Are heart transplants morally acceptable to Catholics?

by Paul Byrne, MD

Dr Paul Byrne is president of the Catholic Medical Association. Dr Byrne has been practicing medicine since 1957 and writing on brain death since 1975.

While the Church has not made a statement specifically about heart transplant, the position of the Church is clear to me, beginning with the Council of Vienne, 1313:

"Moreover, with the approval of the said council, we reject as erroneous and contrary to the truth of the Catholic faith, every doctrine rashing asserting that the substance of the rational or the intellectual soul is not of itself and essentially the form of the human body, or casting doubt on this matter. In order that all may know the truth of the faith in its purity and all error may be excluded, we define that anyone who presumes henceforth to assert, defend or hold stubbornly that the rational or intellectual soul is not the form of the human body of itself and essentially, is to be considered a heretic."

(This passage asserts that it is heretical to believe that the soul is a component of the brain or some other part of the body. The church teaches that the soul is an entity to itself, indeed created in the Image and Likeness of the Creator.)

The position was reaffirmed by the Lateran Council, 1512 - 1517.

An address by Pope Pius XII in 1957, stated:

"But considerations of a general nature allow us to believe that human life continues for as long as its vital functions - distinguished from the simple life of organs- manifest themselves spontaneously or even with the help of artificial processes".

Also, Pope Pius XII, in an address about corneal transplant, stated,

"...public authorities have the duty ... to take care that a 'corpse' shall not be considered and treated as such until death has been sufficiently proved."

Pope John Paul II stated in 1991 to a group on organ transplants:

"... A person can only donate that of which he can deprive himself without serious danger or harm to his own life or personal identity, and for a just and proportionate reason. It is obvious that vital organs can only be donated AFTER DEATH."

Pope John Paul II to the participants of the 1989 Pontifical Academy of Science stated:

"The problem of the moment of death has serious implications at the practical level and this aspect is also of great interest to the church. In practice there seems to arise a tragic dilemma. On one hand there is the urgent need to find replacement organs for sick people who would otherwise die or at least would not recover. In other words, it is conceivable that in order to escape certain and imminent death a patient may need to receive an organ which could be provided by another patient, who may be lying next to him in the hospital, but about whose death there still remains some doubt. Consequently, in the process there arises the danger of terminating human life, of definitively disrupting the psychosomatic unity of a person. More precisely, there is a real possibility that the life whose continuation is made unsustainable by the removal of a vital organ may be that of a living person, whereas the respect due to human life absolutely prohibits the direct and positive sacrifice of that life, even though it may be for the benefit of another human being who might be felt to be entitled to preference."

Another important reference is to #2296 of the CATECHISM OF THE CATHOLIC CHURCH:

Organ transplants are in confirmity with the moral law IF the physical and psychological dangers and risks to the donor are proportionate to the good that is sought for the recipient. Organ donation after death is a noble and meritorious act and to be encouraged as an expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, IT IS NOT MORALLY ADMISSABLE TO BRING ABOUT the disabling mutilation OR DEATH of a human being, even in order to delay the death of other persons.

(Next refers to a question about "The Charter for Health Care Workers" which expresses the opinion that it is morally admissable to harvest the organs when brain death is established. Dr Byrne points out that this document is not in accordance with the "two Councils cited and the statements by the Pope Pius XII and Pope John Paul II)

The position of the Catholic church must be that vital organ excision is prohibited unless the patient (donor) is already dead. And this is a contradiction in itself. Is the soul no longer present when the heart is still beating, there is a recordable blood pressure, a normal temperature, normal salt and water balances, and many internal organs and systems are still functioning and maintaining the unity of the body? These are the findings when a heart or other vital organs are taken for transplant. IF THE SEPARATION OF THE BODY AND THE SOUL CANNOT BE VERIFIED OR THERE IS DOUBT ABOUT THE SEPARATION OF THE BODY AND THE SOUL, VITAL ORGAN EXCISION IS PROHIBITED.

(Dr Byrne was asked to detail the types of organ harvesting and which is acceptable to the church)

There are three types of transplantation:

    1. TISSUE, A PAIRED ORGAN (i.e. you have two of them like for example, a kidney is a paired organ) OR BONE MARROW FROM A LIVING PERSON. The tissue or organ must not be essential for the life or health of the donor such as two kidneys. 

    2. TISSUE AFTER DEATH e.g. the cornea, heart valves, skin, bone and connective tissue (tendon and ligaments). 

    3. UNPAIRED VITAL ORGANS SUCH AS THE HEART OR THE LIVER AFTER A DECLARATION OF BRAIN DEATH. Such determination of brain death is based on absence of functioning of the brain. Again, if this is 'death', why is there a need to call it 'brain death'? The heart is beating; there is normal blood pressure and temperature; there are normal salt and water balances and many internal organs and systems are functioning to maintain the unity of the body. During the hour it takes to remove a heart for transplant, the heart is still beating. Only a beating heart is acceptable for transplant.
As you can see, you can donate one of a paired organ (i.e. where you have two of them like a kidney) during life or tissue after death as explained in #1 and #2 above. It would be best to inform a family member about your decision, and make sure they are aware of the problems with heart and liver donation.
"It is never lawful, even for the gravest reasons, to do evil that good may come of it."

(CF ROM 3 - Veritas Splendor #80)

Courtesy of: HLI Reports, Ap 1998

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