Catholic World News News Feature

Vatican battle looms on 'brain death' September 05, 2008

Probing a front-page article in the official Vatican newspaper that questioned the medical determination of 'brain death," secular journalists have uncovered a lively internal debate on that topic among Church leaders.

When Lucretta Scaraffia published a lively critique of the 'brain death' diagnosis in L'Osservatore Romano (see CWN's September 3 News Plus coverage), several journalists immediately recognized the importance of the debate.

If 'brain death' is not to be considered real death, virtually all transplants of vital organs would be morally illicit, since these organs are invariably taken from 'brain dead' donors. (When death is judged by traditional standards, the organs have already deteriorated enough to be unsuitable for transplantation.) The Church has clearly and repeatedly endorsed organ donation-- several reporters noted that Pope Benedict himself carries an organ-donor card-- and transplants are done at countless Catholic hospitals. So the stakes in this debate are very high.

The president of the Italian Association of Organ Donors, Vicenzo Passarelli, told La Repubblica that anyone who questions the concept of 'brain death' is undermining the entire basis for vital-organ transplants. A philosophical debate on what constitutes "death" may be theoretically interesting, Passarelli said, but "no one doubts the value of brain death in allowing transplants to take place."

Exactly. If 'brain death' is not recognized as real death-- if the patients are still alive-- then the removal of their vital organs will kill them. Without 'brain death,' transplants of vital organs (as opposed to paired organs such as kidneys or lungs) would be impossible-- unless doctors were willing to take the morally fatal step of saying that some lives must be ended in order that other lives may be saved.

So where do we stand if vital-organ transplants are morally acceptable, but the only feasible means of performing those operations is morally objectionable? That is the question raised by L'Osservatore Romano.

Although the concept of 'brain death' has gained widespread acceptance since it was first introduced 40 years ago, the debate inside the Vatican has become increasingly heated. The evidence of that debate-- which has been conducted almost exclusively behind closed doors-- became unmistakable with the publication of Lucretta Scaraffia's signed essay.

Father Federico Lombardi, the director of the Vatican press office, told reporters that Scaraffia's opinions were her own, and the official Church teaching had not changed. That was one vote for the status quo, and acceptance of brain death. But Cardinal Javier Lozano Barragan, the president of the Pontifical Council for Health Care, was quoted by the Daily Telegraph as saying that he agreed "completely" with Scaraffia's analysis: one vote for the other side.

The Pontifical Academy of Sciences has taken up the debate on three separate occasions, and each time endorsed recognition of 'brain death' are a valid definition of death. But those debates have become increasingly contentious-- so contentious, in fact, that the Pontifical Academy suppressed publication of several essays voicing concerns about the concept. Those essays have now been compiled into book form-- over strenuous opposition from some Vatican officials-- in a book entitled Finis Vitae, published in Italy and eventually translated into English. The book will soon be available on the US market.

The 'brain death' debate will be renewed in Rome this fall. The article in L'Osservatore Romano was the first volley of a new-- and perhaps even more heated -- battle.