Revising brain death standards would be dangerous, ethicists say

Uniform Law Commission meeting in Hawaii to consider revised law models for states.

An American bioethics center, along with the Catholic bishops of the United States, are warning that a proposed redefinition of brain death could lead to dire consequences.

With a legal body meeting this week set to vote on the issue, the National Catholic Bioethics Center and the United States Conference of Catholic Bishops wrote in a letter that a proposed revision to the 1981 Uniform Determination of Death Act (UDDA) would replace the standard of whole brain death with one of partial brain death.

“We urge the Commission to retain the current standard of ‘irreversible cessation of all functions of the entire brain, including the brain stem,’” the letter said.

The Uniform Law Commission (ULC), a non-profit organization based in Chicago that drafts model legislation for states, is holding its annual meeting in Hawaii and might vote on whether to recommend that U.S. states change the legal definition of death, Nature reported.

The NCBC and USCCB warned that the proposed revision will allow patients who exhibit partial brain function to be declared “legally dead” when they are not biologically dead.

Their letter cautioned that revising the UDDA to support the idea that partial brain death is sufficient for vital organ retrieval “could have the unintended effect of dissuading people … from becoming [organ] donors and ultimately reduce the number of organs available for transplant.”

The letter, signed by Joseph Meaney, President of the NCBC, and Anthony R. Picarello, Jr., Associate General Secretary and General Counsel of the USCCB, pointed out that in 2000, in an address to 18th International Congress of the Transplantation Society, Pope St. John Paul II said that “the complete and irreversible cessation of all brain activity, if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology.”

While Pope John Paul said that organ donation can be a “genuine act of love” that entails “a giving something of ourselves,” the proper conditions must be met before vital organs such as the heart may be procured only after death has been determined with moral certitude.

“Vital organs may not be procured prior to death and their removal must not be the cause of the donor’s death, as emphasized in the Ethical and Religious Directives for Catholic Health Care Services of the U.S.,” the NCBC and USCCB said.