"You aim at a devout life, dear Philothea, because as a Christian you know that such devotion is most acceptable to God's Divine Majesty," says St. Francis de Sales in his book "Introduction to the Devout Life".
And we can all be Philotheas, as St. Francis notes: "I have made use of a name suitable to all who seek the devout life, Philothea meaning one who loves God."
Below, you will find my best effort at a transcription of the sermon that can be found at the link
to AudioSancto. I have done some minor editing for clarity or to avoid
repetition. I have also added links to articles mentioned. My apologies to the
speaker for any errors.
Some 50 years ago, the moral theologian, Francis J. Connell,
CSSR, was posed a question concerning embalming. Question:
“In view of the modern opinion that apparent
death may precede real death by a considerable period of time, what admonition
should be given to our people
particularly to Catholic undertakers
as to how soon the process of embalming can be started after a person
has apparently breathed his last.”
"This is a problem of
great importance in the US, where the embalming of the dead is a general practice.
The main principal is this: the process of embalming may not be commenced until
it is certain that life is extinct, for undoubtedly, if the person is still
alive, the embalming process will directly cause death. Furthermore, mere
probability, even very great probability, that death is insured will not
justify the beginning of this process, for it is not permissible to do anything
which even only probably will directly cause the death of an innocent
Now let's do a thought experiment. Suppose we were about to
embalm somebody and as we begin to make an incision on the body, suddenly the
corpse begins twitching and grimacing. In light of the moral principle stated
by Fr. Connell, first, that the process of embalming may not commence until it
is certain that life is extinct; and second, that it is not permissible to do
anything which even only probably will directly cause the death of an innocent
person. In light of those moral principles, does anyone think we should
continue the embalming as scheduled?
Does anyone doubt that if we continued the embalming as
scheduled, we'd kill someone?
Does anyone think the proper thing to do would be to give
the corpse an anesthetic so he'd quit twitching, and then continue the
Now let's do another thought experiment. Suppose we were asked
to embalm someone in another room. And when we arrived, we see the person is
actually breathing with a ventilator. He has a heartbeat, has wounds which are
healing, and is producing urine.
In light of those moral principles, first that the process
of embalming may not begin until it is certain that life is extinct, and second
that it is not permissible to do anything which even only probably will
directly cause the death of an innocent person...in light of those moral
principles, would anyone agree to do the embalming as requested?
Does anyone doubt that if we continued to do the embalming,
we would actually be killing someone?
It's just pretty basic "thou shalt not kill" 5th
commandment stuff. If we keep all this firmly in mind, we already know
everything we need to know to understand the moral problem we're going to look
at today. What we'll do first is review and comment on an article and then
before we close we'll quickly consider some comments on this same topic by
members of the magisterium. It's not hard to understand at all; we already know
all the principles needed.
Let's take a quick look at an article... [Aug 14
2008 New England Journal of Medicine]:
"Before the development of
modern critical care, the diagnosis of death was relatively straightforward.
Patients were dead when they were cold, blue, and stiff."
Well, death is death; it's not like some new event in human
history. Why would this change?
The authors are about to answer that question.
from these traditional cadavers cannot be used for transplantation."
There are at least two important bits of information here. First,
that a traditional cadaver, which we'd commonly call a dead man, is cold, blue,
and stiff. Second, that organs from a traditional cadaver – that means a dead
man – that is to say the organs from a dead man – cannot be used for
transplantation. A dead man, a traditional cadaver, is cold, blue, and stiff,
and his organs cannot be used for transplantation.
Let's continue with the article.
"Forty years ago, an ad hoc committee at Harvard Medical
School suggested revising the definition
of death in a way that would make some patients with devastating neurologic
injury suitable for organ transplantation under the dead donor rule."
Let's pause for a moment and unpack that. First off, what is
the dead donor rule? The dead donor rule states that patients must be declared
dead before the removal of any vital organs for transplantation. Well, that
sounds like the same basic idea as the principals for embalming [from the quote
above]: “the process of embalming may not be commenced until it is certain that
life is extinct, for undoubtedly, if the person is still alive, the embalming
process will directly cause death”.
So the dead donor rule states that someone must be declared dead
before the removal of any vital organs, because obviously if the person is
still alive, the removal of vital organs will directly cause death. [As the
previous quote states:] “Furthermore, mere probability, even very great
probability that death has ensued would not justify the beginning of this
process, for it is not permissible to do anything which even only probably will
directly cause the death of an innocent person".
And of course, as we've already heard, the diagnosis of
death used to be relatively straightforward; patients were dead when they were
cold, blue, and stiff. Our authors refer to this patient as a traditional
cadaver, and they point out that organs from a traditional cadaver cannot be
used for transplantation. So some 40 years ago, a committee at Harvard Medical
School suggested that we "change the definition of death in such a way
that there would be organs available for transplantation." And that is
where the concept of brain death comes in.
It gets worse.
"The concept of brain
death has served us well and has been the ethical and legal justification for
thousands of life-saving donation and transplantations. Even so, there have
been persistent questions about whether patients with massive brain injury, apnea,
and loss of brain stem reflexes are really dead."
Whoa. What are we talking about there? What do we mean there
are persistent questions about whether dead patients are really dead? I'm not
putting words in their mouth here. If there were any question at all, to say
nothing of persistent questions, whether someone is really dead, then we've got
real problems. Probability, even great probability that death has ensued will
not justify the beginning of this process, it's not permissible to do anything
which even only probably will cause the death of an innocent person.
Now the authors are going to explain why there have been
persistent questions about whether or not so-called brain-dead patients are
"There have been persistent
questions about whether patients with massive brain injury, apnea, and loss of
brain stem reflexes are really dead. After all, when injuries are entirely intracranial,
these patients look very much alive. They are warm and pink; they digest and
metabolize food; excrete waste; undergo sexual maturation and can even
reproduce. To a casual observer, they look just like patients who are receiving
long-term artificial ventilation and are asleep. The arguments about why these
patients should be considered dead have never been fully convincing."
The authors explicitly state, "These patients look very
much alive, they're warm and pink, they digest and metabolize food, excrete
waste..." And then they state that "the arguments about why ...have
never been fully convincing...". Now that has to qualify as one of the
great understatements of all time.
Death means that the soul has left the body. That's what it
means. The soul has left the body. When our Lord and Savior Jesus Christ died
on the Cross, that meant his soul left his body. That's what happens when we die;
our soul leaves our body. That's what death is. That's why a traditional
cadaver is cold, dead, and blue. The real question is how anyone for even one
second could be convinced that someone who was warm and pink, could digest food
and excrete waste, and reproduce, and looks just like a sleeping patient
receiving artificial long-term ventilation, is actually dead. Perhaps someone
might object that these authors are exaggerating about the conditions of these
so-called brain-dead people.
Let’s refer to a few other sources. Here's another quote
from the New England Journal of Medicine,
this time the March 7, 2002 issue, page 786.
"Some persons who reliably
defined as brain-dead have clinically significant residual functioning as
evidenced by electro-encephalographic activity, unexpected survival, attempts
to sit up, reproducible eye-opening in response to pain, head movements in
response to stimulation. Most perplexing, children who have been given a
diagnosis of brain death continue to grow, and pregnant women have delivered
healthy infants up to 4 months after having been given a diagnosis of brain
death." [The quote is from a book review in the NEJM, available online here.]
Is this some kind of sick joke? Would that it were! Are we
talking about dead people here? Isn't that what we're supposed to believe, that
brain dead people are, well...dead? Because if we're supposed to believe that
brain dead people are dead, then can someone please explain how it is that dead
children can "continue to grow"? Can someone please explain how a
dead woman, a woman who has been dead for 4 months can give birth to a healthy
child? Can someone please explain how dead people can have "attempts to
sit up"? Can someone explain how dead people can have "reproducible
eye opening in response to pain? Can someone please explain how dead people can
have "head movements in response to stimulation"? Can someone please
explain how it is that "some persons reliably have clinically significant
residual functioning as evidenced by unexpected survival..."
Unexpected survival… Just exactly what did these people
unexpectedly survive? A fire? No. A terrorist attack? No. A plane wreck? No.
No, what these people unexpectedly survived was death! Death! They unexpectedly
survived death. Dead people survived death. Death's unexpected all right. Seems
to me that's the point of Easter.
Here's another example. Charleston, West Virginia, May 27,
“A Virginia family was shocked but
relieved when their mother ... woke up after doctors said she was dead. 59-year
old Mrs. Thomas was being kept breathing artificially, with no detectable brain
waves for more than 17 hours. The family were discussing organ donation options
for their mother when she suddenly woke up and started speaking to the
Does this sound like the behavior of a traditional cadaver?
Or consider this case – it's described in the Journal of California Nurses for Ethical Standards – in which a
brain dead patient put his arm around the assisting nurse as he was about to
have his heart removed for transplant. A dead man. Put his arm around the assisting
nurse when he was about to have his heart removed. Does this sound like the
behavior of a cold blue stiff traditional cadaver?
Consider this from the New
England Journal of Medicine: this is a book review of a book called Brain Death.
With respect to diagnosis, for
example, the book Brain Death states
that the observation period can certainly be shortened if a recipient is
waiting, and that a second opinion is not recommended because it may jeopardize
harvesting of organs (14:25) [repeats]
So the important thing is not whether or not the donor is
actually dead. No, the bottom line is, let's not do anything to jeopardize the
harvesting of vital organs. A second opinion is not recommended...now there is
a high standard of morality. It would be interesting to know what kind of money
is at stake here.
Returning to the original article:
"The arguments about why
these patients should be considered dead have never been fully convincing. The
definition of brain death requires a complete absence of all functions of the
brain, yet many of these patients retain essential neurologic functions."
Did they just say that the brains of some brain dead people
retain some functions? Yes they did. In other words, not only is a brain dead
person not dead, in many cases neither is his brain. They continue:
"Some have argued that
these patients are dead because they are permanently unconscious, which is
true, but if this is the justification then patients in a permanent vegetative
state who breathe spontaneously should also be diagnosed as dead, a
characterization that most regard as implausible."
I don't think "implausible" is the right choice of
words there. "Outrageous" or idiotic might be a little more
"Others have claimed that
brain dead patients are dead because their brain damage has led to the current
cessation of the organism as a whole. Yet evidence shows that if these patients
are supported beyond the acute phase of their illness, which is rarely done,
they can survive for many years."
Dead people can survive for many years. What's going on with
our language? If you pay attention to these kinds of things, abortion and all
these subjects, the language starts getting played with. Words matter. If I
play with the words up there at the altar, nothing's gonna happen. Language
matters. That's the Word became flesh. Let's remind ourselves that traditional
cadavers do not survive for many years; they're done surviving because they're
now dead. In fact, in the case of a traditional cadaver, if we don't embalm it,
we have to bury it quickly because it starts to decompose.
Back to our authors:
conclusion to be drawn from this literature is that although it may be
perfectly ethical"[well… it isn't] "to remove vital organs for
transplantation from patients who satisfy the diagnostic criteria for brain
death, the reason that it is ethical cannot be that we are convinced that they
are really dead."
Well, my dear faithful, no one needs a medical degree from
Harvard to recognize that brain dead people are not dead. They're not
traditional cadavers. Once we remove their vital organs, then they become
traditional cadavers, and then they will become cold, blue, and stiff.
It gets worse. As if the situation with brain dead donors
isn't horrific enough, now our authors are going to address the issue of a type
of cardiac death donor.
"Over the past few years,
our reliance on the dead donor rule has again been challenged, this time by the
emergence of donation after cardiac death as a pathway for organ donation.
Under protocols for this type of donation, patients who are not brain dead but who
are undergoing an orchestrated withdrawal of life support are monitored for the
onset of cardiac arrest. In typical protocols, patients are pronounced dead two
to five minutes after their heart stops beating, and the organs are
expeditiously removed for transplantation. Although everyone agrees that many
patients could be resuscitated after an interval of 2-5 minutes, advocates of
this approach to donation say that these patients can be regarded as dead
because a decision has been made not to attempt resuscitation."
Let's translate that into ordinary English. Now we're
talking about patients who are not even brain dead, they're on life support,
and with a surgical team waiting nearby the life support is removed and once
the heart stops beating, you wait for 2-5 minutes…I see, searching about this,
that at Children's Hospital in Denver, they wait a whopping 75 seconds with
infants. And then their organs are removed. Their organs are removed in spite
of the fact that "everyone agrees that many patients can be resuscitated
after an interval of 2-5 minutes. But advocates of this approach to donation
say that these patients can be regarded as dead because a decision has been
made not to attempt resuscitation”.
Words matter. The authors continued:
"This understanding of
death is problematic at several levels. The cardiac definition of death
requires an irreversible cessation of cardiac functioning, whereas the common
understanding of irreversible is 'impossible to reverse' [because that's what it means] in this context, irreversibility is
interpreted as a result of a choice not to reverse. This interpretation creates
the paradox that the hearts of patients who have been declared dead on the
basis of the irreversible loss of cardiac function have in fact been transplanted
and have successfully functioned in the chest of another."
Did you just hear that? People who have been declared dead…
they've been declared dead through an irreversible loss of cardiac function,
that heart won't function. They cut it out, and it's beating in somebody else's
"Again, although it may be
ethical to remove vital organs from these patients, we believe that the reason
it's ethical cannot convincingly be that the donors are dead."
That clause we can agree with. My dear faithful, again, no
one needs a med degree from Harvard or anywhere else to recognize that saying
these sort of cardiac death patients can be regarded as dead simply on the
basis of a decision not to attempt resuscitation no one can think that this
isn't evil. These sort of cardiac death patients are not traditional cadavers
like the so-called brain dead patients, they are simply not dead. They're not
dead, they're alive, and in all cases like this, the surgical team removing the
organs is killing them. Period, close the book.
Let's turn to the teachings of Bishops Bruskewitz and Vasa,
co-authors. This is found in an
article entitled "Are Organ Transplants ever Morally Licit? A Commentary on the Address of John Paul II
to the 18th International Conference of the Transplantation Society”. Bishops
Bruskewitz and Vasa et al:
"People must fully
comprehend that when they agree to be organ donors they give transplant
surgeons a license to terminate their lives. When healthy vital organs are
taken in accordance with the legal common practice of medicine, the donor is
killed. The donor is treated and prepared for surgery in a way similar to any
living patient going to the operating room. After removal of healthy vital
organs, what is left is an empty corpse.
“Such removal is ethically
unacceptable. It is the removal of the organs that changes the living person to
a dead one. It is unethical for transplantation surgeons to continue performing
such procedures that mutilate a living human body. These procedures treat the
donors as if they were artificially sustained biologic entities rather than
human persons worthy of dignity and respect. The removal of a healthy unpaired
vital organ suitable for transplantation from someone who has been declared
legally dead brain dead, but is not truly biologically dead, is not ethically
acceptable. Evil may not be done that good might come of it."
But they haven't told us anything we didn't already know
after considering the question about embalming, have they? It's a question of
natural law. “The removal of healthy unpaired vital organs suitable for
transplantation from someone who has been declared legally dead brain dead, but
is not truly biologically dead, is not ethically acceptable.”
Okay. If we can't cut organs out of brain dead people, can
anything be cut out of truly dead people, traditional cadavers, corpses, and
used for transplantation?
"After death, tissues such
corneas, heart valves, bones, connecting tissues, may still be useful for
transplantation. Note that these are tissues, not organs, and may be taken only
after death because excision of these would otherwise cause mutilation or
death." [inaudible reference]
As Bishops Bruskewitz and Vasa clearly teach,
"All men of good will must
properly understand and explicitly follow the applicable theologic and moral
laws. These laws are no unpaired vital organ can be morally removed from a
living human person. There should be no commercial traffic in human organs. People,
especially the young, must fully comprehend that when they agree to be organ
donors, they give transplant surgeons a license to terminate their lives."
Let's get practical. What does this mean for those of us who
are trying to be faithful soldiers in the Church Militant and thereby save our
immortal souls? It means that we do not sign any kind of organ donation
agreement on the back of our driver’s license or anywhere else. It means that
no matter what our medical condition and how dire the straits we find
ourselves, we do not accept any sort of transplant organ cut out of one of our
brain dead or cardiac dead brothers or sisters. For those in the medical
community, it means that no matter what it may cost us personally and
professionally, we must put these sort of procedures in the same moral category
as tubal ligations, abortions, and contraception; evil may not be done that
good may come of it. These types of organ donor patients are not dead. They're
alive. And healthy vital organs are taken out of organ donors in accordance
with the common legal practice of medicine, the donor is killed. Is killed.
These new definitions of death are nothing but lies. They're lies from the
person standing behind this culture of death, lies from the one who's a liar
and a murderer from the beginning. They're lies. They're killing our brothers