Catholic healthcare professionals attend seminar on bioethical issues

This story was originally published by Catholic News Singapore on 15 March 2009. Republished with permission.

By Daniel Tay, UCAN

SINGAPORE – Organ donation, brain death, euthanasia and palliative care were matters brought up for clarification and discussion among Catholic healthcare professionals in a Church-organised bioethics seminar.

The Singapore Association of the Order of Malta, a centuries-old Church order which primarily supports medical and health-related work, organised the seminar on Feb 21.

Dominican Father David Garcia, a moral theologian, told seminar participants that according to Church teaching, organ donation is “praiseworthy” only if it is an act of charity and self-giving. It is not to be demeaned by trading, he stressed.

He was speaking to 120 Catholic doctors, nurses and other healthcare workers, as well as lawyers, who attended the seminar at the Church-run Mount Alvernia Hospital. Other speakers were from the Catholic Medical Guild of Singapore and the Catholic Lawyers Guild.

The Singapore government in 1987 introduced the Human Organ Transplant Act (HOTA), which allows for a person’s “kidneys, heart, liver and corneas to be removed in the event of death from any cause for the purpose of transplantation”, according to the Ministry of Health website. All Singapore citizens aged 21-60 are included under HOTA unless they choose to opt out.

Church teaching requires that an organ donor gives explicit consent for his organs to be donated (cf. Catechism of the Catholic Church, n. 2296). This implies that “presumed consent” is not ideal unless all potential donors (or their proxies) are fully aware of what they are consenting to.

Pope Benedict XVI, in his address at the international congress, “A gift for life: Considerations on organ donation” last November in Rome, also stressed that extraction of organs for transplantation can only take place after having ascertained a patient’s death.

The congress was sponsored by the Pontifical Academy for Life, the International Federation of Catholic Medical Associations, and the Italian National Transplant Center.

During the Feb 21 seminar, Dr Chan Yeow, an anesthesiologist at a public hospital, explained the neurological criteria used to ascertain brain death. Likening the brain stem to the power box for a house and the cerebrum to the light bulbs in the house, he said that if the “lights” are out (ie. one is deeply unconscious), one can deduce that either the power box is not working or the light bulbs are completely non-functioning. Furthermore, if the power box is permanently destroyed, the entire house loses its electrical supply and cannot function. Hence, if the brain stem is dead, the brain as a whole will not be able to function, he said. The neurological criteria for brain death require the complete absence of consciousness and complete absence of brainstem reflexes as well as irreversible loss of the ability to breathe in the presence of a known cause of brain injury and the absence of any confounding conditions.

Father Garcia told UCA News later that based on current medical understanding, total brain death “seems to be” sufficient to determine a person’s death.

In the latter half of the seminar, he reminded participants that euthanasia is illicit.

With reference to the Advanced Medical Directive (AMD), he noted that the definition of terms such as “extraordinary means” is open to arbitrary judgement.

An Advance Medical Directive (or living will) covers specific directives as to the course of treatment that is to be taken by caregivers should the person be incapable of giving informed consent.

The priest gave the example of amputation, which was judged in the 16th century as an extraordinary means of preserving a person’s life. This is no longer the case today.

A specialist in hospice care, Dr Grace Pang, asserted that true care for the dying takes the form of palliative care rather than euthanasia, which is killing.

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