In 1968, a landmark report from Harvard Medical School set down criteria for determining when a person was brain dead. But 40 years later, a few maverick doctors have questioned whether the consensus is right. If their scruples are borne out, many procedures in transplant surgery could be at risk. The latest twist for this unsettling critique comes from the semi-official newspaper of the Vatican, L’Osservatore Romano.

A front-page article by Lucetta Scaraffia, a well-known history academic who is a member of the Italian National Committee on Bio-Ethics, calls for the issue to be re-examined. She points out that a few Catholic doctors have criticised the Harvard criteria, that brain-death is not used in the Vatican itself, and that Benedict XVI had expressed some reservations several years before his recent election as Pope.

In at least one case, she noted, life-support machines were used to keep a brain-dead pregnant woman functioning for many weeks until her baby was delivered. Such cases, she said, "have put into question the idea that these already were dead bodies, cadavers from which organs could be transplanted". Moreover, the acceptance of the cessation of brain activity as death contradicted Catholic doctrine — which involves the "absolute and integral defence of human life" — by equating the human person with brain functions only.

Ever since 1968 Catholic authorities have backed the Harvard guidelines – one of the few areas on which they agree with non-believers. In 2006, a document entitled "Why the Concept of Brain Death Is Valid as a Definition of Death" was even endorsed by leading Vatican cardinals. So it is unlikely that Professor Scaraffia’s article signals a sudden about-face in Catholic teaching. But in the United States there has been a revival of the question, too – by doctors and ethicists who argue that brain-death is not death, but vital organs may be removed anyway. So it is more than likely that interest in the question will grow. ~ London Times, Sept 3