How could a human individual not be a human person?

[Ghosty1981]

I think that moral theologians are going to have to re-examine this matter closely. The Catechism says that organ donation after death is a noble and meritorious act. But then it apparently simply accepts implicitly the medical definition of “brain death” as actual death.

I agree. Clinical death is not the same as absolute biological death. The Church has so far accepted the clinical determinations of death without changing the philosophical and theological meanings of death. This is why I have to make the distinctions that I do, because the definitions of death are not the same.

I believe that this will be an area that requires more study and certainty as medical science progresses.

I wonder if potential organ donors who have given consent to organ donation have been fully informed that the organs will actually be harvested before they are dead.

In my state we can decide whether or not to be an organ donor when we get our driving license. I don’t recall any mention of what condition the person must be in before their organs are harvested. Clinical death is the legal requirement, but I doubt most people aside from medical professionals have a clear sense of what that means.

 

[o_mlly]

Now this isn’t some kind of dogmatic proclamation, and it may indeed be incorrect, but it remains the most explicit articulation of Church teaching on the matter.

I don’t think we disagree. Note that the pope said “does not seem to conflict” as it relates to the use of the “brain death” protocol. He does not affirm the technique but defers this technical determination to the medical community.

What follows in bold in your quotation from the pope giving moral certainty to the protocol begins with “Therefore” thus making all that follows dependent on the efficacy of the “brain dead” protocol, that is what the pope says “seems” to be true, to be, in fact, true. Evidence as posted earlier strongly suggests that “brain dead” is not, in fact, dead.

 

[Ghosty1981]

Evidence as posted earlier strongly suggests that “brain dead” is not, in fact, dead.

I would go even further and say that “brain dead” is most certainly not “dead” in the sense of the total cessation of vital activity. The body is certainly still alive after clinical death.

In fact, the normal process of dying is a vital process. Google “apoptosis” if you’re not familiar with it.

 

[o_mlly]

I think that moral theologians are going to have to re-examine this matter closely. The Catechism says that organ donation after death is a noble and meritorious act. But then it apparently simply accepts implicitly the medical definition of “brain death” as actual death.

I think a it will take a combination of scientist/theologian to move us forward. One such person is Fr. Nicanor Austriaco, OP.

 

[o_mlly]

I would go even further and say that “brain dead” is most certainly not “dead” in the sense of the total cessation of vital activity. The body is certainly still alive after clinical death.

In fact, the normal process of dying is a vital process. Google “apoptosis” if you’re not familiar with it.

I will go a step further. The person is possibly still alive after clinical death.

I think the scientists overuse adjectives for being dead, as if doing so establishes categories of death. Let the dead just be dead.

 

[Pup7]

No, that’s not how a vent works.

The vent actively expands the lungs. It doesn’t just “introduce oxygen”. Vents are fine tuned for pressure, lung volume, and rate of respiration, among other things. They don’t just send oxygen. It’s expanding the lungs for the patient on full life support.

We attempt to wean the patient from the vent over a series of days once it’s been determined the patient is going to have life support withdrawn due to brain death. If the patient has no spontaneous respiration, there is no brain stem activity. There can be spontaneous respiration, and cerebral death (meaning what we knew as the person - personality, conscious action, what makes you the living you, is no longer present). There cannot be spontaneous respiration with complete death of the brain stem.

 

[o_mlly]

No, that’s not how a vent works.

The vent actively expands the lungs. It doesn’t just “introduce oxygen”. Vents are fine tuned for pressure, lung volume, and rate of respiration, among other things. They don’t just send oxygen. It’s expanding the lungs for the patient on full life support.

We attempt to wean the patient from the vent over a series of days once it’s been determined the patient is going to have life support withdrawn due to brain death. If the patient has no spontaneous respiration, there is no brain stem activity.

I think the issue is not what the ventilator does but what the ventilator does not do.

Does the ventilator metabolize the oxygen? Does the ventilator cause cell respiration? Does the ventilator cause uniform growth, maintain blood pressure, enable the immune system?

There can be spontaneous respiration, and cerebral death (meaning what we knew as the person - personality, conscious action, what makes you the living you, is no longer present). There cannot be spontaneous respiration with complete death of the brain stem.

What makes you you is your soul. Google TK. Brain dead for 20 years on a ventilator.

 

[Pup7]

I’m talking about the conscious mind. Your personality. Your likes and dislikes. If the conscious mind is dead, I’m sorry, but we cannot bring you back as you. And I can’t explain that in the terms of one’s soul. I wish I could - I don’t think anyone can.

If someone has no spontaneous respiration, and life support is halted, cellular activity will stop. Even on a vent, if the brain is dead, eventually it will essentially rot (I think someone posted that earlier). We’re far better at vent management than we were even five years ago, but that is exactly what would happen.

No, it doesn’t do any of the things you say - you’re right - it doesn’t maintain blood pressure (we have to do that with drugs in the case of brain death), it doesn’t cause uniform growth, it doesn’t cause cellular respiration (oxygen does that, and as the medications and the vent keep the blood circulating and oxygenated, respiration will continue even as it begins to fail over time). Even this person on a vent for 20 years is not and can never be who he was, barring a complete miracle.

I watched my dad on life support for days on end - and I watched him die when we decided it was time to withdraw care. There was nothing we could do. It was horrible and I don’t wish that on anyone.

 

[o_mlly]

Even this person on a vent for 20 years is not and can never be who he was, barring a complete miracle.

I watched my dad on life support for days on end - and I watched him die when we decided it was time to withdraw care. There was nothing we could do. It was horrible and I don’t wish that on anyone.

Perhaps the thought behind your your post relates to the extraordinary care of the elderly in their end days. I think we are all agreed that the ventilator is extraordinary and not morally required. One may decline or cease any kind of extraordinary care.

The issue I think under discussion is the continuation of extraordinary care for anyone, young or old, after a pronouncement of brain death in order to harvest their organs. Since the ventilator is not disconnected the only indication of death is the reported absence of brain activity. When the harvest team arrives the patient displays all the palpable signs of life. Just how subjective is the “brain dead” protocol? Some think too much.

The term “brain death” was invented in 1968 to accommodate the need to acquire vital organs in their “freshest” state from a donor who some argue is still very much alive.

While death had previously been defined as lack of respiration and heart activity, “brain death” was judged as compatible with an otherwise living patient. “Brain death” has never been rigorously defined, and there are no standardized tests to determine if the condition exists.

Dr. John Shea, a medical advisor to LifeSiteNews.com, points out that patients diagnosed as “brain dead” often continue to exhibit brain functions.

In “Organ Donation: The Inconvenient Truth”, Shea states that the criteria for “brain death” only “test for the absence of some specific brain reflexes. Functions of the brain that are not considered are temperature control, blood pressure, cardiac rate and salt and water balance. When a patient is declared brain dead, these functions are not only still present, but also frequently active.”

The moral rule for lethal acts is that if one is uncertain of the fact then one may not act. The evidence for number of “brain dead” errors grows. How many mistakes are acceptable? How many patients killed by the harvesting team balance out the good of the organs harvested for others? The Catholic answer, I think, is none.

 

[Pup7]

Life support time for organ harvesting is minimal as the time on a ventilator and the drugs needed to control blood pressure and cardiac contractility are damaging in the long term, and make the organs unsuitable. And your article isn’t accurate on a few points - the biggest one being that only a “few functions” are tested. That’s not true. To have organs harvested the patient must have NO brain stem activity. None. Without brain stem activity, there is no parasympathetic nervous system response, the body will not breathe on its own, and the heart will not beat without assistance.

Patients aren’t killed by harvesting teams. This is never a decision taken lightly by any provider or medical team. EVER.

There’s a lot of misinformation out in the world on this subject.

 

[o_mlly]

Life support time for organ harvesting is minimal as the time on a ventilator and the drugs needed to control blood pressure and cardiac contractility are damaging in the long term, and make the organs unsuitable. And your article isn’t accurate on a few points - the biggest one being that only a “few functions” are tested. That’s not true. To have organs harvested the patient must have NO brain stem activity. None. Without brain stem activity, there is no parasympathetic nervous system response, the body will not breathe on its own, and the heart will not beat without assistance.

Patients aren’t killed by harvesting teams. This is never a decision taken lightly by any provider or medical team. EVER.

There’s a lot of misinformation out in the world on this subject.

You appeal to your own authority. What is gratuitously given may be just as gratuitously dismissed. Do you have any authoritative references to support your claims?

http://jme.bmj.com/content/early/2017/08/28/medethics-2016-103867
The science underlying the claim that the ‘brain dead’ are biologically dead organisms is weak and fundamentally flawed.

 

[Pup7]

Yes.

ICU experience. Knowing the UNOS and CORE criteria for the US. Sitting on ethics teams. Working with doctors. Peer reviewed research. You have Google; finding reliable research is as easy as finding the unreliable. One person’s opinion isn’t indicative of mountains of research. I’ve read the naysayers in many an article and from many a reliable source. I’ve also read the counterarguments. The truth, as I’ve heard many a neurologist say, is somewhere in the middle.

I’m not appealing to my own authority here, and I’m not claiming the medical world is infallible.

My point is, teams don’t sit around like vultures waiting for people to die. That’s not how the system works. No team takes this lightly. Not a one.

You cannot reverse the death of the brain stem. If you stop the drugs, the heart will stop. If you stop the vent and the heart continues to beat, that is a different ball of wax completely. That is correct. But if the brain stem is dead, and you stop the pressors, the heart will stop because there is no signal to tell it to continue.

 

[jlhargus]

How could a human individual not be a human person?

See Father Spitzer’s video on personhood on following link.

https://search.yahoo.com/yhs/search...rt+Spitzer+on+personhood&type=em_appfocus1_cr

 

[o_mlly]

The truth, as I’ve heard many a neurologist say, is somewhere in the middle.

On the matter of ending another’s life, the truth must be a moral certainty. “Somewhere in the middle” is too low a bar.

My point is, teams don’t sit around like vultures waiting for people to die. That’s not how the system works. No team takes this lightly. Not a one.

No one is questioning the integrity of healthcare workers as was previously posted. What is being questioned is the “brain dead” protocol scientifically, theologically and philosophically sound.

You cannot reverse the death of the brain stem. If you stop the drugs, the heart will stop. If you stop the vent and the heart continues to beat, that is a different ball of wax completely. That is correct. But if the brain stem is dead, and you stop the pressors, the heart will stop because there is no signal to tell it to continue.

We cannot reverse the fact that we will all die. Yet, we single out some who are in the process of dying interrupting their dying process with non-therapeutic, non-palliative techniques to instrumentalize the person for the benefit of others. The human person must never be used as an instrument but only an end in themselves. We would not embalm such a person but we would harvest their organs?

 

[Pup7]

The truth of brain death is somewhere in the middle. You took what I said completely out of context.

You cannot reverse the death of the brain stem. That is irrefutable.

And yes, I am an organ donor. Keeping me on life support for a couple of more hours until a team gets there will not change my outcome. We don’t put people on life support to harvest their organs. That is NOT how that process works. If you suffer cardiac arrest and after CPR/ACLS you cannot be revived and you are pronounced dead, you are NOT hooked up to life support to harvest your organs, which is what your statement implies. If that is indeed what you believe, I would suggest you call UNOS or CORE or go visit an ICU and have the record set straight.

And yes, I’m taking that as in insult to my profession and the professions of my colleagues. As I stated, we are not vultures.

 

[Ghosty1981]

I’m not convinced that taking the organs of a willing person who is irreversibly dying is using them as a means to an end like it would be if their consent was not obtained and they were not given all appropriate treatment. At the same time I am not convinced that such a person is truly dead, and taking their heart certainly pushes them further along the path towards death.

I can honestly see some solid foundation for either argument. For now I simply go with what the Church currently allows, and will not go further than that even if the professional ethics become less stringent.

Sticking to the topic of the thread, do we agree that the rational soul of the person is still present in the “brain dead” body? I’ve yet to see a convincing argument that it isn’t.

 

[JimG]

All that I can think of offhand are anecdotes that make me wonder. Instances where long term comatose individuals recovered consciousness and then remembered everything that was said in their presence while comatose. Near death experiences in which a “dead patient” is brought back to life and then is able to describe in detail from a perspective above his body all that happened during the course of the crisis. None of this is clinically conclusive. It just makes me think that the “person” who is the subject of these experiences is not necessarily limited to brain function for experiential (name removed by moderator)ut. So again I wonder what the subjective experience might be for the actual “person” involved even though from our outside objective standpoint it seems like the person is no longer there. How do we know unless we are that person? Of course I agree that as long as death has not occurred the soul remains, and personhood is an expression of the soul.

 

[Seeksadvice]

How do you define “human”?

Is it vaguely human shaped? Does it have the right number of chromosomes?

 

[JimG]

How do you define “human”?

Is it vaguely human shaped? Does it have the right number of chromosomes?

It is an individual member of the human species. All members of the human species have a beginning. A new human individual begins at conception and continues developing into adulthood.

 

[Seeksadvice]

Well, there are things that don’t meet the definition of a human that can come from the union of man and woman. Triploids, tetraploids, etc. Not sure what those are called.