Pope Pius XII and Pope John Paul II both agree that it is the responsibility of doctors and scientists to determine the exact moment of death. In addition, the United States Catholic Bishops Conference asserted that the determination of death should be made by the physician or competent medical authority in accordance with responsible and commonly accepted scientific criteria (Ethical and Religious Directive, no. 62). To this end, a working group of doctors and scientists assembled by the Pontifical Academy of Sciences gave this clinical definition of death: “a person is dead when there has been total and irreversible loss of all capacity for integrating and coordinating physical and mental functions of the body as a unit” (1989, p. 81). The Church teaches that when an indisputable pronouncement of death has been made, donation of organs can commence. The Catechism of the Catholic Church states that Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent (no. 2296). Pope John Paul II vigorously affirmed that a beautiful act expressing the culture of life “is the donation of organs, performed in an ethically acceptable manner, with a view to offering a chance of health and even of life itself to the sick who sometimes have no other hope” (“Evangelium Vitae,” No. 86).
The Ethical and Religious Directives for Catholic Health Care Services (ERDs) based on the principle of totality (body parts are ordered for the good of the whole, and may be disposed of, if necessary, for the good of the whole) affirm that organ donations from the living is a noble and charitable act, while specifying at the same time that the donation will not sacrifice or seriously impair and essential functioning of the donor. It added that to avoid conflicts of interest the physician determining death ought not be a member of the transplant team (Directives, 64). May (2011) observed that the morality of the self-giving of vital organs depends on how the acting person relates himself in his freely chosen act to the great goods of healthy functioning and life itself. If the harm (including the mutilation) suffered by the donor — but in no way intended either by him or those involved in the transplant — does not impair his functional integrity, the evil suffered is an unintended side-effect of an act of self-giving, a morally good act. However, were the donor’s own functional integrity and hence his own health and life to be impaired, it would be wrong for him to choose to give it because the means he would choose, endangering his own health and life, is bad although intended for a good end, but one can never intend or choose evil for the sake of good to come. In all, the Catholic Church applauds and encourages organ donation as a morally good act of self-giving.