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

 Papal Address at Transplants Society Congress

ROME, AUGUST 29, 2000 (ZENIT.org).- This morning John Paul II confirmed the Church's positive attitude to organ transplants, which are "a great step forward in science's service of man," but expressed the Church's rejection of human cloning to obtain organs, as it fails "to respect the dignity and value of the person."

The Holy Father was given the opportunity to analyze at greater length the thorny ethical questions that have arisen at this time because of the new frontiers in biotechnology, when he addressed world experts in this field meeting in Rome for the 18th International Congress of the Transplants Society, which is being held from August 26 to September 1.

Driven by car from his summer residence in Castel Gandolfo to the Palace of Congresses, the Pontiff was welcomed by Professor Raffaello Cortesini, president and organizer of the meeting, and by Professor Oscar Salvatierra, president of the Transplants Society.

Human Cloning
Giving an ethical judgment on scientific plans announced recently by the U.S. and British governments, although not mentioning them specifically, John Paul II made it clear that "attempts at human cloning with a view to obtaining organs for transplants, in so far as these techniques involve the manipulation and destruction of human embryos, are not morally acceptable, even when their goal is good in itself."

The Pope is not opposed to scientific progress; on the contrary, he urges human progress. "Science itself points to other forms of therapeutic intervention, which would not involve cloning or the use of embryonic cells, but, rather, would make use of stem cells taken from adults. This is the direction that research must follow if it wishes to respect the dignity of each and every human being, even at the embryonic stage."

Transplants: An Act of Love
The Holy Father pointed out that as "with all human advancement, this particular field of medical science, for all the hope of health and life it offers to many, also presents certain critical issues that need to be examined in the light of a discerning anthropological and ethical reflection."

After describing the donation of organs as "a genuine act of love," the Pope emphasized that "the human body cannot be considered as a mere complex of tissues, organs, and functions... rather, it is a constitutive part of the person who manifests and expresses himself through it. Accordingly, any procedure that tends to commercialize human organs, or to consider them as items of exchange or trade, must be considered morally unacceptable, because to use the body as an 'object' is to violate the dignity of the human person."

John Paul II also stressed the importance that the organ donor be capable of deciding freely and of giving "informed consent." Should this not be possible, the "consent of relatives" is imperative.

Problem of Verification of Death
The Pontiff continued his analysis by addressing one of the most debated issues in bioethics in recent years: at what point can the organs of a dying person be removed? There has been no lack of unscrupulous doctors who have removed organs when the person was still alive, as transplants are easier then. At the same time, some families refuse to accept the death of a loved one, preventing the donated organ from being usable, as organs degrade rapidly without a supply of blood and oxygen. This is the problem "of ascertaining the fact of death."

The "vital organs that occur singly in the body can be removed only after death, that is, from the body of someone who is certainly dead," the Pope emphasized. "In this regard, it is helpful to recall that the death of the person is a single event, consisting 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. The death of the person, understood in this primary sense, is an event that no scientific technique or empirical method can identify directly. Yet, human experience shows that, once death occurs, certain biological signs inevitably follow, which medicine has learnt to recognize with increasing precision."

In recent times, bioethics experts have given more importance to the total and irreversible cessation of all brain activity, as a sign of the loss of the capacity of integration of the individual organism as such, than to the lack of pulse and breathing for determining death. The Pope explained, "Specifically, this consists in establishing, according to clearly held parameters commonly held by the international scientific community, the complete and irreversible cessation of all brain activity (in the cerebrum, cerebellum, and brainstem)."

According to John Paul II, "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 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 judgment that moral teaching describes as 'moral certainty.' This moral certainty is considered the necessary and sufficient basis for an ethically correct course of action. Only where such certainty exists, and where informed consent has already been given by the donor or the donor's legitimate representatives, is it morally right to initiate the technical procedures required for the removal of organs for transplant."

The Pope does not make a pronouncement about the actual details of what clinical signs constitute brain death, as this enters into the realm of the scientist. As defined in Italy, a diagnosis of brain death requires a "flat-line" EEG that extends for more than six hours (twelve for an infant), proof that heart and lung function will cease if the artificial respiration is briefly switched off, and the concurrence of a second doctor.

Waiting Lists
The Bishop of Rome addressed another serious problem, which not only concerns doctors, but causes anguish in thousands of families: "that of the allocation of donated organs through waiting-lists and the assignment of priorities." The Pontiff answered as follows: "From the moral standpoint, an obvious principle of justice requires that the criteria for assigning donated organs should in no way be 'discriminatory' (i.e. based on age, sex, race, religion, social standing, etc.) or 'utilitarian' (i.e. based on work capacity, social usefulness, etc.). Instead, in determining who should have precedence in receiving an organ, judgments should be made on the basis of immunological and clinical factors. Any other criterion would prove wholly arbitrary and subjective, and would fail to recognize the intrinsic value of each human person as such, a value that is independent of any external circumstances."

Transplants from Animals
The last problem the Pope addressed was that of "xenotransplants," that is, organ transplants from other animal species." In this connection, the Holy Father recalled what Pope Pius XII said in 1956: "in principle, for a xenotransplant to be licit, the transplanted organ must not impair the integrity of the psychological or genetic identity of the person receiving it; and there must also be a proven biological possibility that the transplant will be successful and will not expose the recipient to inordinate risk."
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