Brain Death, Moral Certainty, and the Ethics of Organ Donation in Catholic Thought

Abstract

Organ donation is widely commended in Catholic teaching as a “noble and meritorious act” and a concrete expression of generous solidarity. Yet the practice of procuring vital organs from donors diagnosed dead by neurological criteria (“brain death”) has come under renewed scrutiny. Developments in intensive care medicine, long-term maintenance of patients after a brain death diagnosis, and debates about residual hypothalamic and neuroendocrine function have raised questions about whether current standards of death determination secure the “moral certainty” required by Catholic moral theology. At the same time, donation after circulatory death (DCD) has been proposed as an alternative pathway that avoids some, but not all, of the contested issues around neurological criteria.

This article offers a Catholic theological reading of the contemporary brain death controversy. It proceeds by conceptual and document analysis of key magisterial texts (the Catechism of the Catholic Church, Evangelium vitae, papal addresses, and ecclesial guidelines) and of recent Catholic bioethical literature. It argues that: (1) organ donation remains, in principle, a paradigmatic form of Christian charity; (2) the Church has only provisionally accepted neurological criteria, and always under the condition that they truly track the death of the person; and (3) empirical and conceptual concerns about integrative unity make uncritical confidence in current protocols impossible.

Rather than calling for a blanket rejection of organ donation, the article proposes a path of “cautious generosity” that combines a renewed affirmation of donation with strengthened diagnostic standards, transparent communication, and robust protection of conscience.