Pope John Paul II and the Neurological Standard for the Determination of Death: A Critical Analysis of his Address to the Transplantation Society

Abstract

The introduction of the “brain death” criterion constitutes a significant paradigm shift in the determination of death. The perception of the public at large is that the Catholic Church has formally endorsed this neurological standard. However, a critical reading of the only magisterial document on this subject, Pope John Paul II's 2000 address, shows that the pope's acceptance of the neurological criterion is conditional in that it entails a twofold requirement. It requires that certain medical presuppositions of the neurological standard are fulfilled, and that its philosophical premise coheres with the Church's teaching on the body-soul union. This article demonstrates that the medical presuppositions are not fulfilled, and that the doctrine of the brain as the central somatic integrator of the body does not cohere either with the current holistic understanding of the human organism or with the Church's Thomistic doctrine of the soul as the form of the body. Summary The concept of “brain death” (the neurological basis for legally declaring a person dead) has caused much controversy since its inception. In this regard, it has been generally perceived that the Catholic Church has officially affirmed the “brain death” criterion. The address of Pope John Paul II in 2000 shows, however, that he only gave it a conditional acceptance, one which requires that several medical and philosophical presuppositions of the “brain death” standard be fulfilled. This article demonstrates, taking into consideration both the empirical evidence and the Church's Thomistic anthropology, that the presuppositions have not been fulfilled.

Does the Uniform Determination of Death Act Need to Be Revised?

“…The discussion that follows to address the question raised above is a brief summary of Nguyen’s critical analysis of John Paul II’s (2000) Address (Nguyen 2017, 2018, 241–346). The pope’s statement, which reflects his moral judgment about the use of the neurological criteria, rests on several presuppositions or conditions, all of which must be fulfilled if the conclusion (i.e., the pope’s judgment) is to follow.…”

“… 24. The nuanced language of John Paul II should guard us from interpreting his statement as if it were a plain affirmation that the BD criterion does not conflict (and, therefore, is compatible) with the Church’s anthropology. The phrasing “does not seem to conflict” implies that his presupposition, that the “BD paradigm is not inconsistent with the Church’s anthropology, only seems to be true according to [his] judgment based on the knowledge that he had around the time of his address” (Nguyen 2017, 163). …”

“…If the ventilator can make the BD “corpse” to appear alive, then logically, “if one connects the ventilator to the corpse of a person whose death was determined by the traditional criteria, then one would expect the ventilator […] to give the appearance of life in a dead entity. As intuited by common sense, this will not happen, however” (Nguyen 2017, 161).…”

Response

“…3,4 He added that "for ascertaining the fact of death, namely 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." 3 However, some outspoken critics (eg, Dr Nguyen) 5 were critical of the Pontiff's tentative and qualified support for the concept. 6 The quotes in question came from this summary following the statement: ".…”

Opinions on the Legitimacy of Death Declaration by Neurological Criteria from the Perspective of 3 Abrahamic Faiths

“…The exact moment of body-soul separation cannot be directly identified by modern scientific method, as acknowledged by Pope John Paul II, however the separation sets in motion an unstoppable process of somatic disintegration producing “biological signs that a person has indeed died” 40 , 41 . In other words, if somatic integration of the human organism as a whole continues, it is indirect evidence that the soul is still united to the body 40 . However, the specification of biological parameters indicating that death has occurred “does not fall within the competence of the Church” 42 .…”