Book review: Finis Vitae -- Is "Brain Death" True Death?

By Randy Engel

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

Part II
Introduction — Biology 101

Biologically speaking, the human body is composed of cells, tissues, organs and eleven systems, including three major vital systems. No one organ or system controls all other organs and systems. Interdependent functioning of organs and systems maintains unity, homeostasis, immune defenses, growth, healing and exchange with environment, e.g., oxygen and carbon dioxide.

The wondrous complexity and interaction between the body's vital organs and major systems, in particular, the heart and the autonomic nervous system, is highlighted in John Andrew Amour's essay in Finis Vitae titled "The Heart of the Matter," in which the author speaks of little brains:

The identification of little brains in the heart, gut, and other organs that are dedicated to self- regulation of the organs they subserve suggest that the autonomic nervous system is made up of local networks involved in maintaining the milieu intereurin in a manner not totally subservient to central neuronal. [2] That the internal nervous system is capable of processing information from multiple internal organs along with centripetal (to the brain) and centrifugal (from the brain) information in the maintenance of the milieu intereur represents a novel perspective with which to understand the totality of the human body. [3]

For purposes of this article, it may be well to point out that the human embryo does not develop a brain until he is 6 weeks old, yet he is a living human being, a human person, from the moment of conception. Therefore, human life is present independently from, and prior to, brain function. Anencephalic infants, who lack the upper part of the brain but have a brain stem, are also human persons. Individuals who are in a coma including those who have been labeled "brain-dead" are also living human persons, even if they require a ventilator. In fact, a ventilator can only be of use to a living human being because while the machine can inflate the lungs and provide oxygenated air, at the systemic level, respiration, the exchange of oxygen and carbon dioxide is the task of the patient. [4]

The Brain is Not a Super-Organ

In his excellent introduction to Finis Vitae, editor, Dr. Paul A. Byrne tackles one of the most important medical myths that drives the "brain-death" (aka, "irreversible coma") engine relentlessly forward, namely, that a man's brain is a "super-controller" — the be-all and end-all of his existence.

Here are some basic facts about the brain presented by Byrne that clearly demonstrate why the medical criterion of "brain-death" is untenable.

• The brain is not a single unit. It is composed of several closely interrelated parts (cortex, cerebellum, midbrain, medulla, etc.) Though composed of superficially similar tissues and closely linked together both anatomically and physiologically, these parts can continue to live and act independently of one another, even when one or more of them has been destroyed. [5]
  
  
• The brain as a whole has no physiologically identifiable, single function that can rightly be called the "life-giving function" or the function of the brain as "organ of the whole." [6]
  
  
• The brain has a large multiplicity of different functions that are characteristic of its different parts, each of which can function without the others. [7]
  
  
• None of these parts is in complete control of the others. [8]
  
  
• The loss of brain function or activity, whether reversible or irreversible, is not the same as the total or even partial destruction of the brain, nor does it automatically follow that the person suffering the loss of function is dead. [9]
  
  
• Destruction of the brain and cessation of its functioning and certain activities, are, in principle, directly observable, and such observations can serve as evidence. However, the prognosis of "irreversibility" of cessation of brain function is a criterion which is not an observable condition, and therefore, cannot serve as evidence nor be rightly made part of an empirical criterion of death. [10]
  

As Byrne notes, "...to regard the irreversibility of cessation of brain function as synonymous or interchangeable with destruction of the entire brain is to commit a compound fallacy: identifying the symptoms with their cause and assuming a single cause when several are possible. [11]

In his essay on the legal aspects of "brain death," titled "Determining Death: Is Brain Death Reliable?" German-born jurist Rainer Beckmann reiterates Byrne's analysis that while the brain is "vital" and it is essential for breathing, "there is no absolutely exceptional role of the brain concerning 'self-activity' and controlling.'" [12] According to Beckmann:

... the advocates of the concept of brain death do not see that the brain keeps the human being alive only in interaction with all the other vital organs: heart, lings, kidneys, etc. From a systemic-biological point of view, the brain not only keeps heart, lungs, kidneys, etc. alive, but these organs also keep the brain alive. The brain can therefore not be seen as the absolutely decisive instance for the maintenance of life in a human being. [13]

In his concluding statement, Beckman, Vice-Chairman of the Jurists Society for the Right to Life, reiterates the same position that Dr. Byrne and every contributor to Finis Vitae defends, "The features of death, i.e., the end of the physical-spiritual unity and the biological unity of the organism as a whole, are not reliably indicated by the brain death criterion." [14]

The Utilitarian Philosophy Behind "Brain Death"

Professor Roberto de Mattei, Vice-President of the National Research Council of Italy and editor of the Italian version of Finis Vitae, in "Genuine Science or False Philosophy?" opens the door to an examination of the anti-Christian and utilitarian philosophy that undergirds "brain death" as a definitive criterion for true death. It is a door which has been consistently closed and bolted shut by proponents of "brain death," including many prominent Catholic clergy, professionals, and laymen.

De Mattei reminds the reader that the Ad Hoc Harvard Committee Report was dominated by a utilitarian and materialistic philosophical bias passed off as scientific fact. His quote from a letter dated October 30, 1967, by Henry K. Beecher, Chair of the Committee, to Robert Ebert, Dean of the Harvard Medical School, in which Beecher writes, "The time has come for a further consideration of the definition of death. Every major hospital has patients stacked up waiting for suitable donors," confirms that bias. [15]

"The notion of brain death," explains de Mattei, reflects an "inherent materialism which in fact identifies the vital core of the human being in brain activity itself" as taught by both Engels and Lenin. [16] This belief, he says, is in diametrical opposition to the philosophical foundation of Western civilization which holds that a human being is made up of soul and body, and indeed in its spiritual soul resides his vital core." [17]

Man is More Than His Brain

Many of the contributors to Finis Vitae, including de Mattei, identify with Aristotelian-Thomistic thought, and uphold the traditional Catholic belief that the rationale soul is the one and only "substantial form" of the body. [18] As de Mattei explains, "Obviously 'rational soul' does not by any means indicate the intellectual functions of an individual, but rather the presence within the individual of a life principle of a spiritual nature which encompasses within itself, the potentiality of the operation of those functions." [19]

Further, de Mattei states, "The generatio, i.e., the biological shaping of the body, does not follow, but rather precedes the infusion of the soul, just the way that biological death does not follow, but precedes that of the soul. [20] This means, that at true death, it is the body that separates from the soul and that the cessation of all brain activities is the beginning, not the end, of the body's progressive dissolution process. [21]

Complementing de Mattei's presentation is an article by Professor Michael Potts of Methodist University, Fayetteville, N.C., titled "The Beginning and the End of Life-Toward Philosophical Consistency." As Potts points out, "Issues at the edges of life are inevitably interdisciplinary, that is, they involve not only scientific matters, but also philosophical and theological ones." [22] Potts' section on the metaphysics of human personhood will be of special interest and value to pro-lifers currently engaged in state-wide "Personhood" legislation.

"Brain Death" as a Grave Metaphysical Error

One of the most intriguing and searing attacks on the criterion of "brain death" is Dr. Josef Seifert's summary paper titled "On 'Brain Death' in Brief: Philosophical Arguments Against Equating It With Actual Death, and Responses to 'Arguments' in Favor of Such an Equation." Professor Seifert is Rector of the International Academy for Philosophy in the principality of Liechtenstein and a member of the Vatican's Pontifical Academy for Life.

Seifert traces one of the main root errors of so-called "brain death" to a false biological concept that views human life in terms of "an integrated whole of organs and cells," rather than "human life ... in its concrete incarnate form, derived solely from the presence of the intellective human soul in the body." [23]

Seifert goes further by reminding the reader that:

It is not the life of the soul in the body, but the life of the soul itself, which is also the deepest ground and source of personal life on earth; the human life on earth is precisely the life of the soul as long as it is united with the body and vivifies the body of the human person, bestowing its own life on the body and making the body participate in it. And this life can precisely also exist outside of, and apart from, the body, as the philosophical arguments for the immortality of the human soul show. In the light of these reflections on the nature and different data we call human life, we see more clearly why any reduction of human life to integrated function is wrong and why the loss of a part of bodily integration and co- ordination through brain stem death is no good reason to claim the death of the individual person (emphasis added). [24]

Among the conclusions set forth by Seifert is that a metaphysical notion of death has to guide our action, in that any reasonable doubt as to its occurrence must forbid operations which might bring it about. [25] This essay alone is worth the price of the book.

Bishop Bruskewitz on Extreme Unction and Homicide

Bishop Fabian W. Bruskewitz of the Diocese of Lincoln Nebraska is the only hierarchical contributor to Finis Vitae. His essay, "A Brief Summary of Catholic Doctrine Regarding Human Life," contains information on "brain death" which is unique to the Catholic perspective, especially his latter section on the Sacrament of Extreme Unction, that is, the anointing and absolution of living human beings who are seriously ill or dying. Its relevance for Catholic priests and chaplains is obvious since all sacraments are for the living not the dead. [26]

Addressing the morality of acting on the criterion of "brain death" to secure unpaired healthy vital organs for a waiting transplant recipient from a "brain dead" patient, Bishop Bruskewitz, never a prelate to mince words, recalls the Catholic Church's position on deliberate homicide as "a grievous mortal and spiritually lethal sin," and then lowers the boom with this singular observation:

In the common estimation of humanity, to cut the beating heart out of a breathing person who is ingesting food, excreting waste, and responding o external stimuli, such as jabs and pokes by needles and knives, is considered an act of homicide. [27]

Pro-"Brain Death" Advocates Who Changed their Mind

Among the great strengths of Finis Vitae, are the candid essays written by professionals who either formally favored "brain death" criterion, or who were at least neutral on the subject. These articles are bound to make a deep impression upon the mind of the reader for they invariably touch upon the nagging, ever-present question which is at the heart of the "brain death" controversy, namely, "Do surgeons and other professionals in the transplantation field REALLY believe that "brain-dead" patients are truly dead?

The answer, of course, is "No." "None of them are so naïve as to believe that people with dead brains (sic) are dead in the traditional biological sense of the irreversible loss of bodily integration," or else why would they seek out and support a new definition or definitions of death." [28] Indeed, by the late 1990s, some pro-transplant advocates like Dr. Robert D. Truog, Professor of Medical Ethics, Anesthesiology and Pediatrics at Harvard Medical School, were advocating the abandonment of the "brain death" criterion altogether, in the belief that "killing may sometimes be a justifiable necessity for procuring transplantable organs." [29] Truog also admitted that, "... the concept was never more than a social construction, developed to meet the needs of the transplantation enterprise during a crucial phase of its development." [30]

The "Damascus Moment" for Dr. Weaver

In his introduction to his essay "Unpaired Vital Organ Transplantation," from which I quoted extensively in Part I of this series, former transplant cardiologist Dr. Walt Franklin Weaver explains that until 1988, he willingly and enthusiastically participated in his hospital's heart transplantation program. He said that the only contact he and his colleagues had with donors "was when their hearts arrive in a cooler from distant cities." [31]

One day, Weaver said, "I was asked to consult on a 19-year-old brain injured potential 'donor' tentatively scheduled for a heart transplant to a patient in another city." Weaver recalls that the simple act of sitting at the donor/patient's bedside:

... promptly brought before me what I has known since the first successful heart transplant by Dr. Barnard in 1967. I had blinded myself to the fact that donors are most definitely 'truly' alive. ... This 19-year-old 'donor' had all the signs of a living human being and none of the signs of the truly dead human being. ... He was receiving usual life-support technology and care and his vital signs were quite stable. However, with change in appearance or vital signs, the simple entry of a note indicating 'brain death' in his hospital record by a neurologist instantly marked him as a vulnerable and legally dehumanized human being who could be killed (by removal of his vital organs), experimented upon, or used for surgical teaching. ... [32]

Weaver says that he has experiences "a sense of remorse" when he reflects on "the plight of the unknown and faceless donors who lost their lives without the benefit of a longer trial of current and up-to-date life-support technology prior to their intended death from removal of their vital organs." [33]

The Testimony of Pediatrician Joseph Evers

The moment of truth for pediatrician Dr. Joseph C. Evers concerning the deadly reality of "brain death" criterion came about when he was asked to chair a Pediatric Intensive Care Subcommittee at his local hospital in order to revise the existing protocol for diagnosing brain death in children for the purpose of vital organ removal and subsequent transplantation. This was the first time he was forced to "come to grips" with the scientific, legal and moral issues surrounding "brain death," he said. [34]

Evers began his long journey with a literature search and a dialogue with his valued colleagues. Among the articles that immediately caught his interest was a report of a 24 year-old pregnant woman, who was declared "brain dead" on the 19th day of her hospitalization, but with the assistance of a ventilator lived 5 additional days, just in time to deliver a healthy 29-week-old baby. Evers questioned how it was possible for a "corpse" to nurture her unborn baby and give birth to a living child. [35] He also questioned the necessity of having so many different sets of "brain death" criteria — more than 30 by 1978 — and growing by leaps and bounds. [36]

Evers ultimately resigned from the protocol committee, but not before he told the entire medical staff the reason for his actions and urged them to vote against the protocol. Some did, but not enough and the "brain death" protocol became hospital policy. The pediatrician recalls that after that fateful meeting, a neurologist colleague of his approached him and said," You know Joe, you're right; we just wink at it." [37]

Alan Shewmon — A Conversion in Three Stages

In 1992, D. Alan Shewmon, M.D., Ph.D., Professor of Neurology and Pediatrics at UCLA Medical Center in Los Angeles, began his intellectual quest to investigate the "emergence of impressive counterevidence to the supposed medical 'fact' of 'brain death,' aka "higher brain death," "whole brain death," physiological decapitation." Up until this time he had been a radical defender of "brain death," as death. [38] Shewmon said that it took him until 1997 to venture forth publicly with his new views in opposition to "brain death," and another nine years to develop additional insights and perspectives in support of those views. [39]

Among Shewmon's striking observations and statements cited in his fascinating essay "Brain-Body Disconnection: Implications for the Theoretical Basis on Brain Death" are:

• "I daresay that doctors in general and neurologists in particular, have come to an overwhelming consensus that brain death is death, not because they have examined the evidence and concluded it for themselves, but purely and simply from a professional herd mentality." [40]
  
  
• Shewmon's quote of a bone-chilling statement made by the late Dr. Ronald Cranford, longtime Chair if the Ethics Committee of the American Academy of Neurology, regarding the status of "permanently unconscious patients' who have "characteristics of both the living and the dead." "It would be tempting to call them dead and then retrospectively apply the principles of death, as society has done with brain death" opined Cranford (emphasis by Shewmon). [41]
  
  
• "To admit that many brain-dead patients are deeply comatose, severely disabled, living human beings is progress, not regress. It will force a refinement in our understanding and diagnosis of death, a clarification in our fundamental philosophical principles regarding human life, and a realignment between our understanding and our consciences in dealing with these most vulnerable human lives." [42]
  

Finis Vitae Belongs in Your Lending Library

Finis Vitae belong in your library, but never let it just sit on your book shelf. After you have read it carefully, keep the book in circulation. Loan your copy to family and friends, especially to card-carrying teenage "donors" and their parents, as well as your physician, lawyer, and priest, minister, or rabbi. Consider donating a copy to your local library or to the chaplaincy reading room at your local hospital? E-mail or call your state and federal legislators and find out where they stand on unpaired vital organ transplantation and "brain death" criterion. If they blurt out, "I don't know," educate them. Every pro-life group should have a representative of the Life Guardian Foundation address their members. People Concerned for the Unborn Child in Pittsburgh, PA, recently invited Dr. Paul Byrne, as guest speaker for their annual pro-life banquet. It was my honor to meet Dr. Byrne for the first time.

The Transplantation Industry Is On the Move

Make no mistake about it. The Transplantation Industry is on the move. It doesn't have a heart, but it would sure like yours if it is beating and healthy. And it will say and do anything to get it.

This means you need to take action. At a minimum, all adults and older teens need to carry an "opt-out" medical donor card in their wallet or purse next to their driver's license, and they should make their wishes known to their next of kin. [43] Also, I believe that there is a great need for the creation of an organization dedicated to tending to the needs and concerns of parents and relatives who, in almost all cases without informed consent, signed over their "brain dead" loved one for vital organ harvesting and have come to understand and regret the implications of their actions. Recent studies of heart transplant recipients, who come to understand that a "patient/donor" was killed so that he might live, are also in need of intensive psychological and spiritual counseling and therapy.

I don't know how many people will read this column, but I hope and pray that the information provided here, thanks to Renew America, will be instrumental in saving at least one life, and one family from belatedly having to face the terrible truth behind the Industry's deceptive and deadly mantra, "give the 'Gift of Life.'"

The End

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© Randy Engel