Germany: A Bishop Challenges Brain Death

To frame the issue, Bishop Algermissen explains that "a human being in a state of brain death is in a transitus [transition] interrupted by external intensive care measures. He is prevented from completing the process of dying that has already begun.”

"This state, artificially induced by the resources of intensive care, presents characteristics of both life—such as temperature regulation or certain reflexes—and death, which makes it extremely difficult to determine its ontological and moral status," according to the prelate.

He deduces a question: "Are we really facing a corpse that simply resembles a living human being? Or should we not rather consider the brain-dead patient as a person condemned to death, but not yet quite dead?" The question is indeed crucial.

According to the Bishop Emeritus, neurological research "suggests that we should not attribute to the brain the function of integrating the organism as a whole, which has made it plausible to declare the death of people whose all brain functions have been irretrievably lost."

Finally, Bishop Algermissen concludes: "An organ transplant is not the same as a simple repair consisting of replacing a defective part. Human beings not only have a body, but are also a body imbued with spirit. Discussing these issues requires sincerity."

German philosopher Josef Seifert, opposed to the current concept of brain death, believes that the practice of organ harvesting in cases of brain death urgently needs to be reviewed from a philosophical and ethical perspective. "We warn against the danger of treating the human being as a means to an end and of denying their fundamental dignity," he declared.

A Quote From John Paul II

CNA Deutsch contrasts these statement with a text by John Paul II, dating from 2000, stating that "the criterion currently adopted for determining death—that is, the complete and irreversible cessation of all cerebral activity—does not conflict with the essential elements of a rational anthropology, provided it is applied with perfect rigor." But this quote is not enough.

There is more to examine to understand the Polish Pope's true thinking. Indeed, while the Pontifical Academy of Sciences, which met in October 1985 to study the exact determination of the moment of death, reached their conclusion by taking up the definition of death from the famous Harvard report. It ordered a new meeting in December 1989, which would include the participation of the Congregation for the Doctrine of the Faith.

The conclusions remained essentially the same, but emphasized the fact that one could not determine the moment of death (in fieri), but rather should look for signs of a completed death (in facto esse). Further, caution is always required to affirm this diagnosis and methods should be constantly refined. 

Visibly concerned by the issue, John Paul II insisted on the certainty of death that must be achieved before taking an organ: "More precisely, there is a real probability that the life whose continuation is made impossible by the removal of a vital organ is that of a living person, whereas the respect due to human life prohibits its sacrifice."

Two years later, during a speech at an International Congress of the Society of Organ Sharing on June 20, 1991, John Paul II reiterated the need for informed consent (as opposed to presumed consent). He made no reference to the determination of death, but reiterated that any organ donation must be performed after death.

In 1999, at the 5th Assembly of the Pontifical Academy for Life, brain death and organ donation were again discussed, and a clear divide emerged among Catholic physicians on this issue, even though opponents appeared to be in the minority.

In 2004—and therefore after the 2000 speech reported above—John Paul II convened a new meeting of the Pontifical Academy of Sciences to reexamine the concept of brain death and transplantation, entitled, “The Signs of Death.” The opposition to the concept of brain death prevailed. After the meeting, just as the proceedings were ready for printing, the Vatican stopped everything.

Furthermore, the same Academy organized a new conference the following year, under Benedict XVI, under the same title, "The Signs of Death," with the participation almost exclusively of figures favorable to the concept of brain death. The proceedings were published in March 2007. This 2006 meeting fully endorsed the concept of brain death.

The protagonists who opposed the given definition of brain death responded by publishing their contributions in the book Finis Vitae, published with the support of Roberto de Mattei and the Italian National Research Council, of which he is vice-president.

This account of the facts shows that the situation was not at all clear regarding the thinking of Pope John Paul II, who constantly questioned the concept of brain death. It should be added that Josef Ratzinger, as Cardinal and Prefect of the Congregation for the Doctrine of the Faith, issued several statements demonstrating his skepticism, even opposition, to the concept.

Conclusion

We must carefully note this quote from Pius XII, taken from his Address to the Members of the Gregory Mendel Italian Institute of Genetics on the Problems of Resuscitation, dated November 24, 1957: "General considerations suggest that human life continues as long as its vital functions—unlike the simple life of organs—are manifested spontaneously or even by the means of artificial processes.”

"A good number of these cases are subject to insoluble doubt, and must be treated according to the presumptions of law and fact, of which We have spoken." He said in this regard: "In cases of insoluble doubt, one can also resort to presumptions of law and fact. In general, one will stop at the one of the permanence of life, because it is a fundamental right received from the Creator and whose loss must be proven with certainty."

This is precisely what we can conclude: as Bishop Algermissen says, given the very nature of the resuscitation used, it seems definitively doubtful to apply any criterion for death to a person in a deep coma. And the doubt must then be resolved in favor of life. The path is therefore no longer open to transplants from living donors.