So Your Child Needs a Transplant, by Emily M. DeArdo

I really can’t think of a scarier thing for a doctor to say then, “Your child needs a transplant or she will die.”

And yet, that was my reality, and it might be yours, if you’re reading this. I was nineteen years old when my doctors first broached the subject of a double-lung transplant with me. I have cystic fibrosis (CF), a genetic disease that makes my body's mucus too sticky, because there’s too much salt in my body. That makes the mucus hard to clear, and leads to lung infections, loss of lung function, and eventually, lung failure. It also affects the digestive system of the body by clogging the pancreatic ducts, inhibiting the release of digestive enzymes, and possibly insulin. So people with CF can need double-lung (we have to have both lungs transplanted), kidney, or liver transplants.

At nineteen, I was focused on college, not my possible demise. And yet, without my transplant, I wouldn’t have made it to my twenty-fourth birthday. I was lucky enough to receive my new lungs on July 11, 2005, and I’ll celebrate my sixteenth transplant anniversary this year. But not everyone is that lucky. There is another person added to the national transplant waiting list (for all organs) every 10 minutes in the United States. Twenty people die daily waiting for a new organ, and more than one hundred thousand people are currently on the list in the US. That’s 100,000 families that are affected by organ donation.

If you’ve heard that your child needs an organ, your mind is probably swimming with questions, and if you’re Catholic, one of those questions is probably, “What does the Church say about organ donation?” Well, I’ll tell you!

The first thing is to realize that there are two types of transplants: living donor transplants and “cadaver” (aka, from dead people) transplants. Some transplants like bone marrow, liver, kidney, and parts of a lung, can be done with living donors. However, others, like hearts and a double lung transplants, can only be taken from deceased donors.

In both cases, all major religions regard transplantation as an act of charity. For Catholicism specifically, Pope St. John Paul II wrote in Evangelium Vitae that:

“A particularly praiseworthy example of such gestures is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope.” (86)

Let’s note the “ethically acceptable manner” part. What this means, roughly, is that organs are not coerced from someone. They have to be given as a free gift. Also, people cannot be killed for their organs, because this is not ethically acceptable!

In the United States, we have what’s called an “opt-in” system. That means that if you want to donate your organs or tissues, you have to tell someone and become part of the United Network for Organ Sharing (UNOS) database. (Some countries have an “opt-out” system, meaning that you are an organ donor unless you tell the state that you don’t want to be.) You can get a symbol on your driver’s license that says you’re an organ donor, or you can enroll at donatelife.net. You can even sign up via the Health app on an iPhone! But it’s also best to tell your family your decision, so that they know. If you have questions about donation, check out this FAQ.

Now, I knew all this before my transplant. Heck, at the time Pope Benedict XVI was even an organ donor! I thought that I was in the clear as far as the ethics of transplant were concerned. But after my transplant I noticed that some Catholics feel that organ donation is not acceptable, because they do not believe in brain death (also called neurological criteria) as a cause of death. However, Pope St. John Paul II spoke on this as well, in 2000:

“The use of neurological criteria for the determination of death can be legitimate according to the Catholic Church. In an address he gave to the [18th International Conference of Organ Transplant Specialists] in August 2000, Pope Saint John Paul II observed that their application, if rigorous, “does not seem to conflict with the essential elements of a sound anthropology.” He further stated that “a health-worker professionally responsible for ascertaining death can use these criteria in each individual case as the basis for arriving at that degree of assurance in ethical judgement which moral teaching describes as ‘moral certainty.’ This moral certainty is considered the necessary and sufficient basis for an ethically correct course of action.” Neurological criteria consist of three basic signs: deep coma or unarousable unresponsiveness, absence of cerebral and brain stem reflexes, and apnea. Pope Pius XII and Pope John Paul II both said the Church has no competency in determining death; this properly belongs to medical science." Source - Taken from The National Catholic Bioethics Center [NCBC] website.

I don’t want to get too far into the weeds here, but brain death criteria is rigorous. One of the problems people run into when we talk about things like brain death is that the media (and medical TV shows) do a really crappy job talking about this. They mix up brain death, vegetative states, and comas all the time. So it makes learning about, and talking about, end of death bioethics really hard!

The key thing to remember here is that the organs must be taken ethically: meaning the person is not coerced, or killed for their organs. Being an organ donor doesn’t mean that you get lesser care at a hospital. Doctors and nurses aren’t prowling around looking for people to kill to take their organs.