04 September 2008

Vatican avoids brain death debate

The Vatican distanced itself on Wednesday from an article in its newspaper that suggested re-opening the debate on when a person can be considered dead for reasons of transplants.

The Vatican distanced itself on Wednesday from an article in its newspaper that suggested re-opening the debate on when a person can be considered dead for reasons of transplants.

The front-page article said new questions were being raised about whether the cessation of brain function - so-called brain death - could still be considered valid determination of death as opposed to cardio-circulatory arrest.

"The scientific justification of (the brain death standard) rests on a peculiar definition of the nervous system that is now being questioned by new research, which casts doubt on the fact that brain death leads to the disintegration of the body," the article by Italian history professor Lucetta Scaraffia said.

Titled "The Signs of Death," it caused a storm of reaction from the Italian medical community, which said any change in the Church's position could jeopardise the harvesting of transplant organs.

"This is not a Vatican document," the Vatican's chief spokesman, Rev. Federico Lombardi, said. "It is an article by a historian that takes some considerations into account, but it is not part of Church teaching."

Church and scientists still at odds
The Vatican held two conferences in 2005 and 2006 on end-of-life issues, but did not change its general position to accept a doctor's declaration of brain death. Some participants who wanted it to declare brain death unacceptable later published a book entitled "Finis Vitae - Is Brain Death Still Life", which Scaraffia cited as proof that scientists were questioning this standard for determining death.

Lombardi noted that in 2000 the late Pope John Paul said that if doctors were "scrupulously" sure that the cessation of brain activity was "total and irreversible" they could proceed with transplants.

The New England Journal of Medicine (NEJM) joined the debate last month with an article questioning whether some patients declared brain dead were in fact really dead.

Patients with massive brain damage can be declared brain dead even though their vital bodily functions continue to work, wrote Robert Truog of Harvard Medical School and Franklin Miller of the National Institutes of Health.

"The arguments about why these patients should be considered dead have never been fully convincing," they said.

Another criterion, the end of a heart's beating, seems questionable when doctors can declare cardiac death and transplant and restart the heart in another patient, they said.

These cases suggested, they argued, that "the medical profession has been gerrymandering the definition of death to carefully conform with conditions that are most favourable to transplantation." – (Reuters Health, September 2008)

Read more:
Brain death not the end
Yes to coma feeding, says Pope




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