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Feedback 2009
Peter Singer: ‘Christians condone murder to harvest donor organs’. Is
he right?
Published: 3 January 2009(GMT+10)
Photo iStockphoto
Don N, a longtime CMI supporter, wrote as follows:
After reading a book (Writings on an ethical life) by the infamous Prof.
Peter Singer I have been somewhat concerned about transplants.
Singer justified infanticide partly on the basis that Christians have no problem
harvesting organs from live people. He explains how Prof. Barnard when pioneering
transplants shifted from obtaining organs from the dead to the “brain dead”
after a committee had come up with this definition which was subsequently ratified
by virtually every country. He explained that “brain dead” was a convenient
definition for Barnard to help make his work successful. Singer also took to task
Christians because they readily changed in spite of the fact that hearts still beat,
blood pressure increases as the operation progresses etc. He says that we place
to one side “made in the image of God” when convenient and in effect
murder the donor to harvest the organs. While I am repulsed by various beliefs of
Singer I am not aware of any answer to this (for me at least) vexing question. Do
you have any answers?
Yours in Christ
Don
Dr Carl Wieland replies:
Dear Don
Nice to hear from you! I think, without having read his work on this, that Singer
may be being a bit sneaky by accusing Christians who accept transplanted organs
of condoning ‘murder’ in the case of brain death, and hence not sticking
consistently to their stance on humans made in God’s image. It is very much
part of the incremental strategy used by misotheists to try to change society in
their direction, and it has been seen with the homosexual
and abortion issues as well.
What follows is not meant to be the ‘last word’ and not meant to be
anything other than a very fallible attempt to wrestle with what are hugely difficult
and in some ways almost unanswerable questions. Nevertheless, I think the above
statement re Singer can be justified.
I would look at it keeping this list of points in mind:
- Organ transplantation per se, to save life or heal disease is condoned/permissible
biblically—partly under an implication of the Dominion Mandate in Genesis,
but much more so by way of Christ’s example in healing the sick, etc. Temporarily
and locally reversing the effects of the curse is often called ‘blessed’
in the Word. Note that some transplants can be made without the death of the donor,
e.g. kidneys.
- Point 1 above needs to be qualified by adding: “Provided that it involves
no breach of any other commandment in Scripture”.
- The commandments make it clear that taking of innocent life (murder) is wrong, and
there is nothing in this circumstance (such as “hierarchy of biblical principles”)
that would override that.
- Killing a person in order to harvest their organs to help another is therefore obviously
forbidden, even where that person is gravely ill. (cf.
What about abortion to save the mother’s life? Which discusses the
ethical principle of double effect)
However, point 4 then begs the question that is at stake all along, namely, is brain
death real death? In other words, the turning off of “life support”
for a brain-dead person is either murder by biblical definition or it is not —
whether or not the intention is to harvest the organs.
We can transplant the heart, and the person is much the same. But the same cannot
be said for the brain.
So back to the real question, quite independent of organ transplantation —
is brain death real death? I.e. irreversible under any circumstances? Or is it the
beating of the heart that is the issue? What is the biblical definition of death,
or more importantly, of killing a person? Remember that the heart can keep beating
via its own mechanisms, via a purely mechanical process in a frog, e.g., when the
head is cut off, and the lungs have ceased operating on their own. Unless the lungs
are artificially oxygenated, ie. mechanical ventilation, that process of heart beating
will soon come to an end (in such a brain-dead person with no lung activity), because
the cells of the heart are no longer receiving oxygenated blood.
But if someone is on a mechanical ventilator, and the brain is dead, and the only
thing keeping the heart beating is that mechanical ventilator, is that person alive?
A strong case can be made for saying ‘no’.
There seems to me to be a (reasonable) assumption in Christian discussions of death
of a human being, biblically, that the point at which the ‘persona’
is irreversibly absent from the body is the same point at which there is also no
longer any transcendent component present. If you like, the ‘soul has left
the body never to return’ in simple language (cf. Genesis 35:18, 1 Kings 17:21–22, Matthew 10:28, as well as Brain chemistry
and the fate of the personality after death) and without getting
into vexed discussions on soul/spirit or bipartite vs tripartite views, etc.)
Photo iStockphoto
So what is the seat of the persona, if you like? Is it the heart/circulatory
system? I suggest not. We can transplant the heart, and the person is much the same.
But the same cannot be said for the brain. Conversely, heart stoppage is clearly
not the final indicator of death, since a heart can often be restarted, e.g. by
a defibrillator or CPR. But this must be performed extremely quickly before
there is irreversible brain death, and this supports the point in contention that
brain death is the final indicator. Indeed, replacing heart death with brain death
as the criterion has saved many lives.
In short, it appears to me that a strong argument can be made for the fact that
once the brain is truly dead, then the fact that blood is being kept mechanically
coursing round the body does not alter the fact of death. It may be that for expediency
in ensuring that a potential donor organ is kept oxygenated for longer (and is thus
more likely to be successful as a transplant), the artificial oxygenation/ventilation
system is kept going longer than would otherwise be the case. (Otherwise the organs
would be destroyed by ‘warm ischemia’, i.e. rapid deterioration of still-living
cells in organs of dead people after blood flow ceases.)
That would not be, in my view, the same as ‘killing a person to ensure donor
organs are fresh’, and would be ethically OK – provided that the criteria
for brain death are indeed correct indicators of actual brain death – which
is a clinical/scientific question in its own right. So I’m not downplaying
the complexity of the issue or the difficulties in making such determinations, I’m
just highlighting that it’s not quite the way Singer puts it, if I have understood
your email correctly.
My colleague, Dr Jonathan Sarfati, points out, too, that Singer is actually wrong
about the origins of the notion of brain death. Wesley Smith, in his informative
book The Culture of Death (2000), which strongly argues against
euthanasia, organ harvesting and eugenics, points out that ‘brain death’
(coma dépasse) was coined by French physicians in 1959. Dr Christiaan
Barnard’s first heart transplant (South Africa) was in 1967 and he used the
already existing brain death criterion. But he still waited till the medical machines
were removed and cardiac arrest occurred naturally.
Singer is actually wrong about the origins of the notion of brain death.
Many years ago, while I was working as a medical doctor in major hospitals, my experience
was that such decisions were made on the best medical/scientific evidence available,
were made with care and compassion, and were made on the same criteria by both secular
and very strongly Christian professionals. They were made on the basis of sincere
belief, to the best of their professional and scientific understanding, that the
individual, in the sense of the ‘person’, was truly, absolutely, irreversibly
dead (whether or not their organs were still capable of functioning – as in
the heart still capable of beating spontaneously under its own steam).
While recognizing that all are fallible, and that sinful man can abuse any system
or set of criteria, there was no evidence, at that time at least, that people were
having their life support systems prematurely switched off in order to facilitate
organ transplantation—if anything, the opposite occurred, i.e. ‘life
support’ systems (badly named in this instance, because they were not continuing
the life of the person, just the ‘life’ in the ‘biological function’
sense of organs other than the brain) were kept going well beyond the point at which
they benefited the (now-dead) patient, for purposes of buying time for the organs
to be used in a subsequent transplant.
Some related articles are:
I hope this helps.
Sincerely yours in Christ,
Carl
Nick P from the USA emailed in as soon as the article was published saying:
Dear CMI,
My comment is in unison with Dr. Wieland’s statements. There was an important
study done on this subject that was just recently published: "Why the Concept of
Brain Death is Valid as a Definition of Death: Statement by Neurologists and Others
and Response to Objections," produced by The Pontifical Academy of Sciences in 2008.
First I will say that it was only by happenstance that I came across this article:
I almost never read about (much less research on) medical topics [ironically though
(!), my only response in the past to a CMI article was on the topic of vaccines,
which also involved referencing some literature that came from Catholic institutions].
This article caught my attention, and I quickly realized that there is a critical
distinction to make (one that I was not previously aware of): Brain DEATH is a completely
different matter from other brain related conditions (problems), such as Persistent
Vegetative State or Comas. Not being a medical person, I was previously unaware
of these definitions, and so when I heard of "brain death," this was immediately
associated in my mind with very tough topics such as making hard decisions about
when (or when not) to pull a loved one off of life support (due to comas, persistent
vegetative state, etc). *Those questions remain hard questions (which many of us
will or have had to face)*, but this is A TOTALLY DIFFERENT TOPIC from brain *death*.
Therefore, there really should be no controversy on this topic, as long as one is
aware of (and assents to) the crucial distinction made above. I have the article
in PDF, or you can download it from: (http://www.vatican.va/roman_curia/pontifical_academies/
acdscien/2008/excerpt_signs_of_death_4l_2.pdf,
or referenced at http://www.vatican.va/latest/latest_en.htm). The following is an
excerpt:
‘“Coma”, the “Persistent Vegetative State”, and the
“Minimally Conscious State” are not Brain Death’
The inclusion of the term ‘death’ in brain death may constitute a central
problem, but the neurological community (with a few exceptions) acknowledges that
something essential distinguishes brain death from all other types of severe brain
dysfunction that encompass alterations of consciousness (for example, coma, vegetative
state, and minimally conscious state). If the criteria for brain death are not met,
the barrier between life and death is not crossed, no matter how severe and irreversible
a brain injury may be.
The concept of brain death does not seek to promote the notion that there is more
than one form of death. Rather, this specific terminology relates to a particular
state, within a sequence of events, that constitutes the death of an individual.
Thus brain death means the irreversible cessation of all the vital activity of the
brain (the cerebral hemispheres and the brain stem). This involves an irreversible
loss of function of the brain cells and their total, or near total, destruction.
The brain is dead and the functioning of the other organs is maintained directly
and indirectly by artificial means. This state results solely and specifically from
the use of modern medical techniques and, with only rare exceptions, it can only
be maintained for a limited time. …
As an aside … of course Peter Singer knows all of this. It boggles the mind
that someone could be so untruthful
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