The New Barbarians

China's Gruesome Organ Harvest (The whole world isn't watching. Why not?) by Ethan Gutmann in the Weekly Standard relates stories of organ farming in China. Well, we do it here, too, though not in such obviously distasteful ways as the Chinese. Shall we grow embryos for siblings from which we can harvest an organ? England says okay and we're not that far behind. Shall we not harvest the organs we "need" from bodies yet alive? Anita Kuhn's Down on the Transplantations exposes what the experts really say and know. Alas, Brave New World comes in with the fog on little cat feet (I can't help a Sandburg reference to the city of Chicago, which is just fine with all this, as long as the money comes in.)

I'm reading Robert Pogue Harrison's Forests, in which he notes the end of the Christian era as a "prolonged and indefinite event," and "an era in itself." Shakespeare's tragedies are written in the context of this end. The Bard

did not portray the dissolution so much in Christian terms as in terms of gross violations of natural law. Natural law lies at the basis of positive law; it is not the law of nature as such but rather the transcendent foundations of human social law. The depraved Shakespearean characters--Iago, Edmund, Macbeth, etc.--violate the most sacred natural bonds, and once such bonds lose their binding power Shakespeare's characters degenerate into a savagery of spirit which recalls [Giambattista] Vico's words about those treacherous human-aged men who have been "made more inhuman by the barbarism of reflection than the first men had been made by the barbarism of sense. For the latter displayed a generous savagery, against which one could defend oneself or take flight or be on one's guard; but the former, with a base savagery, under soft words and embraces, plots against the life and fortunes of friends and intimates" (New Science, 1106).

The "soft words and embraces" remind me of Lewis's barbarians with clean fingernails. They've been here for a long time, growing in strength, armed with not mere physical prowess and passions, but schooled in sophisticated and deadly barbarous reflections, which allow them to cut up and sell human flesh, allow the trafficking of a new slavery, sexual and otherwise, pornographers, pimps, plying a trade in human degradation that only a demon could love. Most of our leaders are blind to this or are fine with this. Lord, have mercy.

Comments

[Michael D. Harmon]

Am I getting the impression the slippery slope has now become a slippery cliff?

There comes a time in an in-flight emergency when the pilot has to make a decision about whether the aircraft has become uncontrollable. Then the only option is provided by whether you have a parachute or not.

We as a nation (not as a faith, don't misunderstand me) are about to "adversely impact the air-ground interface" and I don't see a single canopy popping open.

Camps? No, there will not be camps. There will, however, be courts (Canada has shown us the way, and the anti-Mormon protests and attacks show us the means) that find us guilty of making other people feel bad by what we say or do, and there will be fines and jail terms for that.

Best to brush up on prison ministry techniques. There are full-time opportunities in the field coming open soon.

[Karen]

The problem with your post here, and with every other post on modern morals and ethics at Mere Comments, is that it boils down to "there is something out there that I really don't like, and I'm not going to make any suggestions on how to fix it." What, precisely, is the problem you want to address? I don't have the Magic Real True Christian decoder ring, so I can't figure out what you're talking about here.

Is the problem China's abominable human rights record? That's not news. How to fix it without causing much more harm is a seriously tricky problem, and I don't see you offering any solutions here.

Is your problem transplant surgery in the first place? Do you want it banned? There is a good argument in favor of banning organ importation, which can be made entirely on safety grounds. We don't and can't ensure that donated organs come from volunteers with clean medical histories, and it's no benefit to the transplant patient to get a heart with, say, no valve defects but from a patient with untreated Hepatitis C. Banning transplant surgery entirely means you favor a policy that will kill patients that would survive under the current regime. How is that any different from a policy of denying feeding tubes to vegetative patients?

Please, from now on could you state clearly what it is you find objectionable and the facts that lead you to the conclusion that it is objectionable?

[Tony Esolen]

I'll give it a try here.

We find cannibalism barbaric. We find it a vile attack against the sanctity of the human body, and the human person. We find that it bears out Lewis' wisdom in That Hideous Strength and The Abolition of Man: that man's conquest of nature is usually some men's conquest of other men, with nature as the instrument; and that man's conquest of man's nature is simultaneously, in the very act, a subjugation of man beneath brute nature, perhaps beneath the machine.

We do not think that live human beings ought to be harvested, like barley and hops. We do not think that human beings ought to be grown in order to be harvested. We do not think that human beings ought to be reduced to instrumentalities, for someone else's benefit. We will agree with Kant on this, if not on everything else, that it is evil to treat a human being as a means only.

We do not agree that this position is morally equivalent to killing those who might otherwise live. Again, even Kant would agree here, not to mention Thomas Aquinas and all the other great Christian moral teachers since the apostles and their successors wrote the Didache. If a certain number of people have grown accustomed to feeding from human flesh, or to using live human beings to cobble together a stay against death, that custom cannot sway our minds. If I say to the hungry cannibal, "I am sorry, I know you are starving, but you may not kill Jerry over here to survive," I am not killing; I am preventing him from killing.

If we have not the moral sense to distinguish between organs taken from dead people, and using still living people to shore up somebody else's life, or between either of those and producing, as on an assembly line, human life for the express purpose of the cannibal, then it were far better for us if we had no transplantation at all. It is not worth an extra couple of years of my life -- no, it is not worth my life at all, I had better die on this instant, than by my actions so to reduce any human being (and therefore all human beings) to the status of an ear of corn, or a ball-bearing, or a lever. If you are in the presence of a human being, even in embryo, you are in the presence of something holy. If a Christian cannot believe that -- a Christian who might occasionally be expected to remember that the Incarnation occurred at the moment of Mary's submission to the will of God -- then I pray that God will not take his time wiping our civilization off the face of the earth, so that something more human might spring up in our place.

[Karen]

Okay, so does all transplant surgery constitute cannibalism? That's the problem I've got here; the post doesn't distinguish between what goes on in China and what goes on in, say, Rochester, Minnesota. If your issue is with the truly depraved Chinese practice, then please explain how that connects with this country? I am not aware that the US imports organs for transplant, and if so I agree we should stop immediately, and we should of course condemn China for allowing this, but what else should we do? Break all our trade deals? Boycott Chinese products? Products that use Chinese parts? Revoke Most Favored Nation status?

If your problem is with the American or European practice on transplants, please be more specific. Do you object to all transplant surgery? Is there some aspect of organ harvesting to which you object? Is this about stem cells? Cloning? I'm really not trying to be snarky, I genuinely don't understand.

You have a perfect right to complain about anything you wish on your own blog. If you wish to persuade people to agree with you about these things, however, you need to make specific proposals. A general rant against cannibalism doesn't persuade anybody about anything.

[NTBH]

Karen,

I would not presume to speak for Dr Esolen, but it does appear that he answers your question in his comment.

"If we have not the moral sense to distinguish between organs taken from dead people, and using still living people to shore up somebody else's life..."

Here he explains that there is a difference between taking organs from dead people for the purpose of a transplant and harvesting organs, which, I believe is the true target of the original post and his comment.

Dr. Esolen, I appreciated the original post, but I believe that your comment posted above is excellent, thank you.

[Tony Esolen]

Fair enough. How about these for specific proposals:

1. An international treaty outlawing human cloning as a crime against humanity, punishable by the severest measures against the perpetrators. As far as I'm concerned, that might include permanent incarceration without parole. Any nation engaging in human cloning should be considered at war against all other nations. Obviously, we're nowhere near such an international consensus. We may be very near the reverse.

2. The outlawing of the transplantation of organs from living human beings.

In general, though -- how is it fair to ask people to come up with specific proposals regarding what you would do instead of the evil that they are currently doing? Isn't it enough, sometimes, to call upon people to stop engaging in the evil? Or, in this case, to refrain from beginning to engage in the evil?

I believe that Jim's point is that we may still find China's practice abominable, but we are not far from it ourselves.

[DGP]

Actually, there *is* a problem with the dead-donor rule. (I was somewhat frustrated with Anita Kuhn's article, which was terribly misleading.)

Consider: We allow and even applaud donations of redundant organs, so long as these pose little (never none) health risk to the donor. Why? Because natural law is not precisely reflected in the dead-donor rule, which is merely heuristic. The absolute moral norm is this: Organ donation should never cause or hasten the donor's death.

Now consider the case of non-heart-beating donations. In the US, we harvest hearts or livers or other vital organs from people who could possibly be resuscitated, but for whom it has already been decided that we will *not* resuscitate. (Granted, such a decision can be made rightly or wrongly -- another story.)

In these cases, the harvesting of vital organs does not cause or hasten death. If the heart has already stopped, and we are morally certain that it will not restart, then to remove it makes no difference to the life of the donor -- no matter that the same heart could be restarted and could sustain life, in the donor or in someone else.

To be morally certain, one must simply ascertain that one does not harvest an organ that could possibly participate in spontaneous resuscitation. To know what is possible may depend upon some medical knowledge of the patient (the very young, for example, are believed to self-resuscitate more frequently than the elderly or infirm), but I am assured that spontaneous resuscitations after 60 seconds are exceedingly rare. My hospital waits two minutes after the cessation of a heartbeat, and most wait for five minutes.

The argument is more complicated with respect to brain-death criteria, but available:

http://www.ncbcenter.org/details_news.asp?idOfEvent=412

[Michael]

Karen,

If you clicked on Mr. Kushiner's linked article, the first four paragraphs read thus:

In a remarkably candid article about organ donation in the New England Journal of Medicine (NEJM), a doctor and a bioethicist make the unnerving observation that, in cases involving vital organs, many “donors” may not actually be dead at the time their organs are taken from them. While this statement corroborates the view of many pro-life groups, scientists, and physicians, it is likely to be news to the general public.

In their article, published online on August 14, 2008, Dr. Robert D. Truog of Harvard Medical Center and Children’s Hospital Boston, and Dr. Franklin G. Miller, a bioethicist at the National Institutes of Health in Bethesda, Maryland, note that organ donation has been guided from its inception by the “dead donor rule,” which “simply states that patients must be declared dead before the removal of any vital organs for transplantation.” The traditional criteria for determining death, they note, was “straightforward: patients were dead when they were cold, blue, and stiff.”

Death Newly Defined

The problem for transplant medicine is that by the time many organs, especially vital organs, are extracted from such donors’ bodies, they are no longer usable for transplantation. So, in 1968, a committee formed and headed by Henry K. Beecher at Harvard proposed a new definition of death based on so-called brain-dead criteria: A patient with “devastating neurologic injury” could then be considered eligible for organ removal under the dead donor rule. Brain-dead criteria have been in use ever since.

But, Truog and Miller write, these criteria are problematical because patients whose injuries are entirely intracranial “look very much alive: they are warm and pink; they digest and metabolize food, excrete waste, undergo sexual maturation, and can even reproduce. . . . The arguments about why these patients should be considered dead have never been fully convincing.”

In recent years, another definition of death has been proposed for prospective organ donors: cardiac death. Under cardiac criteria, a patient can be declared dead on the basis of “irreversible cessation of cardiac function” if his heart stops beating for as little as two to five minutes. Such a patient’s vital organs can then be removed for transplant while they are still usable.

In other words, many organs being transplanted are harvested from living bodies, people who are themselves alive without their express consent. A kidney donor might choose to give up one kidney to allow his brother to live. A man might--we do not allow people to do this, but he might--surrender his heart at will to save the life of another. But modern transplant medicine takes organs from living people without consent, instead of removing organs after death from people who had previously consented.

To take organs from one who is alive, effectively killing him, is not the same as saying "when you die, we will collect your organs." It is instead saying "we will collect your organs, then you will die." More than that, it is in effect allowing doctors to state which life is more valuable: the living donor whose organs they could harvest, or the recipient awaiting an organ from a dead man.

That is what Mr. Kushiner finds despicable, and I, for one, heartily agree with him.

[Karen]

Thank you Dr. Esolen, those are the kinds of points I was seeking.

On your point about why it's necessary to make specific points as well as addressing evil: if a large number of people are doing something, presumably those people don't think they're doing something evil. It's necessary to show alternatives to evil as well as to condemn it.

[Michael]

Fr. DGP,

Would it be acceptable for a person to say: "Do not resuscitate me; if I am to die, it is by God's will. Take what you can to save the life of others." ? If so, the dead-donor rule is fine. That one can lay down his own life for the life of another is something I believe we ought to encourage. Indeed, if I am to say "I would die for my son," and then be restrained from picking up such a cross--from donating my heart to save him, even as it beats in my own chest--might be a denial of willful sacrifice.

Of course, there is always the quagmire of maybe God has a purpose for this person's die and organ donation in general is interfering with the whole process. Complex moral issues at work here, but what else is new?

[DGP]

>>"Do not resuscitate me; if I am to die, it is by God's will. Take what you can to save the life of others." ? If so, the dead-donor rule is fine.

No, it's not. At issue is the invocation of the dead-donor rule under conditions in which it no longer functions as an adequate expression of the moral law. Depending upon circumstances, a man whose heart has been stopped for nearly twenty minutes may yet be resuscitated. Consequently some protest that the man may not be considered dead until he is beyond all possibility of resuscitation, and his vital organs may not be taken until he's dead.

I reassert: The natural law prohibits organ donation whenever it causes or hastens the donor's death. (This is merely an instantiation of the fundamental principal that you can't kill an innocent man to benefit another, even if he asks you to.) If a man is to be considered alive as long as he retains the potential for resuscitation, then contemporary medical technology has differentiated the natural law from the old dead-donor rule.

[Michael]

>>Depending upon circumstances, a man whose heart has been stopped for nearly twenty minutes may yet be resuscitated. [...] If a man is to be considered alive as long as he retains the potential for resuscitation, then contemporary medical technology has differentiated the natural law from the old dead-donor rule. (emphasis added)<<

Fair enough, but if resuscitation is bringing someone up from death, then to refrain from resuscitation doesn't hasten death, but rather lets sleeping dogs lie--if a person is dead, and not resuscitated, then he is dead. I think we have a conflict of definition here regarding "resuscitation", just as in the Aleph, Beth, Gimel thread.

I think to harvest from people who are devoid of observable "higher" brain function, while their bodies are yet living, is morally reprehensible; it is organ harvesting. But if a person's body has died, and we fail to bring it back to life, then does that "hasten" death or merely acquiesce to it?

[Stuart Koehl]

>>>To take organs from one who is alive, effectively killing him, is not the same as saying "when you die, we will collect your organs."<<<

Ah, but in China, they basically decide if you will die based on whether they want your organs. As I mentioned in another thread, Larry Niven wrote a series of stories set in the near future in which life could be extended indefinitely through transplantation. The problem, however, was a chronic shortage of organs. It then became pragmatic and popular to harvest the organs of criminals condemned to death, altering the means of capital punishment to one that did the least damage to the desired organs. Everything was harvested, except the brain--even the skin.

Well, as you can imagine, supply still can't keep up with demand, so they keep defining the death penalty downward, until people are being executed from traffic violations. The problem only ends when a new series of drugs is developed that allows for the regeneration of any sort of tissue--sound familiar?

[DGP]

>>if a person is dead, and not resuscitated, then he is dead. I think we have a conflict of definition here regarding "resuscitation",

That would work, although to me it's counterintuitive (in this medical context, not in the ABG thread) to speak of resuscitation as the equivalent of resurrection.

But this is not what Anita Kuhn, and by extension James Kushiner, are arguing:

"So in order to meet the criteria of 'irreversible cessation of cardiac function,' the word 'irreversible' has to be interpreted to mean 'we won’t try' to resuscitate rather than 'we can’t.' The dishonesty of this becomes apparent in what the authors describe as the paradoxical situation in which a heart declared to have permanently lost all function while in the chest of its original owner may in fact function very well when it has been transplanted into the chest of another person."

She confuses the life of an organ with the life of the donor, and accuses interlocutors such as myself of dishonesty and "gerrymandering." Yet I'm not alone: The impeccably Catholic NCBC, which I cited above, allows for these sensible distinctions.

[Michael]

>>She confuses the life of an organ with the life of the donor, and accuses interlocutors such as myself of dishonesty and "gerrymandering."<<

Agreed. If a heart stops beating for a significant length of time, restarting it would not cause the person to come alive--even in a vegetative state. Lower brain functions that regulate such things cease from oxygen deprivation (due to the heart no longer pumping blood carrying said oxygen, which the lungs are no longer inhaling); the heart would have to be artificially pumped to maintain blood flow--and then it is not life, but a pale imitation of it.

I believe you and I, Father, have a similar stance.

[labrialumn]

Humans are cloned all the time. One local school district has several sets of twins and one of triplets.

It is the cloning of humans in order to treat those humans as subhuman resources that is immoral.

There are certain organs, such as kidneys, that can be transplanted without killing anyone. However, we never use the organs of dead people. When the person truly dies, their cells all start breaking down at once, and their organs are useless for transplant. A person "in persistent vegetative state" that is, in a coma, or even not in a coma, as with Terry Schiavo, are what are used as subhuman resources these days.

We are at the point where autosomal stem cell technology can grow replacement organs with your own DNA, thus no need for anti-rejection medications. If, say, you are up for a heart bypass surgery, it would be time to harvest some of your stem cells while they are at it, and grow you a new heart, and put it on ice for when you need it. I fear that in coming months it may be only those rich enough to obtain this outside of the nationalized health care system will be able to obtain such organs, and those deemed lebens unswerten leben will be sources for organ transplants. Soylent Green meets The Patchwork Man.

The older novel _The Patchwork Man_by Larry Niven is a good read on what society may well soon come to be like. Eventually even moving violations were cause for being sent to the organ banks.

Michael, that sounds more like suicide.

A human is not dead until the non-material part leaves the material part for its eternal destination. Lazarus was dead. People in a coma are not.

[Michael]

>>Michael, that sounds more like suicide.

A human is not dead until the non-material part leaves the material part for its eternal destination. Lazarus was dead. People in a coma are not.<<

Did Christ commit suicide by willingly surrendering his life for the lives of others? Dying for another is, to an extent, selfless. Killing yourself with no express purpose other than to end your own life is suicide. More importantly, I'm not advocating that we allow such things. What I said was if a person did this, it would be considerably different (and have a far better argument for moral acceptability) than the practice of harvesting organs from patients without consent while they are still alive.

As for the definition of death: we have no clinical way of knowing when such an event occurs. It could be brain death; it could be the cessation of bodily function (meaning the lower brain is no longer maintaining activity to sustain physical life); the soul may not leave the body for a waiting period of 3 weeks. Heck, I'm inclined to think it may very well vary from person-to-person.

I honestly do not know when harvesting organs becomes acceptable. As Fr. DGP pointed out, an organ's viability is not the same as the viability of the entire person. Shall we put people on machines to maintain their life because their liver is still viable even when they're heart and lungs are not? My question here is very simple: when do we medically define death so as to make harvesting organ's acceptable such that it also aligns with a theological definition thereof? I'd say the answer to that question is completely dependent on your presuppositions regarding the soul's interaction with the body.

[labrialumn]

Michael,
As I said, the cells all start disassembling their DNA and breaking down all at once whenever the mysterious controlling mechanism that keeps a body alive, quits. Other posts have shown that "brain death" isn't the death of the brain, the brain is still working. The person just isn't able to get to court on her own and demand her right to life. Terry Shiavo was conscious and communicating in spite of her husband withholding the therapy for which he had gotten all that money that he wanted to spend on his concubine and their children. But she was 'brain dead'.

When the body dies, that is when a lot of people think is when the non-material part leaves, and it certainly seems more plausible to me than some of the other notions.