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| Death: Our Birth into Eternal life
Fr. Joseph Baker |
The following article is the next installment in a series that will appear in the Catholic Herald to offer catechesis and formation concerning end-of-life decisions, dying, death, funerals, and burial of the dead from the Catholic perspective.
An ever-emerging issue at the end-of-life is organ donation and the leaving of one’s body to “science.” Since the first successful organ transplant in 1954, organ donation and its morality have been an ongoing topic of discussion. While complex and nuanced, a general sketch of organ donation can be useful.
A major distinction is between living and non-living donors. Because they are still alive, living donors are limited as to what they can donate.
Living donors
Living donors can donate blood or plasma. They can also donate some organs such as one of two kidneys, one of two lobes of the liver, one of the two lungs, a part of the pancreas, or a part of the intestines.
Insofar as living donors are concerned, the key principle is that of functional integrity.
According to this principle, “The transplantation of organs from living donors is morally permissible when such a donation will not sacrifice or seriously impair any essential bodily function” (Ethical and Religious Directives, 30). The donor cannot suffer substantial permanent harm to his or her own functionality.
Besides the integrity of bodily function, the psychological impact on the donor must be considered. There are not only physical risks but also psychological dangers in organ donation.
As the Catechism points out, “Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient” (CCC, 2296).
Especially when one knows the recipient, the pressure of an organ transplant may cause severe psychological distress. Even more so if the transplant fails and the organ is rejected by the recipient’s immune system.
Particularly at the end-of-life, non-living organ donation comes into focus. Since Pope Pius XII’s first statement about non-living organ donation in 1956, the Church has consistently and repeatedly permitted and lauded organ donation after death.
Organ donation after death
As the Catechism reaffirms, “Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity” (CCC, 2296). Along these lines, Pope John Paul II points to organ donation as a particularly praiseworthy action which helps to build up the culture of life.
“A particularly praiseworthy example . . . is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope” (Evangelium vitae, 86).
One of the most challenging aspects of non-living organ donation is the determination of death since a person must be declared dead before they can become a donor. While death is understood as the separation of the soul from the body, judging when this has, in fact, happened can be difficult. As reaffirmed by several popes, the specific task of determining that a person has died is not a question of philosophy or theology but lies within the competence of medical doctors and scientific knowledge.
Historically, the loss of one’s heartbeat (i.e., a circulatory determination of death) was the norm for declaring someone dead. While this usually sufficed, the introduction of resuscitation techniques allowed for the artificial continuation of respiratory and cardiocirculatory function much longer than ever before.
Brain death
As a result, in 1968 Dr. Henry Beecher from Harvard Medical School introduced the idea of “brain death.” While not uncontroversial, in 1994 the Pontifical Academy of Sciences recognized the permanent loss of brain functioning (i.e., a neurological determination of death) as an acceptable indicator of death.
In particular, those who are declared “brain dead” are ideal organ donors, because, as long as cardiopulmonary support is provided, their organs are easily preserved.
Similar to non-living organ donation, individuals may desire to donate their body to science after death. According to the Catechism, “Autopsies can be morally permitted for . . . scientific research” (CCC, 2301). The use of cadavers is important for medical training and ongoing research.
Echoing the Catechism, the United States Conference of Catholic Bishops (USCCB) states that “those who wish to do so may arrange for the donation of their organs and bodily tissue, for ethically legitimate purposes, so that they may be used for . . . research after death” (Ethical and Religious Directives, 63).
Rather than treating one’s body as a commodity, this donation must always be a free gift. As long as one is motivated by service to fellow human beings and not by financial gain, donating one’s body to “science” is a great act of solidarity.
Practically, there are a few important points to consider. First, it is prudent to inform one’s family members and loved ones ahead of time about the intention to make such a donation. Family members wanting closure could be devastated if they were caught off guard and denied the ability to see their loved one’s remains.
Second, even though a Mass of Christian Burial (i.e., a “funeral” Mass) cannot be held, arrangements should be made for a Memorial Mass to be celebrated.
Praying for the dead is an important spiritual work of mercy. Third, one’s legal documents should require that, once research is finished, the body be returned (often sent as cremated remains) so that an appropriate interment can follow.
As Damian Lenshek has reinforced in his articles, the bodies of the dead must be treated with respect and charity, with faith and hope in the Resurrection. This holds true even for those who donate their body to “science.”
Donating all or part of one’s body after death is not an easy decision. Those deliberating such a donation should become well informed about their decision and make appropriate plans ahead of time.
As a heroic act of charity, no one is required to become an organ donor. Nevertheless, as Pope John Paul II wrote in a 2000 address, “There is a need to instill in people’s hearts, especially in the hearts of the young, a genuine and deep appreciation of the need for brotherly love, a love that can find expression in the decision to become an organ donor.”
The donation of organs at the end-of-life offers the gift of health and life to those who are most in need and those who may be without hope. Indeed, making an informed decision to be an organ donor is one of the most powerful ways we can demonstrate love of neighbor.
Sts. Cosmas and Damian, patrons of surgeons and physicians, pray for us!
Fr. Joseph Baker is the ethicist for the Diocese of Madison and the pastor of Blessed Trinity Parish in Dane and Lodi.