Question:

I would like to know if it is morally correct to abort a baby who has no brain and, above all, if he can be considered a human being. I would also like to know if his organs can be used for transplantation.

Answer:

Anencephaly is the congenital absence of a large portion of the brain, skull, and scalp, with its genesis in the first month of gestation.

Regarding the identity of the anencephalic subject, Monsignor Sgreccia states: “It seems to us beyond dispute that the anencephalic is the fruit of human fertilization, with a human form, which from the moment of fertilization is teleologically directed by its own vital principle. One should not doubt, therefore, that we are dealing with an individual of the human species, who must be respected as a person in the same way as any other embryo.” This answers the question concerning abortion of the anencephalic: the answer is negative. As a human being, his life must be respected from the moment of conception until natural death.

Taking this into account, Sgreccia himself responds to the three questions related to these cases:

1) The procurement of organs from the living anencephalic. This is a procedure accepted by those who consider that he is not a human individual, or by those who consider that the absence of a large part of the cerebral mass is a situation analogous to brain death. First of all, it is false that he is not a human individual, as stated above. As for the analogy with brain death, this is not a scientific hypothesis, for in this case, the brain lesion is only partial; it does not involve the brainstem structures, which are therefore capable of autonomously maintaining vital functions. Obtaining organs from the living anencephalic is therefore a moral aberration.

2) Resuscitation of the anencephalic newborn. There are four possible procedures:

• As soon as born, the anencephalic infant is intubated and connected to a ventilator, maintaining all vital parameters to proceed with organ extraction as needed and independently of the presence or absence of brainstem activity. This is ethically unacceptable.
• As soon as he is born, he is resuscitated and monitored until brainstem activity ceases; this practice appears disproportionate to the diagnosis, constituting a veritable therapeutic obstinacy.
• The newborn is followed with ordinary care only until hypertension or bradycardia appears, at which point he is resuscitated while awaiting brainstem death; this procedure, with the sole purpose of transplanting organs, represents a form of instrumentalization of the human being and is ethically unacceptable.
• The newborn is followed with ordinary care only until cardio-respiratory arrest occurs, after which organ extraction proceeds. This is the practice that most respects the value of the anencephalic person.

3) As for organ transplantation from anencephalic fetuses after their death, there are no objections as long as death has been duly verified.

Fr. Miguel A. Fuentes, IVE

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