By  Michael H. Brown

If it were a matter of living or dying, would you choose an organ transplant?

Many of us, thanking science, would say yes.

It doesn't seem like much of a decision, and the Vatican says it's okay, even encourages people to donate their organs when they die.

But as it happens, there is a growing controversy over whether or not many whose organs are taken are actually yet dead.

I first became aware of this speaking with a high-level surgical nurse who was on our pilgrimage to the Holy Land. She took issue with the Vatican determination and told me that she refused to go on organ "harvests": plane trips with doctors who are heading off to procure organs from someone who is on his or her deathbed.

The reason: she didn't think a lot of them were deceased; she felt in some cases their souls were still in their bodies.

They were unconscious but alive when their organs were taken.

It is a staggering notion that was brought into sharper focus last year by Discover Magazine in an article that started by noting how one organ harvest proceeded over the objections of the anesthesiologist, who "saw the brain-dead donor react to the scalpel."

Eerie stuff. Before and after choosing such an option, one needs to pray for the right course -- certainly, that the organ come from the right donor (one that is fully departed, as the Church says).

As noted by the writer, Dick Teresi, it was in 1968 that thirteen men gathered at Harvard Medical School to redefine death, "hammering out a simple set of criteria to declare a person dead in less time than it takes to get a decent eye exam." It was now decided that someone had passed into death when he or she lost "personhood." No longer was loss of heartbeat required. Death now meant brain death -- and that was decided based on reaction to pain, whether there are any spontaneous movements or breathing, the presence or absence of reflexes, and a flat EEG (which measures electrical brain activity). If a person was brain-dead -- or at least no longer functioning as far as the lower brain stem, which controls so much of the body --  organs could now be harvested.

And so the way was paved for what is now a $20-billion industry.

One doctor who at first accepted that definition later reversed himself, compiling 150 documented cases of "brain-dead" patients whose hearts continued to beat and whose bodies did not disintegrate after a week's time. "In one remarkable case, the patient survived twenty years after brain death before succumbing to cardiac arrest," reported Teresi.

In other words: brain "death" is not always death.

In fact, the bodies of brain-dead people -- known as "beating-heart cadavers" -- can heal wounds, fight infections, and respond to certain stimuli. Brain-dead pregnant women can gestate a baby. There have been at least twenty-two such documented cases. Healthy babies have been born to them (one pregnant woman was kept alive for 107 days to have her child).

Most people don't realize that "dead" donors are frequently kept on a ventilator so the organs remain fresh. Their hearts are often defibrillated. Their kidneys are treated. They urinate. Fluids are administered to avoid incipient diabetes. It is a new obsession, frets Dr. Michael DeVita of the University of Pittsburgh's Medical Center: recycling the bodies of people who (in his chilling words) are only "pretty dead."

This is very serious spiritual territory.

Our Church may want to revisit certain aspects.

Are there donors who may have recovered? Do they feel pain? "I like my dead people cold, stiff, gray, and not breathing," said Devita flatly. "The brain-dead are warm, pink, and breathing. They look sick, not dead."

Very serious.

In one case, reports Discover, "an anesthesiologist administered a drug to a beating-heart cadaver to treat an episode of tachycardia during a harvest. The donor began to breathe spontaneously just as the surgeon removed his liver."

In another case, a thirty-year-old was declared brain dead even though he was breathing on his own. Over the objections of the anesthesiologist, who saw the donor move and react to the scalpel, his organs were excised. It was in vain: the person who was to receive the liver died before he could get the organ, which thus went untransplanted.

And so we see a potential scandal here. When does the spirit leave the body?

What if other parts of the brain remain alive when the stem is "dead"?

Are any organ donors conscious but not obviously so during the "harvest"?

Again, most of us would choose this route, given no alternative. But praying for the right way is a must. Too often we simply walk right through medical procedures. We should also pray for donors, and if choosing this option, have a priest bless the transplant.

In an especially startling case, a woman who "died" after giving birth was readied for organ harvest but after treatment regained consciousness.

Some fear the donors may be in severe, unspoken pain.

Others argue it's just reflexes. Perhaps that's true. Perhaps it's just that we can keep a body technically alive through the force of technology.

Heavy stuff. But we have to face it. Oh, we should, Church, further explore this.

And we need to remember one thing, stated by one of the greatest brain surgeons in history: all of the brain may be in the mind, but not all of the mind is in the brain.

[resources: afterlife books]

[Michael Brown retreats: Louisiana and Indiana]

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