Stephen N. Nelson, "The Least of These": a Christian Moral Appraisal of Vital Organ Procurement from "Brain-Dead" Patients.

Stephen N. Nelson, "The Least of These": A Christian Moral Appraisal of Vital Organ Procurement from "Brain-Dead" Patients, ETHICS & MED., Spr. 2004, at 7.

In this article, the author argues that because removal of vital organs (including heart and lungs) from living patients kills them (in that the procedure, by definition, results in death as traditionally understood, viz., the permanent cessation of cardiorespiratory function), procurement of vital organs for the purpose of transplantation from "brain-dead" patients who are biologically alive constitutes intentional killing of innocents for utilitarian purposes (euthanasia). Furthermore, he argues by analogy that like the human embryo, the human fetus, the cognitively impaired, the terminally ill and the aged, the "brain dead," biologically alive human being, by virtue of biological taxonomy, reflects the image of God and thus must be considered a "person," without relevant moral distinction, and with the entitled right not to be harmed unjustly. Therefore, proximate participation in the organ procurement procedure in the "brain-dead," biologically alive patient in any manner is immoral.

The "brain-dead" patient is not a corpse. As Capron has observed, "the Ad Hoc Committee equated brain death with irreversible coma, itself a condition of (limited) life, not death." The assertion by proponents of a neurological criterion for death that "brain-dead" patients will experience biological death in short order, Truog asserts, confuses prognosis with diagnosis. Indeed, intensive technological support can maintain "brain-dead" patients for weeks after the diagnosis. For example, the literature documents a number of irreversibly brain damaged pregnant women (including those diagnosed as "brain dead") in whom physiological homeostasis was maintained to allow their fetuses to grow to viability.

Historically, noncardiac signs of death over time included rigor mortis (temporary muscle rigidity), algor mortis (fall in body temperature) and livor mortis (discoloration of the skin). "Brain-dead" patients do not "look" dead because they display none of these findings. In fact, "brain-dead" patients are very much biologically alive. Except for unresponsiveness, these patients manifest no evidence of "dis-integration" characteristic of biological death. Integrated cellular and organ...