Janet Smith, Ph.D.
Published May 25, 2007

Life Ethics The Life Ethics columns are a project of the Archdiocesan Committee on Health Care Ethics, health care professionals of the archdiocese who advise Cardinal Adam Maida on bioethics issues.

Organ transplantation is one of those issues about which Scripture says nothing directly — after all, organ transplantation was not possible until the early 20th century. We need to draw upon theological and philosophical principles to discern the morality of organ donation.

Since donating an organ seems like such a obviously generous thing to do, it may be surprising to some that the answer was not obvious to Catholic theologians who struggled with the issue.

The question concerned whether organ transplantation violated the moral norm that we should not mutilate our bodies. The Church understands God to have designed the body well and that our bodies are gifts from God to be treasured; we can’t do anything we want with them. It is a principle useful for determining the morality of tattooing and body piercings and amputating healthy limbs or trying to turn one’s appearance into that of a lizard (as one philosophy graduate student was intent on doing).

God gave us our hearts and our lungs and other organs for our benefit. Indeed, it is immoral to donate a vital organ to another; say if the pope or a president or even one of our own children needed a heart transplant. That’s the case even if we desired to make the ultimate sacrifice of our own lives for someone else by donating an organ, we should not do so by killing ourselves.

It is moral to jump on a hand grenade to save the life of another for it would be a matter of allowing one’s self to be killed to help another. For a living person to donate a vital organ, like a heart, to save another is immoral: it would be committing suicide to help another and that is immoral.

But is it mutilation or an immoral risking of one’s life to donate a nonvital organ such as a kidney? Eventually theologians came to the consensus it is an act of charity to donate an organ, so long as one does not take undue risks with one’s own life or deprive one’s body of something essential to its well-being and as long as the donor gives fully free consent. In Directive No. 30 of the U.S. bishops’ "Ethical and Religious Directives for Catholic Health Care Services," we read "The transplantation of organs from living donors is morally permissible when such a donation will not sacrifice or seriously impair any essential bodily function and the anticipated benefit to the recipient is proportionate to the harm to the donor…."

Moral theologians make a distinction between sacrificing anatomical integrity (e.g., one gives up a kidney) while still retaining functional integrity (one still has a functioning kidney). If one were to donate an eye to another one would violate both kinds of integrity since one needs both eyes for seeing well. Moreover, while the Church teaches that donating organs is moral, it teaches that selling organs is immoral. Again, one’s body is a gift from God and one should not sell something so precious and personal; one should not sell one’s kisses or parts of one’s body.

In "Evangelium Vitae," John Paul II lauded those who donate their organs to others as an act of "everyday heroism" (86). He noted that donors are living manifestations of the culture of life. In our abortion culture where some women are not willing to care for the children in their own wombs, the witness of those who give so freely to others is a welcome witness indeed.

Janet Smith, Ph.D., is the Fr. Michael J. McGivney Chair of Life Ethics at Sacred Heart Major Seminary.