Proposed Changes to Definition of Death Threaten Brain-Damaged Patients

BROOMALL, Pa., July 21, 2023—The National Catholic Bioethics Center (NCBC) and the National Catholic Partnership on Disability urge the Uniform Law Commission not to change its recommendation for the definition of brain death from the irreversible cessation of brain function to the permanent cessation of most brain activity. Such a change in policy would allow living patients with severe brain damage to be declared legally dead.

Under the proposed changes to the Uniform Determination of Death Act, whole brain death would be replaced with partial brain death. Consequently, nonresponsive patients with severe neurological injury could be declared brain dead even if they still exhibit some integrated brain function. Rather than improve the accuracy of clinical protocols, this change would bring them in line with current practices, which have been criticized for their lack of rigor and potential for abuse. Moreover, although motivated by a noble desire to save lives through organ donation, relaxing the existing standard of whole brain death involves an implicit judgment that doctors can violate the physical integrity of these vulnerable patients to benefit other patients whose lives are considered more worth saving.

 Patients with severe neurological injury cannot speak for themselves, and given the complexity of their conditions, it can be very difficult for their family and friends to effectively advocate on their behalf if they do not have medical expertise. Consequently, the medical and legal communities have a special duty to protect these patients by establishing adequate safeguards so that vital organs may not be procured prior to death or be the cause of the donor’s death. In this context, relaxing the criteria for declaring a person brain dead not only could dissuade people from becoming donors but also could have a disastrous effect on trust in the physician-patient relationship.

 To ensure that organ donation remains a selfless gift motivated by genuine love of neighbor, and to support a strong relationship of trust between patients and physicians, the standard for determining brain death must include the complete and irreversible cessation of integrated function in the whole brain. Commenting on the review process, NCBC Staff Ethicist Edward Furton said, “The Uniform Law Commission is about to affirm that current neurological criteria for determining death are too rigorous and need to be relaxed. Instead of calling for their more careful application, the lax standards are to be incorporated into the rule. This will result in the withdrawal of support from those who demand complete confidence that the patient has died before organs are donated.”

The National Catholic Bioethics Center provides education, guidance, and resources to the Church and society to uphold the dignity of the human person in health care and biomedical research, thereby sharing in the ministry of Jesus Christ and his Church. The NCBC envisions a world in which the integral understanding of the human person underlying Catholic teaching on respect for human life and dignity is better understood and more widely embraced in America and worldwide. More information can be found at ncbcenter.org.

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