Click here for original document of address given by John Paul II

ROME, AUGUST 29, 2000 (ZENIT.org).- Once again, John Paul II has not been satisfied to give a "pro forma" address. He took advantage of his meeting today with experts in organ transplants to provide orientation based on the Gospel for many of the problems facing this field today. ZENIT spoke with Fr. Gonzalo Miranda, secretary of the Roman Sacred Heart University Center for Bioethics, about the meaning of this discourse.

-- ZENIT: What point in this address do you find most outstanding?

-- Fr. Gonzalo Miranda: Much of what the Holy Father said was really a confirmation of orientations already given by the magisterium of the Church. However, John Paul II also pronounced his opinion on one of the most delicate and debated issues in recent years in the field of medicine, that of the validity of the so-called "neurological criterion" for the proof of the death of an individual person.

This magisterial pronouncement (of the ordinary magisterium), is especially important because a few years ago, a division arose over this issue among people generously dedicated to the struggle to protect human life, including some philosophers and doctors.

-- ZENIT: Could you elaborate on this disagreement within the pro-life camp?

-- Fr. Miranda: One side is justly concerned by the abuses that could arise in carrying out organ transplants, and which in fact do happen. It appears that the criteria given by the Pope -- not to remove vital organs until it is certain that the individual they are taken from is already dead -- is not always respected. Furthermore, some countries or places have defined legal death as the death of the brain stem or the cerebral cortex, without having a cessation of all the functions of the brain. Furthermore, there is a certain confusion over the clinical parameters that should be analyzed to declare "brain death."

However, beyond these extremely legitimate concerns, there was a basic disagreement of a philosophical character. Some considered it impossible to declare a person dead if his or her heart continued to beat because it was connected to an artificial respirator -- even if it was shown with certainty that all brain functions had ceased irreversably and totally. According to these groups, in this case, the person remains alive, because he or she continues to show certain vital functions, and because there is still a certain degree of integration among the various parts of the organism. Thus, they said, the patient is not a cadaver in which some vital functions remain active (as actually always occurs after death), but rather a living organism, and therefore, a living person.

-- ZENIT: Has the magisterium pronounced on this issue before?

-- Fr. Miranda: The "Letter to Health Care Workers," a sort of manual of medical ethics published a few years ago by the Pontifical Council for the Pastoral Care of Health Care Workers, expressed an opinion in favor of accepting the criterion of brain death, but until the present moment, there had been no properly magisterial pronouncement on this problem.

Some time ago, some people had asked the Holy See for a pronouncement with doctrinal authority over this so acute and delicate issue. The Pope clearly shows in his discourse that he is up to date on this argument, when he says that it is "one of the most debated issues in contemporary bioethics, as well as to serious concerns in the minds of ordinary people." Therefore, the Pope, aware of his mission as doctrinal teacher of the Church, decided to make an explicit magisterial pronouncement. His teaching leaves no room for doubts. After asserting that "with regard to the parameters used today for ascertaining death... the Church does not make technical decisions," he asserts that "the criterion adopted in more recent times for ascertaining the fact of death, namely 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. Therefore a health-worker... can use these criteria... as the basis for arriving at... 'moral certainty,'... the necessary and sufficient basis for an ethically correct course of action."

-- ZENIT: Then brain death is the same as actual death?

-- Fr. Miranda: It is important to note that the Holy Father presents brain death as a "sign" that the individual organism as such has lost its capacity for integration. Shortly before this he affirmed that the death of the person properly consists in "the total disintegration of that unitary and integrated whole that is the personal self. It results from the separation of the life-principle (or soul) from the corporal reality of the person." This is important because it helps to avoid the mistake of thinking that persons are only their bodies, or that the human soul is located in the brain or in any other part, or even that the person is the brain. The person is a union of body and spirit, and the body is the body of a living person, animated by the spirit, in as much as it is an organism whose parts and functions are integrated. It is not enough to have a certain integrated interaction among some of the organs and biological functions. Given that the capacity for integration of the organism as a whole necesarily depends on the functions of the brain, the total and irreversable cessation of these is a sign that this capadidy has been irreversibly lost, that is, we are no longer before a living organism, a living person.

It is also interesting to note that the Pope affirms that the criterion of brain death "does not seem to conflict with the the essential elements of a correct anthropological conception." Note the words "does not seem to conflict," which appear in the text the Pope pronounced. The expression in the Italian translation offered to the press is stronger: "non appare in contrasto," does not appear to be in conflict, that is, there is no conflict.

-- ZENIT: In summary, what is the significance of this statement?

-- Fr. Miranda: As I said before, in some way, the Pope chose to speak expressly on this delicate problem and taught that the so-called "neurological criterion" is in fact acceptable. The question remains delicate and complex, especially as it refers to the correct anthropogical understanding alluded to by the Pope. I think that we will have to continue studying this problem, but now, we who sincerely wish to seek the truth and defend human life, and who believe in the doctrinal authority of the Vicar of Christ, mave a clear teaching and a clear call to fidelity.
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