is interesting to note that the country with the highest rate of organ donation for both living and dead donors is Spain In that country, the discussion of organ donation takes place at a time remote from the immediate grief and shock (such as occurs when considering donation with a traffic accident victim). Therefore people have time to become educated and informed about the way organ donation takes place. Sensitivity and respect are seen as crucial in the nation-wide co-ordination of the program. Spanish clinicians are careful not only to protect the traditional definition of death, but also to offer radiographic images which confirm visually the total loss of brain function to the families of the deceased.

On the other hand, watering down the ethical standards of truly free and well informed consent, of the determination of death or the “gift” nature inherent in such a life-saving donation will not only be destructive of the “culture of life” upon which medicine must be built, it will also create fear and distrust the very people who might be considering donation.

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