February 14 is not only Valentine’s Day, but it is National Donor Day. According to the website promoting the annual event, “National Donor Day is a time to focus on all types of donation—organ, eye, tissue, blood, platelets and marrow” by encouraging people to donate their body parts. Valentine’s Day and National Donor Day are linked by a spirit of self-giving motivated by love.
However, the heart a person gives on National Donor Day is literally one’s own. Once one’s body is dedicated to the matchmakers at the United Network for Organ Sharing (UNOS), the relationship is final. Family members or appointed surrogates are powerless to revoke the previous engagement. UNOS and regional Organ Procurement Organizations (OPOs) are in control of wedding your body to a stranger (see Understanding the Uniform Anatomical Gift Act).
Often, the choice to be a registered organ donor is made in a split-second at Department of Motor Vehicle (DMV) sites around the country. If you have a driver’s license, you’ve seen the posters and were asked the potentially lethal question: “Do you want to be an organ donor?” If you answered yes, you were added to the registry. Now, if you no longer want to be a donor, you need to take steps to remove your name from the registry at the DMV (see How Sign Up Works on Organ Donation FAQ ).
Dr. Alan Shewmon had this to say about being an organ donor: “Just as cigarette ads are required to contain a footnote warning of health risks, ads promoting organ donation should contain a footnote along these lines: ‘Warning: it remains controversial whether you will actually be dead at the time of the removal of your organs.’” We elaborate on Shewmon’s concern in Harvesting Organs & Cherishing Life but suffice it to say; registered organ donors are not biologically dead when their organs are harvested.
While there is nothing wrong with donating body parts after biological death, being a registered organ donor may be a death sentence. Organs, unlike tissues—corneas, skin, bone, blood, platelets, and marrow—can only come from a living donor. The heart, lungs, liver, and kidneys are dependent on a continuous supply of oxygen and nutrition from the circulatory system. Take away their blood flow, and they rapidly become non-viable and begin to decompose, making them unsuitable for transplantation. Hence, the urgency to harvest organs from people who are still alive.
Historically, elapsed time without breathing or a heartbeat marked medical and legal death until 1968. In that year, physicians at Harvard Medical School proposed “irreversible coma” (total brain failure) as a definition of death. They did this for a couple of reasons, but a major one was to increase the supply of organs for donation. This paved the way for the Uniform Determination of Death Act (UDDA) in 1981, the legal definition of death in the United States today. Under the UDDA, donors diagnosed as “brain dead” still have beating hearts and breathing lungs assisted by life-support, so their organs are kept in good shape for harvesting.
In 2018, Harvard Medical School hosted a conference to re-evaluate the 50-year legacy of their redefinition of death and the UDDA. The expert consensus was the UDDA did not define death as a biological occurrence, but it served pragmatic purposes. The UDDA is a legal fiction. Like laws that allow abortion, the UDDA permits a definition of death at odds with science. In fact, recently, the two life denigrating laws were connected by Justice Sotomayor during oral arguments for the Dobbs v. Jackson Women’s Health Organization case in the United States Supreme Court.
This lawsuit concerned a 2018 ruling in Mississippi that banned abortions after 15 weeks of pregnancy. Although the nervous system begins to develop around 6 weeks, pro-choice advocates argue that sensation (pain) is not experienced in the unborn baby until the point of “viability,” roughly 24 weeks or 6 months after conception. Thus, the 15-week benchmark is considered too early to stop the choice for an abortion.
During the argument about the sensory experience of unborn babies, Justice Sotomayor compared these responses to people defined dead under the UDDA. She said, “Virtually every state defines a brain death as death. Yet, the literature is filled with episodes of people who are completely and utterly brain dead responding to stimuli. …So I don’t think that a response to—by a fetus necessarily proves that there is a sensation of pain or that there’s consciousness.”
According to the UDDA, those without “all the functions of the entire brain, including the brainstem, is dead.” Yet, as Sotomayor admits, people meeting this criterion are still “responding to stimuli.” When harvesting organs from people classified as dead under the UDDA, anesthesia is required to reduce objective signs of distress in the body. This indicates not just a “response to stimuli” but the brain and body reacting to surgical cuts to remove organs! Hence, the Surgeon General warning for organ donation Shewmon recommends.
The crux of the whole matter is how a person defines human life (see Monists Disguised as Dualists). Biological life starts at fertilization in the womb and stops after cells in the body no longer promote life. These are well-established facts of science. Organ donors declared dead under the UDDA are still alive, so don’t be deceived by seductive Valentine ploys to grab your heart. “Cherish Your Life! DON’T Be a Registered Organ Donor.”
The Alliance is an organization that advises hospitals on procuring organs more efficiently. When healthcare professionals approach traumatized family members to ask for an organ donation or navigate an unconscious person’s prior decision, the group suggests remembering this acronym: RATE (Respect, Acknowledge, Trust, and Empower). Of course, the intent is not to affirm the potential organ donor’s reduced life but to harvest their organs. We suggest using RATE this way:
Respect the breath of life the Creator has given. Refuse to be a registered organ donor. Refuse to donate a loved one’s organs. Instruct healthcare professionals to respect your decision to affirm life.
Acknowledge the facts of science. If vital signs are still present in the body, a person is still biologically alive. An individual with a beating heart on life support is not dead.
Trust what science and Holy Scripture say, not United States law and medical opinions. Physical death is an event that doesn’t occur until the spirit (i.e., the breath of life from the Creator) separates from the body, and this will be seen after cardiopulmonary function ceases. Thus, the only way to determine biological death as a fact is to remove life support entirely (see The Harmful Apnea Test).
Empower each other by refusing to be registered organ donors, standing firm against the UDDA, and affirming life.
Since the first kidney transplant in 1954 and heart transplant in 1967, a few attempts were made to increase America’s donor pool. The first move was in 1968 with the Uniform Anatomical Gift Act (UAGA). Intricately connected to the UAGA was a push to create brain-death criteria, codified as law in 1981 as the Uniform Determination of Death Act (UDDA). The UAGA permitted organ donation. The UDDA redefined death to authorize the harvesting of perfused organs from unresponsive people on life support with hearts still pulsating in their chests.
Another attempt to expand the pool of donors came in revisions to the UAGA, first in 1987 and later in 2006. The 2006 revision made a registered donor’s desire to donate supersede their same rights under the Patient Self Determination Act (PSDA). Under this regulation, life-support to preserve organs and tissues will continue regardless of prior instructions to withdraw it.
Even if a legally appointed family member or surrogate attempts to enforce these advance directives, the UAGA trumps that right. Aggressive medical treatment with the intent to keep the body alive, under the delusion the donor is dead, will continue. The 2006 UAGA reform requires the treating doctor to notify the regional Organ Procurement Organization (OPO) and begin the harvest process. A person’s desire to be a registered organ donor is now a mandate to donate in most states, regardless of prior directives protected by the PSDA.
When it comes to defining human life, there are fundamentally two views: monism and dualism. Monism is a philosophy of being that says humans are made up of one substance and dualism, two. According to the former, biochemical processes in the body give humans life. In the latter, a spirit or soul animates the body. The Uniform Determination of Death Act (UDDA) is based on monism. Underneath these two positions are numerous subdivisions.
The Bible asserts a dualist view: “Then the LORD God formed a man from the dust of the ground and breathed into his nostrils the breath of life, and the man became a living being” (Gen. 2:7). Humans are “dust,” or body, and “breath of life,” or spirit. Thus, the Christian view is incompatible with monism and the UDDA, which essentially says the brain equals the spirit or soul. According to the Bible, the spirit is distinct from the brain, heart, lungs, etc.
Historically, Christians have gravitated toward Plato or Aristotle to define dualism. Plato taught the body contained the soul, and Aristotle, the soul, “forms” or ensouls the body. Although the views of Plato and Aristotle are not biblical, holding to them didn’t matter much until the advent of life support in the 20th century. The problem for modern Christians is the dualism Plato and Aristotle taught may permit a declaration of death even though biological life is still present in the body.
Holding to the teachings of Plato and Aristotle, it is possible to argue that a non-responsive person with a beating heart dependent on life support is deceased. According to modern interpretations of their dualism, the part that made this person a human has separated from the body. Of course, this is really dualism disguised as monism. The brain is being viewed as the center of life, not a spirit distinct from the brain animating the body. The teachings of Plato and Aristotle are subsumed under the neurological standard of the UDDA.
The Bible is clear, the One who was made in every way like us died a human death (Heb. 4:15; Rom. 5:12; Heb. 2:9). “Jesus,” on the cross, “crying out with a loud voice, said, ‘Father, into your hands I commit my spirit,’ having said this, he breathed his last breath and died” (Luke 23:46). Death occurs after cardiopulmonary function ceases. At this point, the spirit or soul has separated from the body.
The apnea test is the gold standard for determining brain death while people are still on a ventilator. A blood sample is taken from an artery (carries oxygen-rich blood to the body) for this examination. The amount of carbon dioxide in the blood is measured. Then the ventilator is turned off and disconnected. As the carbon dioxide in the arterial blood increases, the person is monitored for breathing (the carbon dioxide in arterial blood stimulates receptors in the brainstem to cause breathing). After the carbon dioxide reaches a certain level in the blood and no visual attempts are made to breathe, brain death is diagnosed. The person is now legally dead in the United States and may be plundered for organs.
However, the apnea test itself can cause damage to the critically ill person and misdiagnosis. Rising levels of carbon dioxide in arterial blood cause dilation or opening of the arteries, contributing to increased blood flow and swelling in the brain. The result is intensified intra-cranial pressure on the brain enclosed in the skull, which destroys neurons (nerve cells), and this causes stress on the brainstem (where breathing is regulated). The apnea test increases pressure and swelling in the brain, essentially reversing the primary goal of reducing injury to the brainstem to permit normal breathing. The result of the apnea test is increased harm to the vulnerable person and an inability to inhale.