Wednesday, July 11, 2012

Quaeritur: Does Every Heart Transplant Involve Murder?


QuaeriturI was considering a career as a heart surgeon, but a friend told me that it is a mortal sin for a Catholic to have a heart transplant because in taking someone's heart, you are killing him.  Is this true?

Respondeo: Excellent question.  Legally, heart donors have to be declared "brain dead" before they can remove their heart.  So the philosophical question is whether a "brain dead" patient is really dead, which means, basically, that their brains are necrotic (i.e., "rotten") and hence there is no possibility of them ever recuperating or even regaining consciousness.  (This is what it should mean, although doctors often declare, as 'brain dead', patients who only show some signs of brain dysfunction, and few ever really ensure that the whole brain is necrotic).  In any case, brain death is different from a coma (or 'Persistent Vegetative State'), because in a coma, the patient has their brain intact, but it just doesn't work; and comatose patients do sometimes regain consciousness. 

The Church has taught that one may hold the opinion that brain dead patients are really dead (i.e., their souls have left their bodies).  So if a philosopher or theologian or physician holds that opinion---and most do---they are not heretics for doing so.  But the other opinion, namely, that brain dead patients are really alive (i.e., their souls are still informing their bodies), is also perfectly admissible.  We are also allowed to hold it.  So the issue is open to debate among Catholics.

My own opinion is the latter opinion, namely, that "brain death" is not really death.  This is not a very popular opinion, in particular because it means that heart transplants involve murdering a truly living (though "brain dead") patient.  A good book that defends this position is Mattei, ed., Finis Vitae: Is Brain Death Still Life?, from which I have quoted before.  My reasoning is that there are  many biological functions going on in the body of the "brain dead" patient, which means that that patient has to have a soul.  The patient is definitely alive.  Any biologist (as opposed to  a medical doctor) would agree that there is life in that organism.  For a formal version of my argument, see this previous post.

Some Thomists would reply that indeed such a patient is alive, but it is no longer a human being, because it does not have a brain.  So it is some other kind of living organism, one that is not human, and thus it is permissible for us to kill it.

My reply: the only way that that patient is not a living human being is if, for some reason, the human soul has left the body and some other, (animal or plant) soul has come in its stead.  This is highly unlikely (why would God do such a thing?), and, therefore, we should err on the side of caution, and assume it is a human being, and not kill him just to prolong someone else's life.  The end (saving someone else) does not justify the means (probably killing someone, no matter how bad a state they're in).


mgunnarson said...

In what document does the Church allow these contrary positions? I'd be curious to read it.

Jeff Gunnarson said...

To answer the question. Yes become a heart surgeon! We need solid skilled catholic heart surgeons. You could become an expert as regards organ transplants. Just don't do transplants!
Secondly, I am not a Thomist but I find it disturbing that that one is declared non human when there is no brain. Does that apply to the beginning of life as well? I would have to disagree with all respect to Thomas.

Anonymous said...

What is wrong with this analysis?:

Taking the heart from a living patient has two effects, one good and intended, the other evil and (potentially) unintended. The good effect is the saving of the life of another who will die without receiving a heart transplant. The bad effect is the certain death of the "donor".

Notice that, even without the right intentions, the life of the transplant recipient is never obtained THROUGH the death of the "donor".

Daniel Offutt

Don Paco said...

@Daniel, the death of a patient is not a mere side effect of taking his heart away from him. Taking a patient's heart away *amounts to* killing him. In technical terms, the death of the patient is the "finis operis" (not merely a "finis operantis") of taking his heart.

Don Paco said...

@Jeff, St. Thomas never commented on the phenomenon of brain death. The opinions presented above are those of different THOMISTS.

The opinion that without a brain there can be no rational soul present is the opinion of SOME Thomists. Other Thomists, such as myself, think that there HAS to be a rational soul present despite the absence of a brain, just as there is a rational soul present without a brain at the beginning of life--as you point out.

PS. The question was not whether or not to become a heart surgeon, but whether it is true that heart transplants amount to murdering the donor.