Hey, Father! Is organ donation OK?

I have long thought organ donation was a loving and humane service to those in medical need. I have my desire to be an organ donor on my current license. Lately, I’ve been learning that organs cannot be extracted from anyone unless they are still alive. Also, declaring someone brain dead is a slippery slope because brain dead individuals might recover. This could mean killing one person to save another. What is the Catholic Church’s position on organ donation? Is it ethical according to Church teaching?

– Nancy in Springfield

The Church not only regards organ donation as ethical but calls it “a noble and meritorious act and is to be encouraged as an expression of generous solidarity” (Catechism of the Catholic Church, n. 2296). In the year 2000, Pope Saint John Paul II gave an address in which he called organ donation “a genuine act of love” (Address to the 18th International Congress of the Transplantation Society). In your question, however, you raise legitimate concerns about the circumstances of organ donation which can indeed affect its moral legitimacy. Here is a summary of a few important criteria that should help to clarify the matter.

First, there are two basic kinds of organ donation: living donation and cadaver donation. In a living donation, as the name suggests, the donor is alive and donates some non-essential organ or portion of tissue. Common examples of living organ donations are kidneys and segments of the liver. Blood and bone marrow are also living tissue donations. The Church always approves and commends these living donations, provided the donor understands the procedure and freely consents to it. Cadaver donations are given after death and usually involve vital organs such as the heart, lungs, and liver. These donations are morally permissible provided that two criteria are met: 1) the patient or family must give free and informed consent to the organ procurement; 2) the patient must be deceased when vital organs are removed.

The second criterion of death is usually the debated point. When exactly should a person be declared dead? This question is especially relevant in the case of organ donation, as most organs can only be preserved outside of the body for a period of hours. The primary biological indicators used to determine death are cardiac death and brain death. Brain death has been the dominant indicator used in modern medicine for decades. Brain death is defined as the irreversible and complete loss of function in the whole brain. Using brain death to define death can lead to situations in which a person appears to be “alive” by other criteria, for example, continued heart and circulatory function with the use of a ventilator. In most cases, however, this is an artificially produced state of prolonged organ function that only resembles being “alive” in the proper sense of the word. There are difficult cases in which the recovery of brain function, while statistically very unlikely, is theoretically possible. Such cases are very technical and often debated.

The Church does not claim the competency to make judgements about complex biological and neurological criteria. In the same address cited above, Pope Saint John Paul II said that “the Church does not make technical decisions” regarding such criteria. The human person is not reducible to material processes and death likewise is not merely a physical event but the disintegration of body and soul. Thus, no one can determine the precise moment of death, scientifically or spiritually. The Church’s concern is to safeguard human dignity at every stage of life and condition, including during sickness and the dying process. Therefore, all that is needed for vital organ donation to proceed legitimately is “moral certainty” that the person is deceased based on the best biological indicators available. Moral certainty is not perfect or mathematical, but it is sufficient and necessary to make reasonable choices. Once this certainty is obtained—and again, with informed consent provided—organs may be ethically procured.

To clarify, one may never directly end the life of one person (the donor) in order to extend or improve the life of another (the recipient). However, the use of artificial life support, which keeps blood oxygenated and circulating even after brain death, is not morally obligatory. Therefore, one may remove this life support and allow death to occur, at which point organs can be removed. Also, one may delay the removal of such organ-sustaining life support so that the organ recipient can receive the organ or organs as quickly as possible. Allowing death to occur by the removal of extraordinary (non-obligatory) means of care is not killing the person, even though death may follow the removal of this care almost immediately.

Catholics should prayerfully consider organ donation as “a genuine act of love.”  Many resources are available for those who have further questions. Because we as human beings are a unity of body and soul, organ donation “is not just a matter of giving away something that belongs to us but of giving something of ourselves” (John Paul II, ibid). In a way, Christ himself gave us a beautiful example of this by giving us his own Body and Blood in the Eucharist. And in the end, we have his promise of bodily resurrection, which will restore and glorify all that was lost.

Father Christopher Trummer, S.T.L, is parochial vicar at St. Agnes Parish in Springfield, associate delegate for Health Care Professionals, associate chaplain of the Springfield Chapter of the Catholic Physicians Guild/Catholic Medical Association and has a license in Sacred Theology in Moral Theology at the Pontifical University of the Holy Cross in Rome, Italy.