Randy Engel
Book review: Finis Vitae -- Is "Brain Death" True Death?
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By Randy Engel
January 17, 2012


"Why Does A Corpse Need Anesthesia? —
A Hundred and One Questions and Answers on the Fiction of 'Brain Death'"

Part I


    MAYOR — As Mayor of the Munchkin City
    In the County of the Land of Oz
    I welcome you most regally

    BARRISTER — But we've got to verify it legally
    To see...

    MAYOR — To see?

    BARRISTER — If she...

    MAYOR — If she?

    BARRISTER — Is morally, ethic'ly

    FATHER NO. 1 — Spiritually, physically

    FATHER NO. 2 — Positively, absolutely

    ALL OF GROUP — Undeniably and reliably
    Dead! ...

    CORONER — As Coroner, I must aver
    I thoroughly examined her.
    And she's not only merely dead,
    She's really, most sincerely dead. [2]

      On the Death of the Wicked Witch of the East
      From the film script based on L. Frank Baum's
      The Wonderful Wizard of Oz
Introduction

The above scene from the 1939 film The Wizard of Oz quite clearly demonstrates that most people — be they lay or professional — have little difficulty in distinguishing a live human being from a dead one. Thus even the unsophisticated Munchkins were able to rattle off in an easy sing-song fashion that the wicked Witch of the East was dead in every way — positively, absolutely, undeniably, and most sincerely dead.

The Traditional Criteria for Death

Throughout the ages, great care has been taken to avoid the unthinkable mistake of declaring a person dead who is still alive.

The classical determination that a human being is dead and that the soul has separated from the body includes the absence of a heart beat, pulse, and blood pressure. The three major systems — the circulatory and respiratory system and the entire brain — are no longer functioning. The person has stopped breathing. There is poor color of the skin, nails, and mucous membranes. Rigor mortis, rapid decomposition and putrefaction are among the last recognizable signs that death has occurred.

What remains is a corpse — an empty, cold, blue, rigid body unresponsive to all stimuli. Ventilation will not restore respiration to a corpse. A pacemaker can send a signal, but it cannot initiate a heartbeat in the person who is truly dead. Healing never occurs in a corpse. [3]

But, this was before the creation of the fiction of "brain death." as the criterion for death by the Harvard Medical School Ad Hoc Committee on "Brain Death' in 1968. [4]

Because unpaired vital organs suitable for transplantation can only be obtained from a living donor, the new utilitarian golden mean of "brain death" requires that the donor be alive enough to provide fresh vital organs for transplantation purposes, but dead enough to grant legal immunity from prosecution to the transplant surgeon and his team, and the medical center, for acts of killing or homicide.

Some readers may recall that my very first article for Renew America on March 21, 2011, was titled "Don't Give Your Heart Away — know the facts about unpaired vital organ transplantation. http://www.renewamerica.com/columns/engel/110321 So it seems fitting that, on this, my upcoming first anniversary as a columnist for Renew America, that I revisit the scene of the crime and reveal new evidence in opposition to the false, un-scientific, and outdated criterion of "brain death" promoted by the vital organ transplantation industry and its minions.

Finis Vitae Almost Didn't Make It to Print

In his introduction to Finis Vitae, Paul A. Byrne, Neonatologist and Clinical Professor of Pediatrics at the Medical University of Ohio, and President of the Life Guardian Foundation, gives some interesting facts behind efforts to thwart the publication of this important book. [5]

Dr. Byrne reports that in 2004, Pope John Paul II asked a group of faithful lay Catholics to collaborate with the Pontifical Academy of Sciences (PAS) to re-examine in depth the issues of "brain death" and unpaired vital organ transplantation. Previous official meetings held by the PAS on these critical matters in 1985, and again in 1989, were with few exceptions, dominated by scientists and physicians loyal to the organ transportation industry, and produced little in the way of illuminating the true nature and implications of the controversies surrounding the definition of "brain death" as a valid criterion for true death, and the institutionalized practice of excising unpaired vital organ from living persons for transplantation purposes.

One of the key provisos imposed on organizers of the meeting by the Vatican was that both sides of the issues, pro and con, be equally represented at the conference.

On February 3-4, 2005, "The Signs of Death" Conference was convened in Vatican City by the PAS. At the conclusion of the conference, the usual preparations were made to print and distribute the proceedings of the conference, but at the 11th hour, the printing was called off without any explanation.

That this mishap involved more than a bureaucratic error became evident when the PAS organized another conference on September 11-12, 2006, under the same title "The Signs of Life." This time, however, there was no requirement imposed by the Vatican on the organizers for balance in the selection of presenters. Not surprisingly, the deck was conveniently stacked in favor of the advocates of "brain death," and the proceedings were printed and distributed without any delay.

The source of the behind-the-scenes intrigue was traced to pro-"brain death" advocates within the Board of Directors of the PAS and Curia and lay officials associated with the Pontifical Academy of Life and the Pontifical Council for Healthcare Workers. [6]

Fortunately for the Catholic faithful the world over, Byrne and his colleagues who oppose "brain death" decided to publish their papers from the original 2005 "The Signs of Death" Conference under the auspices of the National Research Council of Italy.

The Italian version of Finis Vitae, edited by Professor Roberto de Mattei, was published in 2006. And in 2009, the English version was edited and updated by Dr. Byrne and published by the Life Guardian Foundation.

The eighteen papers published in Finis Vitae in opposition to "brain death" are authored by world-class neurologists, philosophers, neonatologists, jurists, and bioethicists, and are remarkable for their exquisite truthfulness, clarity, and conviction. Let's take a closer look at their arguments which have the capability of crippling the whole mercenary transplantation industry if they were but more widely known.

Harvard Ad Hoc Committee Repeatedly Discredited

In my earlier article for Renew America, "Don't Give Your heart Away...." I explained briefly the history of the Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death which was formed in 1968 for the purpose of redefining death so as to permit physicians to legally excise and transplant fresh vital organs from living human beings. This quest for a redefinition of death came on the heels of Dr. Christiaan Barnard's first human heart transplant operation (killing) in South Africa on December 3, 1967, and Brooklyn surgeon Dr. Adrian Kantrowitz's murder of a live, 3-day-old baby, in order to secure a beating heart for an 18-day-old baby with heart disease, on December 6, 1967. Scalpel-sharp criticism of the Harvard fiasco is found throughout the text of Finis Vitae. Professor Emeritus Robert Spaemann, one of Germany's leading Catholic philosophers, who made his presentation in opposition to "brain death" at both the 2005 and 2006 "The Signs of Life" Conferences pulls no punches when he says:
    The new definition of death as "brain death" makes it possible to declare people dead while they are still breathing and to bypass the dying process in order to quarry spare parts for the living from the dying. Death no longer comes at the end of the dying process, but — by the fiat of a Harvard commission — at its beginning. [7]

    The commission intended to provide a new definition [of death], clearly expressing their main interest. It was no longer the interest of the dying to avoid being declared dead prematurely, but other people's interest in declaring a dying person dead as soon as possible. [8]
Professor Spaemann reminds card-carrying donors and their families especially, to be aware that "A transplantation physician professionally sides with the recipient, not the donor of organs." [9] The practical application of this obvious conflict of interest is that the donor card may become the donor's death warrant. As another contributor, Cicero Galli Coimbra, M.D., PhD, a Clinical Neurologist at the Federal University of Sao Paulo, Brazil, points out, "... nowadays many brain injured patients conceivably evolve to deep coma and are submitted to diagnostic procedures for BD/BSD (brain death/brain-stem death) without having even received the current standard of basic care to prevent further brain injury from secondary insults (emphasis added). [10] Among these tests is the apnea test for determination of "brain death," which is administered for the ultimate benefit of the organ recipient not the injured patient. [11]

The Coup de Grace of the Apnea Test

The necessity of ending the practice of carrying out the deadly apnea test on potential organ donors to determine "brain death" is another major theme found in Finis Vitae. While this test is often categorized as "cardinal," "essential," "central," or "mandatory," in reality, the apnea test serves no therapeutic purpose whatsoever for the potential donor. Rather, its primary purpose is to determine if the patient can or cannot breath on his own in order to declare him "brain dead," and thus eligible to be an organ donor. True informed consent concerning the nature of and dangers posed by the test are usually withheld from family members lest they withhold support for the test, without which the transplantation protocol cannot proceed. In another of Coimbra's essays, "The Apnea Test — A Bedside Lethal 'Disaster' to Avoid a Legal 'Disaster' in the Operating Room," the neurologist states that the apnea test administered to the seriously brain injured patient may cause "irreversible damage to brain tissue," and even death. [12] However, he says, while most physician advocates may publicly comment on "the possibility of damage by the apneic insult to transplantable organs," they are unwilling to publish information on "the ethical implications of worsening the clinical and neurological conditions of the potential donor or even causing his (or her) death." [13] According to Coimbra, the apnea test is not only "undoubtedly unethical" but it is also "technically useless for its own intended or declared purpose of characterizing the irreversible loss of respiratory reflex." [14] Because the apnea test "violates the most fundamental guidelines for the management of severe brain injuries by inducing hypercarbia, hypotension and hypoxia," Coimbra says, "it may solely administer the coup de grace" to a potentially recoverable patient lined up for organ procurement. [15] Dr. Coimbra laments the fact that, "... too many lives have been lost during the last decades of blindness, when the diagnosis of 'death' has been applied to the silent brain receiving critical levels of blood supply." But, he concludes on a more hopeful note that "A patient who would have hopelessly died years ago, may now recover by novel and effective therapies developed from improved knowledge on the pathophysiology of coma." [16]

The UK Experience with "Brainstem Death"

In "Brain Death — A United Kingdom Anesthetist's View," clinician, physician, and anesthetist of some 42 years, David J. Hill, M.A., FRCA, answers the question posed in this article's title, "Why Does a Corpse Need Anesthesia?" The answer is, of course, that a corpse doesn't need anesthesia, but a living person whose heart is about to be cut out from his body along with other vital organs, DOES. In his introductory remarks, Hill explains that he had entered the organ transplantation field early in his medical career. His practice included the removal of corneas, and later kidneys, from cadavers. [17] But he later withdrew from the transplantation program after experience with beating-heart donors. Hill became convinced that these patients were "not dead in any normally accepted way," and that donors and potential donors were being "deceived by not being allowed fully informed consent." [18] In 1976, the Conference of Royal Medical Colleges and their Faculties in the UK drew up a paper mistitled "The Diagnosis of Brain Death." The term "Brain Death" was later replaced with "Brainstem Death," and finally "Death for Transplant Purposes," and "Death certified by brainstem testing." The original and ostensible purpose of the paper was declared to be the formalizing of guidelines for the removal of ICU life support systems from seriously injured patients who could not be fully resuscitated and for whom further treatment remained futile. The patient's subsequent death was ascertained and certified in the traditional manner, i.e., by the total cessation of breathing and circulation. The real reason for the new criteria and tests, however, did not become clear until three years later when the same Conference issued a Memorandum stating that these criteria and tests could also be used to discern death "because by then all functions of the brain have permanently and irreversibly ceased." [19] Thus, "the legal framework for obtaining viable organs for transplantation," was put into place even though the brainstem testing was 1) incapable of determining higher brain functions which operate independently of the brainstem, and 2) tests for destruction of the brainstem are incomplete says Hill. [20]

The Lazarus Phenomenon

One of the most fascinating aspects of Hill's presentation is his comments on the so-called "Lazarus phenomenon" where patients who have been certified dead by brainstem testing exhibit purposeful movements. [21] These spontaneous movements which obviously cause "great alarm" in the operating room or ICU, says Hill, are dismissed by the staff as "purely reflex and terminal" although they are coordinated and may well represent cerebellar and higher brain involvement. [22] Also dismissed as mere reflex, he says, are the movements and the accompanying rise in pulse rate and in blood pressure at the beginning of and during surgery — responses which correspond to the responses of any surgical patient who is too lightly anaesthetized. [23] "It is always necessary to paralyze the beating heart donor in order to prevent patient movement and to make the surgery possible," Hill states. "It is not natural to observe so many signs of life in one supposed to be dead," Hill reflects. "As has been observed by others, no pathologist would readily perform a post mortem examination on such a responsive body; no undertaker would bury or cremate one," Hill concludes (emphasis added).

Aggressive Media and Government Hype Keeps the Public Clueless

Many of the contributors to Finis Vitae freely express their deep distress at the hype, disinformation, and lack of true informed consent associated with the mass media and government's promotion of Excise Murder, Inc. Cardiologist Dr. Yoshio Watanabe of Japan, in his article on his country's seven-year experience after the promulgation of the Organ Transplantation Law (1997-2004), reports that both the mass media and the Japanese government issued "propaganda" rather than "well balanced information" on the matter, promoting the act of organ donation as "a noble deed" based on love of humanity and brotherly love. [24] Watanabe said that most lay people were made to believe that organ transplantation was a "wonderful therapy that could save lives" not an act of murder of the living donor for the benefit of the organ recipient. [25] Similarly, Dr. Coimbra reports that money and a vast propaganda machine fuel the organ transplantation industry in Brazil. [26] "... there is a gigantic, everlasting advertising campaign devoted to convincing people to accept organ donation, and to communicate to their family members their wish (before becoming 'brain dead).'" [27] Coimbra makes an additional point often overlooked in the transplantation controversy, that prevention campaigns dedicated to increase the compliance with effective treatments available for the control of hypertension and diabetes (the two leading causes of chronic renal failure) are almost non existent, thereby "preserving an indefatigable and high demand for transplantable organs." [28]

What About the Donor's Interest?

The ugly, utilitarian reality of surgical organ harvesting is always carefully hidden from the public explains former transplant cardiologist Dr. Walt Franklin Weaver in his essay, "Unpaired Vital Organ Transplantation Secular Altruism? Has killing become a virtue?" [29] Members of transplant teams composed of surgical specialists from various medical centers view the donor "as in a mirror dimly" says Weaver:
    If not spirituality blinded, they were often visually blinded since often their view of the "donor" would be obscured by surgical drapes that often would have been placed prior to the arrival of the surgical harvest team. As each of them delivered the organs of their specialty to recipients in their various medical center, there would be "speaking in tongues of men and angels and clanging cymbals" and the local media, hospital spokesmen, other doctors, and patients would praise them for bringing their "gifts of life" .... [30]
Speaking from experience, Weaver admits that human pride and glory are motivating factors for transplant physicians. He ends his observation by paraphrasing the words of God to Saint Catherine of Siena — "Do you know, physician, who you are and who I am? You are he who is not, and I am he who is." [31]

(to be continued)

[In Part II of "Why Does A Corpse Need Anesthesia? — A Hundred and One Questions and Answers on the Fiction of 'Brain Death,'" I will examine the philosophical and metaphysical arguments against "brain death" and the extraordinary admissions of pro-"brain death" proponents who have come over to the opposition camp following what they refer to as their "Damascus Moment."

NOTES:

[1]  Finis Vitae — Is "Brain Death" True Death? is published by the Life Guardian Foundation. For ordering information go to http://lifeguardianfoundation.org/.


[3]  See Michael Fund interview with Dr. Paul Byrne, "The Myth of 'Brain Death,'" at http://www.michaelfund.org/TMF_Newsletters.php.

[4]  According to Dr. David Evans, a contributor to Finis Vitae, The term "brain death" did not originate with the Harvard Committee (1968), but can be traced to common usage among Intensive Care Unit staff beginning in the mid-1950s as a verbal "shorthand" for coma patients who were incapable of breathing on their own, unresponsive to stimuli, and showed no signs of brain function. See p. 115.

[5]  Byrne essay, "Death: the absence of life," Finis Vitae, p. 84.

[6]  See Charter for Heath Care Workers, Pontifical Council for Pastoral Assistance at http://www.ewtn.com/library/CURIA/PCPAHEAL.HTM.

[7]  Robert Spaemann, "When Death Becomes Inhuman" at http://payingattentiontothesky.com/category/robert-spaemann/.

[8]  Spaemann, "Is Brain Death the Death of the Human Being," Finis Vitae, p. 260.

[9]  Ibid., p. 262.

[10]  Dr. Cicero Galli Coimbra, "Are 'brain dead' (or 'brain-stem dead) patients neurologically recoverable?" Finis Vitae, p. 335. Please note that both of Coimbra's essays were added to the final text of Finis Vitae.

[11]  Ibid., pp. 313-319, 355. See the tenderly-related story of Dr. Coimbra's care for a young brain injured Brazilian girl who critical condition was compromised by the administration of two apnea tests of 10 and 12 minute duration , in order that she might declared "brain dead" and qualify as an organ donor.

[12]  Dr. Cicero Galli Coimbra, "The Apnea Test — A Bedside Lethal 'Disaster' to Avoid a Legal 'Disaster' in the Operating Room," Finis Vitae, p. 135.

[13]  Ibid., 135.

[14]  Ibid., 136, 137.

[15]  Ibid., 137.

[16]  Ibid., 161.

[17]  Some organs and tissues like corneas, and to a lesser extent, kidneys can be obtained from truly dead persons. Other vital organs like the heart, lungs, liver, pancreas, small bowel and so on must be obtained from a living patient/donor.

[18]  David J. Hill, "Brain death — A United Kingdom Anaesthetist's View," Finis Vitae, p. 163

[19]  Ibid., p. 166.

[20]  Ibid.

[21]  Coimbra confirms Hill's statement in his essay on apnea testing, p. 149. He describes certain movements of the "brain dead" patient: "the arms flex quickly to the chest from the patient's side, the shoulders adduct, and in some patients, the hands cross or oppose just below the chin. The limbs then return to the patient's side, sometimes asymmetrically.

[22]  Ibid., p. 171.

[23]  Ibid., 172.

[24]  Dr. Yoshio Watanabe, "Controversies on Brain Death in Japan and Our Seven-Year Experience After the Enforcement of the Organ Transplantation Law," Finis Vitae, p. 284.

[25]  Ibid.

[26]  Coimbra, "The Apnea Test ...," p. 159.

[27]  Ibid., p. 159.

[28]  Ibid.

[29]  Walt Franklin Weaver, "Unpaired Vital Organ Transplantation Secular Altruism? Has killing become a virtue?" Finis Vitae, p. 11.

[30]  Ibid.

[31]  Ibid.

© Randy Engel

 

The views expressed by RenewAmerica columnists are their own and do not necessarily reflect the position of RenewAmerica or its affiliates.
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Randy Engel

Randy Engel, one of the nation's top investigative reporters, began her journalistic career shortly after her graduation from the University of New York at Cortland, in 1961. A specialist in Vietnamese history and folklore, in 1963, she became the editor of The Vietnam Journal, the official publication of the Vietnam Refugee and Information Services, a national relief program in South Vietnam for war refugees and orphans based in Dayton, Ohio... (more)

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