Signs of death and organ donation

Letter to the Pontifical Academy of Sciences

Pope John-Paul II
1 February 2005

Distinguished Ladies and Gentlemen,

1. To all of you I offer cordial greetings and I would like to express my appreciation for the Pontifical Academy of Sciences, ever devoted to its traditional task of study and reflection on the delicate scientific questions facing contemporary society.

The Pontifical Academy has chosen to dedicate this session of the Study Group – as on two earlier occasions during the 1980’s – to a theme of particular complexity and importance: that of the “signs of death”, in the context of the practice of transplanting organs from deceased persons.

2. You know that the Church’s Magisterium has maintained from the outset a constant and informed interest in the development of the surgical practice of organ transplant, intended to save human lives from imminent death and to allow the sick to continue living for a further period of years.

Since the time of my venerable predecessor, Pius XII, during whose pontificate the surgical practice of organ transplant began, the Church’s Magisterium has continually made contributions in this field.

On the one hand, the Church has encouraged the free donation of organs and on the other hand she has underlined the ethical conditions for such donation, emphasizing the obligation to defend the life and dignity of both donor and recipient; she has also indicated the duties of the specialists who carry out this procedure of organ transplant. The aim is to favour a complex service to life, harmonizing technical progress with ethical rigour, humanizing relationships between people and correctly informing the public.

3. Because of the constant progress of experimental scientific knowledge, all those who carry out organ transplants need to pursue ongoing research on the technical-scientific level, so as to ensure the maximum success of the operation and the best possible life expectancy for the patient. At the same time, a constant dialogue is needed with experts in anthropological and ethical disciplines, so as to guarantee respect for life and for the human person and to provide the legislators with the data needed for establishing rigorous norms in this field.

In this perspective, you have chosen to explore once again, in a serious interdisciplinary study, the particular question of the “signs of death”, on the basis of which a person’s clinical death can be established with moral certainty, in order to proceed with the removal of organs for transplant.

4. Within the horizon of Christian anthropology, it is well known that the moment of death for each person consists in the definitive loss of the constitutive unity of body and spirit. Each human being, in fact, is alive precisely insofar as he or she is “corpore et anima unus” (Gaudium et Spes, 14), and he or she remains so for as long as this substantial unity-in-totality subsists. In the light of this anthropological truth, it is clear, as I have already had occasion to observe, that “the death of the person, understood in this primary sense, is an event which no scientific technique or empirical method can identify directly” (Address of 29 August 2000, 4, in: AAS 92 [2000], 824).

From the clinical point of view, however, the only correct way – and also the only possible way – to address the problem of ascertaining the death of a human being is by devoting attention and research to the individuation of adequate “signs of death”, known through their physical manifestation in the individual subject.

This is evidently a topic of fundamental importance, for which the well-considered and rigorous position of science must therefore be listened to in the first instance, as Pius XII taught when he declared that “it is for the doctor to give a clear and precise definition of ‘death’ and of the ‘moment of death’ of a patient who lapses into a state of unconsciousness” (Address of 24 November 1957, in: AAS 49 [1957], 1031).

5. Building upon the data supplied by science, anthropological considerations and ethical reflection have the duty to put forward an equally rigorous analysis, listening attentively to the Church’s Magisterium.

I wish to assure you that your efforts are laudable and will certainly be of assistance to the competent Dicasteries of the Apostolic See – especially the Congregation for the Doctrine of the Faith – which will not fail to ponder the results of your reflection, and then to offer the necessary clarifications for the good of the community, in particular that of the patients and the specialists who are called to dedicate their professional expertise to the service of life.

In exhorting you to persevere in this joint commitment to pursue the genuine good of man, I invoke the Lord’s copious gifts of light upon you and your research, as a pledge of which I affectionately impart my Blessing to you all.