Brain Death

[tacf]

My thoughts on brain death. Curious what others thought.

Death occurs when the soul is separated from the body. A proof of this is found in the Gospel of Matthew, "And Jesus again crying with a loud voice, yielded up the ghost." Also see the catechism of the catholic church.

Once the rational soul has departed, the body that remains will no longer be able to perform the actions only a soul is capable of. Now, one may argue on just what are the actions performed by the soul that only it is capable of; however, a detailed discussion of this is beyond the scope of these notes. Using St Thomas' classification, the three categories of souls for corporeal creatures are the vegetive soul, which has nutritive and reproductive powers, the sensitive soul, which has the vegetive powers plus sensation (which includes memory and imagination), appetition and sometimes locomotion, and the rational soul, which has all the sensitive powers plus the powers of the intellect and will.

Given the powers of the soul defined above, to say that the soul is no longer united to the body one must observe that none of the effects of the powers of the soul are seen. It is important to say "none" of the effects are observed; for if a particular organ has a defect, it prevents the soul's action in that organ and subsequently the visible expression of one of the soul's powers. An example of this is an infertile man; a bodily defect may prevent the expression of the reproductive power, but he still has a rational soul.

It is also important to reject an erroneous understanding of how the soul is united to the body. Many think the soul operates on the body through some portion of the brain only, and the rest of the body is not united to the soul in any way outside of this. But that is not the understanding of St Thomas, who states, "[The soul] is not in each part of the body, with regard to each of its powers; but with regard to sight, it is in the eye; and with regard to hearing, it is in the ear; and so forth."[1]

A better understanding of these points can be gained by some examples:

A group of cells taken from Henrietta Lack's cervical cancer tissue was taken for research in 1951.[2] The original cells have died, but reproduced more cells before they did so (using the same processes all cells in the body do). Derivatives of the original cells are still in use today, and are called "HeLa" cells. Question: Because we see her tissue still expressing effects of the nutritive and reproductive powers, does that mean her rational soul is still present and she has not in fact died? Answer: No. When a tissue is separated from the body, the rational soul is no longer united to that tissue; however, no creature in existence is without a "form" of some kind (the soul being the "form" of animate creatures). The follow up question: What form does the tissue now have? Answer: The powers proper to vegetive souls have their effects observed in the tissue collected, even though it is over 60 years old; therefore, the tissue has a vegetive soul as its form. This is true by the fact that a quality (including a power or capacity) that was part the original form may still be present in the form of one of its parts after corruption. An example of this is a house. If a house is corrupted by tearing some of it down, a part may still retain the form of a kitchen, which has the capacity for helping to cook like a house, but not one for helping to sleep like a house. A part may even retain the original form almost entirely, which is the case when a house loses a shingle - it is still a house, though less perfect. And since art imitates nature, the example of a house can apply though it is an artificial form.

Further clarification is possible by considering kidney transplants. In this case, the kidney extracted from the donor receives a vegetive soul as its form. This is so because when it is supplied with blood (its very specialized nutrition supply), we observe nutritive acts occurring. This solves the question: what happens if the donor dies before the recipient does - is the donor's rational soul still present in the living kidney? The answer is no, as the kidney now has a vegetive soul of its own, or has been assimilated by the recipient to be united to the recipient's soul. The subsequent question of does the kidney have a vegetive soul or is it now united to the recipient's soul is complicated. On the one side we have the example of persons eating living insects, which clearly are assimilated into the body and have their matter unified to the eater's soul through nutritive acts. On the other side we have the example of conjoined twins, which clearly are physically united and clearly have separate rational powers, which tells us two distinct souls are present. My opinion is that initially at least the kidney has its own vegetive soul, because if we did not transplant it but by artificial means supplied it with blood it would still perform acts proper to a vegetive soul.

A third clarifying example is seen with artificial heart replacement. Although less than 10,000 total artificial heart transplants have occurred at the time of this writing, even one successful case gives proof of concept. In this case, a beating heart that is unable to pump enough blood to keep a person alive for much longer is removed from the body and replaced with a mechanical pump. In this instance, prior to the surgery a power of the soul was being limited by a defective organ. At the same time, by the art of medical engineering a pump was produced capable of imitating the effects of the heart on the blood (namely, moving it). After the surgery, the heart (until it dies) has a vegetive soul, and the person retains a rational soul. Question: is the pump now united to the recipient's soul? Answer: The rational soul's natural power over the artificial heart is zero, as it is only controlled by artificial means. This is similar to the case of a house, which does not have a natural form, but only an artificial one. The general principle is as follows: If the soul/body composite does not show regulation of the transplant by natural means, then the transplant is not united to the soul.

With these examples the case of brain death is clear. Brain death criteria vary by institution, but all try to demonstrate that what are considered proper acts of the brain are no longer present. This is done by checking reflexes, respiratory drive, etc. But the truth of the matter is that regardless of the criteria used or what the findings are, all can still easily say that the soul is still present, as the other organs of the body are still performing their proper acts. And the argument that all the functioning organs now have vegetive souls is false, because they are still performing their proper acts as a unified whole. This is not the case in transplants, where it is only by human art that the organ with a vegetive soul performs acts directed for the good of the rest of the body. A superficial but obvious example supporting this is the fact that recipients of transplants must undergo immunosuppression to prevent the transplant from attacking the recipient's body and the recipient's body attacking the transplant. It is clear that no human art has unified the organs of a person declared brain dead; therefore, the principle uniting them is their natural form, which is the rational soul. As long as the rational soul remains united to the body, the person is alive, and removal of organs from that person which results in death is an act of killing.

Finally, since the act of removing organs nessecarily causes the departure of the rational soul, this is killing the person. And killing an innocent person is an act of murder, so deriving organ transplants from persons declared brain dead is an act of murder.

[1] Summa Theologica, Part 1, Question 76, Article 8

[2] Batts DW (2010-05-10). "Cancer cells killed Henrietta Lacks – then made her immortal". The Virginian-Pilot. pp. 1, 12–14.