This is a brief republished reflection on the Sacrament of Confirmation sixty=three years to the day after I received it at the hands of the late Bishop Walter P. Kellenberg, the founding bishop of the Diocese of Rockville Centre, Long Island, New York.
Another original article should appear by the Feast of the Seven Dolors of the Blessed Virgin Mary in Passiontide or, at the very latest, by Saturday of Passion Week.
Our Lady of Sorrows, pray for us.
Saint Benedict of Nursia, pray for us.
Saint Isidore the Farmer, pray for us.
Saint Maria de la Cabeza, pray for us.
Dr. Byrne's Statement to the Uniform Law Commission:
The Uniform Determination of Death Act (UDDA) has been adopted in all 50 states based on the recommendation of the Uniform Law Commission (ULC). Now the ULC is considering revision of the UDDA.
The UDDA states, “An individual who has sustained either 1) irreversible cessation of circulatory and respiratory functions, or 2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards.”
The first (1) is termed death by cardio-pulmonary criteria and the second, (2) death by neurological criteria (DNC) aka as “brain death” (BD).
When DNC, aka BD, the heart is beating with circulation delivering oxygen to every part of the body and taking away waste products.
A reason to declare DNC is to get organs for transplantation from patients with a beating heart, circulation, and respiration (exchange of oxygen and carbon dioxide in tissues). Proposed UDDA revisions by BD proponents would, by statute, take away any rights of patients or their families to prevent declaration of BD by doctors and would explicitly not require consent for doing the dangerous procedure of the apnea test (PAT).
The ULC is considering revision of the UDDA so DNC will be done without providing notice, information, or getting consent from loved ones to declare BD including the procedure of the apnea test (PAT) with its risks.
The PAT involves removing the life-supporting ventilator for up to 10 minutes or longer. The PAT purposely increases carbon dioxide to stimulate brainstem nerves to initiate a breath as would occur in a healthy person. There is no validation data that a patient with an injured brain will respond normally to high levels of carbon dioxide by taking a breath or a gasp. The function of taking a breath may not be observed. The part of the brain being tested may not be functioning but that does not mean it is destroyed. It may be potentially able to recover if in the state of penumbra (blood flow that is too low to detect but not totally absent). The PAT may harm the patient since increased carbon dioxide can make brain swelling worse causing brain destruction. In addition, the PAT does not test all brainstem functions related to breathing. Families may be told that oxygen will be given implying that the test is safe. Giving oxygen does not protect against harms from high carbon dioxide and may depress other breathing reflexes. The PAT is of no benefit to the patient and only risks harm.
The patient declared DNC has a beating heart and other organs suitable for transplantation but is not a true corpse or cadaver suitable for burial or cremation.
Potential organ donors asked to give consent at the DMV may believe that organs are taken only after true death. They should know that when organs are taken from a BD patient the heart is beating and circulation is present.
No one should be declared dead until rightly and correctly a cadaver ready for burial or cremation.
What can we do?
- Write to the Uniform Law Commission and tell them that the UDDA needs to be repealed and replaced by “No one shall be declared dead unless respiratory and circulatory systems and the entire brain have been destroyed. Such destruction shall be determined in accord with universally accepted medical standards.”
- Full and complete information and the opportunity to decline use of neurological criteria alone to declare death must be provided.
- Full and complete information and the opportunity to decline the Procedure of the Apnea Test must be provided.
- Full and complete medical records must be made available on request within 24 hours to family, surrogates, attorneys, and designated physicians including while the patient is still in hospital.
- Communicate the same to your federal and state legislators.
The Honorable Samuel Thumma, Chairman
Members of the Determination of Death Act Committee
Uniform Law Commission
111 N. Wabash Avenue, Suite 1010
Chicago, IL 60602
info@uniformlaws.org
(312) 450-6600