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Wednesday, 5 September 2012

Does fifth commandment forbid heart tranplantation?

Heart transplantation is becoming more popular these days. You might have noticed one such venture which took place in Kerala also. It was well appreciated by most of the Media. There were also Malayalam movies with central theme as heart transplantation. Seeing the real beating heart being taken out from the donor, you might have had a question whether heart transplantation is actually accentuating death of the donor. This is a little quest into this constantly scrutinized subject. Hope you might notice author’s effort!                                        

Who are selected for heart donation?
Science explains death in 3 ways, termed modes of death namely coma, asphyxia and syncope, each representing the failure of a major organ to function in an optimal level to sustain life. In coma it is the brain that fails, in asphyxia it is the lung and in syncope the heart. Those selected as donors are those in coma - as in this state, their brain is badly damaged (irreversibly) due to an insult (ischemia or hemorrhage) while their heart still remains suitable for transplantation.

What constitutes death? 
A well explained theological explanation is difficult. But science comes to our aid, by describing death as cessations of bodily functions necessary for life clinically represented by bilateral fixed and dilated pupils, absent spontaneous respiration and no cardiac activity. Further supported by a plain ECG reading and many more…
Yet, in the theological point of view, the Catechism of Catholic Church states: “The unity of soul and body is so profound that one has to consider the soul to be the "form" of the body: i.e., it is because of its spiritual soul that the body made of matter becomes a living, human body; spirit and matter, in man, are not two natures united, but rather their union forms a single nature” (CCC 365).  Death represents the separation of the spirit and the body. So what still remains is the debate on the point of separation of the spirit and body.
Pope Pius XII in 1957 in an Address to International Congress of Anesthesiologists stated: "But considerations of a general nature allow us to believe that human life continues for as long as its vital functions—distinguished from the simple life of organs manifest themselves spontaneously or even with help of artificial processes." and
Pope John Paul II to the Participants of the 1989 Pontifical Academy of Sciences stated: Death can mean decomposition, disintegration, a separation. It occurs when the spiritual principle which ensures the unity of the individual can no longer exercise its functions in and upon the organism, whose elements left to themselves, disintegrate.” So again in conclusion: death means the separation of the human spirit from its earthly body. This is characterized by the absence of vital functions and as long as the vital organs are functioning it shows the persistence of spirit and the person is said to be alive.

Are brain dead actually dead?
The church relies on science (modern medicine) to help it in describing or pointing the point of death or no return to normalcy. Every now and then the church formulates pastoral guidelines on death description without violating the ecclesiastical laws through the works of The Pontifical Academy for Life, The Pontifical Council for Health Care Workers etc… so it is well said that brain death is described accordingly to present scientific knowledge of the day. The present day medical science teaches that:  A COMPLETE and IRREVERSIBLE brain death can be considered a real death. While Coma many times may be due to death of the lower centers of brain (brain stem) alone and such patients would have difficulty only in breathing. Such patients are not dead but just diseased and can be treated with the aid of a ventilator. This state is called persistent vegetative state and it is entirely different from brain death. On the contrary, if both higher and lower centers of brain are dead, patients have undergone complete brain death and are called dead as they cannot be kept on (treated with) a ventilator forever. With complete brain death, central regulatory mechanisms will no longer function, so blood pressure, electrolyte levels, temperature regulation etc. will all soon get "out of whack". Disintegration will inevitably set in. Heart contractions will typically cease in brain-dead individuals after a few days despite the presence of a ventilator.

On the third side, if the upper centers alone die, leaving behind functions of lower centers intact, of course then the patient will respire on his own and hence is not dead.

Is it possible to determine complete and irreversible cessation of brain functions?
Deterioration of brain functions can be objectively determined by a battery of tests, as stated by Harward University. But the question whether reversible or irreversible, cannot be empirically determined. So again, the cessation of both higher and lower brain functions are, in fact, directly observable and objective while those on reversibility is not. Irreversibility is the presently believed dictum in neuroscience; major neurological injuries are usually considered irreversible. Bringing to say, that now Brain death is an end state of no return to normal. Yet science has much left to discover or I better say unravel, our presently considered irreversible brain death may one day, in the future will be just another treatable neurological disorder.

What if science invents artificial brains?
Mankind is quite far from that feat at the moment, but it does not rule out the option. If man does one day succeed in making an artificial brain that could function in keeping the physiological functions intact, we would have cured brain death. And lets hope they develop a proper successful version of the artificial heart too…

Finally, should we donate our hearts?
Catholic Church is as social institution. All the laws of the Catholic Church including that of the ecclesiastical are made for the humans and not vice versa.  God created laws as a way of life where every commandment or rule is made to serve the love (that is God) and not for the sake of the law.
It’s always good to remember that: It’s always good to remember that:
“The Sabbath was made for humankind and not humankind for the Sabbath” (Mark 2:27)
So nobody is forbidden by any commandment from donating heart out of love. Amen

Tuesday, 10 July 2012

Cochin Metro Railway: At a Prolife Angle

The long cherished dream for a better traffic in Cochin is budding and will be flowered by 2016.  Cochin metro railway will soon be an alternate traffic to get rid of the congested road travels. Along other citizens of kerala, I heartily welcome this newer step of development.

We all like development, both in infrastructure and ultra structure. Most of you have dreamt, at least once, to travel all around the developed countries simply because you are attracted to their better infrastructural development as compared to ours. Here I wish to point out some fundamentals that call for a better development.

Most of the times, for a ‘basic’ human, happiness is a direct outcome of development. Development is always coupled with economy of the nation. The more economic is a nation the more developed it would be. And you will see more metro railways there..

What is the factor that governs economy? I say ‘human resource’.  Of course, many will contradict saying that the population hinders economic growth and puts the country underdeveloped. In a large population, resources of a nation will be shared by more number of people resulting in getting less for each one. But this view assumes that the resources are finite. However the resources of a nation are not finite since its value can be only measured by the productive technologies available to that time. I.e. resources are not valuable to us in themselves, but only for what they can do. See for example, when a new technology comes we need to depend less on resources.  Silica is seen abundantly on the earth crust but it was of no use until years back. When the science developed, we learned to use Silicon in fiber optics which then lessened the demand of copper. It’s merely the interaction of human and science creates resources. 

So, how can we get better resources? We need better technologies for better resources.  The technologies won’t come by it; there should be someone to find out the laws of nature. All these laws including the recently explored Higgs mechanism are created by the God. However God want us to go in search of these laws to know Him more and more. That is why education is devoted to God. Basically, I was trying to say that we need humans to explore science.

Does all human need to explore science? I will say not since technologies once explored can be shared. So, why we need more humans for economic growth and development? This can be answered by answering another question that why metro railway did not come in Cochin before Delhi and Mumbai. Answer obvious na? It was more in need for Delhi and Mumbai. What does govern this need? Here comes the importance of population. Studies show a direct proportion between the population density and economic growth. What is the need of a metro railway without much population density? According to a Danish economist Ester Boserup populations must grow beyond a certain minimum level before they can get into the process of economic development. Population growth makes possible the development of towns, and the concomitant implication of specialized technologies and skills like use of advanced techniques to produce food owing to the growing demand and making alternate traffics like metro railways will keep the town developed and bring more economy. 

Japan, Singapore, Hong Kong etc all has experienced a rapid population growth. See how developed they are. Take an example of Singapore which has a population density of more than 3500. People there don’t suffocate or experience collision on roads while walking owing to high population density. Still more and more people are migrating there. That country has grown in terms of development owing to a rapid population growth.

To develop more, for metro rails into malls and to live in a country with all its richness, let us pray for the abundance of life.