Response

Abstract

We thank Dr Nguyen for his thoughtful comments on our 2014 article on brain death and Islam.1Miller A.C. Ziad-Miller A. Elamin E.M. Brain death and Islam: the interface of religion, culture, history, law, and modern medicine.Chest. 2014; 146: 1092-1101Abstract Full Text Full Text PDF PubMed Scopus (42) Google Scholar Although not the focus of the article, we address his comments regarding Catholicism. The loss of integration view has since predominated in Christianity since accepted as doctrine by the Council of Vienne (1312 ad). Pope Pius X stated that the specification of biological parameters indicating that death has occurred “does not fall within the competence of the Church.”2Pope Pius X. Address to an international congress of anesthesiologists. L'Osservatore Romano.http://www.lifeissues.net/writers/doc/doc_31resuscitation.htmlDate accessed: September 10, 2019Google Scholar Rather, it pertains to the responsibility and competence of the medical profession to judge and establish the signs that serve as reliable indicators that death has occurred with adequate moral certainty. According to Pope John Paul II, the exact moment of body-soul separation cannot be directly identified by using modern scientific methods; however, the separation sets in motion a process of somatic disintegration producing “biological signs that a person has indeed died.”3Pope II, John Paul Address of the Holy Father John Paul II to the 18th International Congress of the Transplantation Society.Med Etika Bioet. 2001; 8: 12-14PubMed Google Scholar,4Pope II, John Paul Address of the Holy Father John Paul to the Pontifical Academy of Sciences. Vatican City, 2005http://w2.vatican.va/content/john-paul-ii/it/speeches/2005/february/documents/hf_jp-ii_spe_20050201_p-acad-sciences.htmlDate accessed: September 10, 2019Google Scholar He added that “for ascertaining the fact of death, namely the complete and irreversible cessation of all brain activity if rigorously applied, does not seem to conflict with the essential elements of a sound anthropology.”3Pope II, John Paul Address of the Holy Father John Paul II to the 18th International Congress of the Transplantation Society.Med Etika Bioet. 2001; 8: 12-14PubMed Google Scholar However, some outspoken critics (eg, Dr Nguyen)5Nguyen D. Pope John Paul II and the neurological standard for the determination of death: a critical analysis of his address to the transplantation society.Linacre Q. 2017; 84: 155-186Crossref PubMed Scopus (13) Google Scholar were critical of the Pontiff’s tentative and qualified support for the concept. With reference to the quotes attributed to Pope Benedict XVI,1Miller A.C. Ziad-Miller A. Elamin E.M. Brain death and Islam: the interface of religion, culture, history, law, and modern medicine.Chest. 2014; 146: 1092-1101Abstract Full Text Full Text PDF PubMed Scopus (42) Google Scholar clarification is warranted. Upon request from Pope Benedict XVI, a meeting on “The Signs of Death” was organized in 2006 at the Pontifical Academy of Sciences. During this meeting, 15 international neuroscientists (including Dr Conrado Estol) were invited to present their views on topics including brain death. Dr Estol published a review of the meeting.6Estol C.J. To live and let die: a brain death symposium at the Pontifical Academy of Science.Int J Stroke. 2008; 2: 227-229Crossref Scopus (6) Google Scholar The quotes in question came from this summary following the statement: “… concepts and conclusions reached following the oral presentations and discussions.” In retrospect, we now know that Pope Benedict XVI did not offer his personal views on the subject. The academy’s concluding statement reads in part:“Most of the arguments against brain death are not sustainable and are incorrect diversions when scrutinized from a neurological perspective…the relatives of brain-dead individuals should be told that their relative has died rather than that he is ‘brain-dead,’ with the accompanying explanation that the support systems produce only an appearance of life. Equally, the terms ‘life-support’ and ‘treatment’ should not be employed because in reality support systems are being provided to a corpse.”7Ziegler J.J. The principle of caution must prevail. Catholic World Report.https://www.catholicworldreport.com/2011/04/27/the-principle-of-caution-must-prevail/Date accessed: September 10, 2019Google Scholar We respectfully disagree that the quotes were “the words of Estol”; it would seem these were conclusions of the academy. Regardless, the point that the Pontifical Academy of Sciences does not have magisterial authority is well taken. We thank Dr Nguyen for helping to clarify this point and apologize for any confusion or misinformation. Quotes on Brain Death From Estol Incorrectly Attributed to Pope Benedict XVICHESTVol. 157Issue 1PreviewWhile researching an article on the social and legal complexities of “brain death,” I came across the literature review in CHEST (October 2014) by Miller et al.1 In that article (bottom of page 1094), Miller et al wrote “Pope Benedict XVI subsequently expanded on this by stating:” followed by two block quotes (page 1095). The authors also wrote, “Additionally, he stated:” between the two block quotes. Full-Text PDF