Catholic Medical Quarterly Volume 62(3) August 2012 p44

Letters

Brain Stem Death and Organ Transplantation

Dear Editor,

If we are to consider whether bodily death has occurred in a human person [1], it is first necessary to consider what is the purpose of a human being’s earthly life. As Christians we believe life on earth is a moral journey in which we decide whether to accept God’s invitation to life forever with Him. If the body is no longer capable of functioning in this capacity, the purpose of his life no longer exists. That is why the diagnosis of permanent, irremediable loss of brain function is critical to the diagnosis of death because this is when the patient is no longer capable of moral decision making. Even non believers accept that the purpose of life is over if a person will never ever be able to communicate with others ever again. If other systems remain viable - and cardiorespiratory function is most immediately necessary for all bodily systems - it is not permitted to hasten death, but neither should futile treatments be instituted.

If not only conscious capacity, but also, through damage to the brain stem, the capacity for respiration is permanently destroyed, then the body is dead, although artificial ventilation may maintain alive other organs. The largest organ of the body, the skin, remains alive hours, maybe days, after someone has been diagnosed dead by the traditional triad: loss of consciousness and cardiorespiratory function. In fact, the body is not totally dead until it is corrupt, a fact recognised by the Lord Who in raising Lazarus to life, wanted to give His opponents definitive and absolute proof of His power as God over life and death.

When a doctor is faced with the decision of diagnosing death, he can only do his best to make an accurate diagnosis. Patients who have been diagnosed dead by the traditional method have recovered. It is never possible definitively to diagnose permanent loss of consciousness and cardiorespiratory function when attempting to resuscitate someone who has suffered cardiac arrest as Dr. Evans himself pointed out, since he was able to restore someone after a forty minute struggle. Does this mean that all victims of cardiac arrest should be resuscitated for forty minutes at least? When should one stop?

Yours sincerely,

Margaret Sealey (Dr)
Retired Consultant Anaesthetist