Organ Donations - Part 2

The transplantation of organs from a living donor to another person is more complicated. The ability to perform the first kidney transplant in 1954 caused a great debate among theologians. The debate focused on the principle of totality whereby certain circumstances permit a person to sacrifice one part or function of the body for the interest of the whole body. For instance, a person may remove a diseased organ to preserve the health of his whole body, such as removing a cancerous uterus. These theologians, however, argued that a person can not justify the removal of a healthy organ and incur the risk of future health problems when his own life is not in danger, as in the case of a person sacrificing a healthy kidney to donate to a person in need. Such surgery, they held, entails an unnecessary mutilation of the body and is thereby immoral.

Other theologians argued from the point of fraternal charity, namely that a healthy person who donates a kidney to a person in need is making a genuine act of sacrifice to save that person's life. Such generosity is modeled after our Lord's sacrifice of Himself on the cross, and reflects His teaching at the Last Supper: "This is my commandment: Love one another as I have loved you. There is no greater love than this: to lay down one's life for one's friends" (Jn 15:12-13). Such a sacrifice, these theologians held, is morally acceptable if the risk of harm to the donor, both from the surgery itself and the loss of the organ, is proportionate to the good for the recipient.

Moving from this reasoning, these "pro-transplant" theologians re-examined the principle of totality. They argued that while organ transplants from living donors may not preserve anatomical or physical integrity (i.e., there is a loss of a healthy organ), they do comply with a functional totality (i.e. there is the preservation of the bodily functions and system as a whole). For instance, a person can sacrifice one healthy kidney (a loss of anatomical integrity) and still be able to maintain health and proper bodily functions with the remaining kidney; such a donation would be morally permissible. Using the same reasoning, however, a person cannot sacrifice an eye to give to a blind person, because such an act impairs the bodily functions of the individual.

Pope Pius XII agreed with this broader interpretation of the principle of totality, and declared organ transplants from living donors morally acceptable. He underscored the point that the donor is making a sacrifice of himself for the good of another person. However, such transplants must fulfill four criteria: (1) the risk involved to the donor in such a transplant must be proportionate to the good obtained for the recipient; (2) the removal of the organ must not seriously impair the donor's health or bodily function; (3) the prognosis of acceptance is good for the recipient and (4) the donor must make an informed and free decision recognizing the potential risks involved.

A moral question which has arisen in this area is whether someone can sell one of his own organs for transplantation. The answer is a definitive "no." The selling of an organ violates the dignity of the human being, eliminates the criterion of true charity for making such a donation, and promotes a market system which benefits only those who can pay, again violating genuine charity. Pope John Paul II underscored this teaching: AA transplant, even a simple blood transfusion, is not like other operations. It must not be separated from the donor's act of self-giving, from the love that gives life" (Address to the First International Congress of the Society for Organ Sharing," June 24, 1991).

The Ethical and Religious Directives for Catholic Health Care Services provides the following guidance: The transplantation of organs from living donors is morally permissible when such a donation will not sacrifice or seriously impair any essential bodily function and the anticipated benefit to the recipient is proportionate to the harm done to the donor. Furthermore, the freedom of the donor must be respected, and economic advantages should not accrue to the donor" (No. 30).

Therefore, organ donation is morally permissible under certain conditions. Generally, in the case of donating organs after death, the gifts that God has given to us to use in this life our eyes, hearts, liver, and so on can be passed on to someone in need. In the case of donating organs while alive, such as giving a healthy kidney to a relative in need, the donor needs to weigh all of the implications; in charity, a potential donor may decide he cannot offer an organ, such as if he were a parent and would not want to increase the risk of not being able to care for his own dependent children. Although organ donation is not mandatory, it is commendable as an act of charity.