Pontifical University of St. Thomas Aquinas, Rome, Italy
The introduction of the “brain death” criterion constitutes a significant paradigm shift in the determination of death. The perception of the public at large is that the Catholic Church has formally endorsed this neurological standard. However, a critical reading of the only magisterial document on this subject, Pope John Paul II’s 2000 address, shows that the pope’s acceptance of the neurological criterion is conditional in that it entails a twofold requirement. It requires that certain medical presuppositions of the neurological standard are fulfilled, and that its philosophical premise coheres with the Church’s teaching on the body-soul union. This article demonstrates that the medical presuppositions are not fulfilled, and that the doctrine of the brain as the central somatic integrator of the body does not cohere either with the current holistic understanding of the human organism or with the Church’s Thomistic doctrine of the soul as the form of the body. Summary: The concept of “brain death” (the neurological basis for legally declaring a person dead) has caused much controversy since its inception. In this regard, it has been generally perceived that the Catholic Church has officially affirmed the “brain death” criterion. The address of Pope John Paul II in 2000 shows, however, that he only gave it a conditional acceptance, one which requires that several medical and philosophical presuppositions of the “brain death” standard be fulfilled. This article demonstrates, taking into consideration both the empirical evidence and the Church’s Thomistic anthropology, that the presuppositions have not been fulfilled.
Since the 1968 publication of the Harvard report introducing the “brain death” standard as the new medical definition of death, the controversy over this criterion has remained unabated despite the intervention of state legislatures and authoritative bodies to grandfather the “brain death” paradigm into public acceptance and to dampen the intensity of the debate at the level of society at large.1 The ongoing case of Jahi McMath has brought the controversy to public attention again, however.2 The “brain death” controversy has caused divisions not only within secular academia but also among Catholics, The Linacre Quarterly 84 (2) 2017, 155–186 Catholic Medical Association 2017 DOI 10.1080/00243639.2017.1307502 including the ordained, especially those holding high ecclesiastical offices. As a group, Catholics opposing the “brain death” paradigm are in the minority.3 In contrast, not a few Catholics supporters of “brain death” occupy prominent positions in the Church, such that their publications, coming from a level of authority, give the impression that the “brain death” standard has been “given the stamp of approval of the Roman Catholic Church” (Lock 2004, 137; see, also, Eberl 2015, 235).4 However, these documents do not contain magisterial authority; they remain only opinions/suggestions advanced by scholars working with and for the Magisterium. The crucial question is thus, “has the Catholic Church indeed formally endorsed brain death as death?” The magisterial document that touches on the neurological standard is the address of the Holy Father John Paul II to the 18th International Congress of the Transplantation Society in August 2000. It has been hailed by Catholic “brain death” defenders as the indication that the Church has“indeed give[n] definitive approval to the use of neurological criteria for the determination of death” (Furton 2002, 455; see, also, Diamond 2007, 492; Haas 2011, 279; Eberl 2015, 235). However, a critical reading of this rather synthetic document should take into account other papal pronouncements on the issues of death and organ transplantation, and also the premises (medical and philosophical) embedded in the document itself. These seem to have been overlooked by most commentators as they focused mainly on the third paragraph of article 5 of the address. Thus, in order to answer the aforementioned question, whether indeed the Church, through her magisterial teaching, has fully endorsed the “brain death” standard, the purpose of this essay is to re-read critically John Paul II’s August 2000 address, unpacking and analyzing the premises contained therein. In this way, it will be demonstrated that the so-called “definitive approval” is only a conditional approval pending the fulfillment of several specific presuppositions or conditions. As will be shown, these presuppositions have not been met whether on the empiricalpractical level or on the philosophicalanthropological level. Since the pope’s address was about both organ transplantation and the use of the neurological standard for the determination of death, the essay will begin with a brief account of the genesis of “brain death” (less known or inaccessible to the public), which sheds light on the motivating reasons for the introduction of the “brain death” criterion.5 It will become evident that the same motivations still operate today, and that they do not necessarily cohere with the Church’s mission and her precepts.