There is tremendous societal pressure to obtain organs for transplantation. Approximately 43,000 organ transplants were performed in 2022, but as of February 27, 2023, approximately 104,000 patients remained on the organ transplant waiting list. Organ demand exceeds supply.
Of the organ transplants performed in 2022, the majority (85%) were from “dead donors.” But these “dead donors” are not the cadavers we associate in our minds with death. Cadavers cannot be a source of fresh, viable organs. New definitions of death have been created to provide legal justification for organ harvesting from patients who in the past would have been considered alive. In the words of one group of transplantation advocates, “Donor shortage worldwide has led to the development of different strategies to increase the organ donor pool.”
The most recent innovation in pursuit of fresh organs is termed “normothermic regional perfusion with controlled donation after circulatory death” (NRP-cDCD). A more accurate description of this procedure is found in a position statement opposing NRP-cDCD by the American College of Physicians, the nation’s second-largest physician organization: “organ retrieval after cardiopulmonary arrest and the induction of brain death.”
In NRP-cDCD, a patient on life support who does not meet “brain death” criteria, and for whom a decision independent of organ donation was made to discontinue life support, is taken to the operating room. The patient is removed from life support and doctors wait for the patient’s heart to stop. If the patient’s heart stops, doctors wait a brief period (typically two to five minutes) and then begin invasive surgery.
First, surgeons cut open the chest cavity to prepare to harvest the heart and lungs. Then surgeons occlude the arteries carrying blood to the patient’s brain, either by directly clamping the blood vessels or by inflating balloons within the vessel lumens, with the specific goal of preventing blood flow to the brain.
Circulation of warm, oxygenated blood throughout the body is then re-established either via cardiopulmonary bypass or Extracorporeal Membrane Oxygenation (ECMO) and a heartbeat is restored. This keeps the patient’s organs, including the heart itself, fresh and viable for transplantation.
I strongly encourage readers to watch this short video showing surgeons perform this procedure before continuing to read.
Currently NRP-cDCD is being utilized in many states, including Arizona, California, Nebraska, New York, and Tennessee. There is enthusiasm for this technique in the transplant community because of the quality of the organs obtained, and it seems likely that NRP-cDCD will become more broadly utilized in the absence of public opposition.
….I and many others are convinced that “brain dead” patients are living, but wounded, human persons. If one accepts this, then patients undergoing NRP-cDCD are subjected to a severe brain insult, and then subsequently killed by the act of organ harvesting.
However, even if one were to unquestioningly accept that “brain dead” patients are dead, the ethical issue arises that “brain death” was intentionally caused in NRP-cDCD patients. Some proponents of NRP-cDCD claim that inducing “brain death” cannot kill the patient because death has already been established using circulatory criteria – the very same patient whose heart is now beating and in whom blood is circulating….
We Catholics must present a clear and unified voice to society upholding the sacredness of human life. Let us stand united in opposition to NRP-cDCD and closely scrutinize the morality of its constituent predecessors, DCD and “brain death.” Let us advocate for transparency in the process of organ donation by providing comprehensive information to persons at the Department of Motor Vehicles about the various ways they can be declared “dead” if they become organ donors, including NRP-cDCD.
Complete story in Catholic World Report.