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The Ethics of Organ Donation – Brain Death is not Actual Death

The Human Tissue (Transplantation, Post-Mortem, Anatomical Examination and Public Display) Bill 2022 is currently making its way through the houses of the Oireachtas in Ireland. This bill intends to deal with the sensitive subject of organ donation. One of the dangers that arises in matters where ethics is of concern, is where legislation is being driven on a ‘needs first’ basis rather than on an ‘ethics first’ basis.

The Minister for Health, Stephen Donnelly, when introducing the bill at second stage, cites the following as one of the aims of the legislation.

“Our aim is to help increase the donor pool in Ireland while always fully respecting the wishes of individuals and their families.”

He also speaks of around 570 people waiting for organs to become available. Immediately a danger arises, will the need for organs lead to ethical compromise? The answer is ‘Yes’. This can be seen in the way that ‘consent’ is being treated in order to introduce what is called the ‘opt-out’ system of organ donation in Ireland. Minister Donnelly explains;

“Under the new opt-out system, all adults in Ireland will be considered to have agreed to be an organ donor when they die unless they have recorded a decision not to donate on an opt-out register or are in one of the identified excluded groups. This is often referred to as deemed consent, and will apply to the donation of the heart, lungs, liver, kidneys and pancreas.”

It is important to note that consent is an act of the will and that so-called ‘deemed consent’ or ‘presumed consent’ is a fallacy. It is not consent at all. Imagine if you will, that a bill were to be passed, where those who do not ‘opt-out’ of a supposed ‘housing provision for refugees bill’, are deemed to have consented to having the government house refugees in their home. There would be uproar. But because organ donation is couched in terms of being a ‘precious gift’, it applies subtle social pressure for us to agree to organ donation without any deeper look at the ethical questions.

Prior to this the Minister told us that “Globally, the most significant problem affecting transplant programmes is the shortage of suitable organs to transplant.” In other words, the government needs to find a way to get more organs for transplant, and the easiest way to do this is to presume that those who are in a coma have already consented because they did not sign an opt-out form. Those who end up in a coma are in the very unfortunate position that they are unable to communicate and therefore cannot contradict the government operatives who desire to take their organs.

Deputy Pauline Tully gave the example of Wales. “A recent study published in the journal Anaesthesia in May 2020 compared deceased organ donor rates in Wales, which introduced an opt-out system in 2015, with England, which only introduced it in 2020. In the three years between 2015 and 2018, the rate of consent in Wales was double that which was seen in England and donor numbers rose rapidly.”

This is not true. There was no increase in the rate of informed free consent, what happened is that the medics, under government legislation, presumed that unresponsive comatose patients had given consent. This could no longer be confirmed from the patient in question whose organs were about to be removed. This is unethical and makes a lie of any government assertions that they fully support the idea of consent.

Consent is defined in the bill as follows.

“consent” means the giving of a permission or an agreement, that is voluntarily and freely given or made, for the use of human cells, organs and tissues —
(a) for the purpose of transplantation activities, post-mortem examinations, anatomical examination or public display, as the case may be, and
(b) in respect of which purpose, the person giving consent has received information sufficient to allow that person to understand the nature, risks, and benefits of the proposed purpose;”

It is obvious that so-called ‘deemed consent’ is contrary to this definition.

This is part of the new world without God. Human beings are regarded as little more than animals to be farmed and when we outlive our usefullness, as determined by government, then we and our vital organs become the property of the state and the state decides what is to be done with us. This is part of the culture of death spoken of by Pope John Paul II.

The Minister seeks to assure us that this is not the case. “I want to be absolutely clear that in no way does the move towards an opt-out approach mean that individual choice on this most sensitive issue is being threatened or eroded.” If this is so, then there is no need for an ‘opt-out’ system as the ‘opt-in’ system guarantees that consent has been given.

Another problem concerns the very process of organ donation. The medical professionals developed the term ‘brain death’ at Harvard University in 1968. They specifically sought to facilitate the removal of organs from comatose patients for transplant. It was ‘needs driven’ and not ‘ethics driven’.

There is a Catholic doctor based in Italy who has done much research on the ethics of organ donation. I recommend people to read her work. She looks at the ethical position from a Catholic perspective in this document – https://www.jahlf.org/wp-content/uploads/2019/05/DN-2017-JP-II-and-the-neurological-standard.pdf – which was presented at the 2019 conference on ‘Brain Death’ hosted by the John Paul II Academy for Human Life and the Family.

You can also watch below a fascinating video by Dr Cicero Coimbra where he asserts that the methods and tests used to determine brain death are flawed and give incorrect diagnoses of brain death.

Dr Cicero Coimbra, M.D.,Ph.D. on Brain Death

If you would like to watch more of the video from the 2019 conference on Brain Death you can access them HERE

You can read the published papers HERE and some unpublished papers HERE

May God bless you

John Lacken

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