Update: This comes from Fr. Benedict Ashley, O.P.'s excellent Healthcare Ethics: A Theological Analysis (1997):

11.4 Organ Transplantation

Transplants from Deceased Donors

Any surgical procedure involves some reconstruction of the human body, but there is a striking difference between procedures such as setting a broken bone or sewing up a wound or removing a tumor, which assist a natural healing process or remove a diseased part, and a procedure by which an organ originally belonging to another is transplanted into the human body in place of one of its own parts that has become dysfunctional. The latter procedure involves the rights not of one person but of two and thus raises a new moral question.

Two types of organ transplants are possible, one involving an organ or tissue taken from a dead person and given to a living person and the other involving an organ taken from one living person and given to another living person. Transplanting an organ or tissue from a dead person to a living person in itself presents no ethical problem. With few exceptions, religious groups as well as humanistic ethicists have recognized the worth and ethical validity of such transplants (Jonsen, 1985; John Paul II, 1984d, 1995). If some serious question arises concerning transplant from a dead person to a living person, it stems from factors other than the transplant itself. For example, concern was expressed at first about the worth of heart transplants, most of it arising either from the great expense of money and personnel involved in a medical procedure that brings little substantive value to human society in general (Ramsey, 1970; Thorup et al., 1985) or from fear that in some cases the organ donor had not actually expired (P. Williams et al., 1973). These concerns are no longer prominent, however, because of better survival rates in recipients of heart transplants and from greater ability to ascertain the criteria for total brain death (Black, 1984). John Paul II (1995) echoing the thought of Pius XII (1956a["Allocution to a Group of Eye Specialists" (May 14), The Human Body: Papal Teachings, Boston: St. Paul Editions, 1979 [1960], n. 637-649.]), summed up Catholic teaching on transplants involving an organ from a dead person:

Quote

The Gospel of Life is celebrated above all else in the daily living of life which should be filled with selfgiving for others . . . A particular praiseworthy example of such gestures is the donation of organs performed in an ethically acceptable manner, with a view to offering a chance of health and even life itself to the sick who sometimes have no other hope (n. 86).

Transplants from Living Donors

Far more difficulties arise, however, with organ transplants between living persons. Before 1950, the morality of transplanting an organ from one living person to another was discussed by Catholic theologians from a theoretical point of view (Cunningham, 1944 [Cunningham, Bert, The Morality of Organic Transplantation, Washington, DC: Catholic University of America Press, 1944.]). Although an interesting question, it was somewhat impractical because transplants between living persons generally were not yet technically feasible. Many theologians who considered the subject did not approve of it. These theologians argued that the principle of totality and integrity would justify mutilation or injury to one part of the body only if it was done to preserve the person's own health or human life. The principle would not justify a transplant to another person, however, because one person is not related to another person as means to end or as part to whole. Thus one person's bodily integrity could not be sacrificed for another.

Whatever the theoretical discussions, organ transplants from living donors began to be performed in the early 1950s. Because of genetic similarity, identical twins were the first subjects of kidney transplants. Many early transplants were not successful because the transplanted organ often was rejected by the reaction of the recipient's immune system (Murray, 1986). Yet as some succeeded, scientists began to argue that unless there was freedom to undertake such experiments, medical progress would be hampered (Fox and Swazy, 1978). Thus, ethicists and moralists gave the problem closer scrutiny.

Gerald Kelly (1956), a leader in this development, wrote:

Quote

It may come as a surprise to physicians that theologians should have any difficulty about mutilations and other procedures which are performed with the consent of the subject but which have as their purpose the helping of others. By a sort of instinctive judgment we consider that the giving of a part of one's body to help a sick man is not only morally justifiable, but, in some instances, actually heroic (p. 246).

In developing the rationale for a more liberal opinion, Kelly maintained, "It is clear from reason and papal teaching that the principle of totality cannot be used to justify the donating of a part of one's body to another person. Moreover, since man is only the administrator of his life and bodily members and functions, his power to dispose of these things is limited." Kelly, however, sought to delineate as clearly as possible the limits of this dominion, especially concerning organ transplants. Further, he asked whether there is any other way in which this seemingly worthwhile and Christian action can be justified. He suggested that the principle of fraternal love, or charity, would justify the transplant, provided that there was only limited harm to the donor. Although it was not unanimously accepted, some theologians agreed with this opinion and developed it more clearly. Distinguishing between anatomical integrity and functional integrity, they stated that the latter, not the former, was necessary to ensure human or bodily integrity (McFadden, 1976).

Anatomical integrity refers to the material or physical integrity of the human body. Functional integrity refers to the systematic efficiency of the human body. For example, if one kidney were missing from a person's body, there would be a lack of anatomical integrity, but if one healthy kidney were present and working, there would be functional integrity because one healthy kidney is more than able to provide systematic efficiency. If a cornea were to be taken from the eye of one living person and given to another, however, the case would be different. Not only would anatomical integrity be destroyed, but functional integrity would be destroyed as well. The loss of sight in one eye severely damages vision, especially depth perception. Thus in this case, more than anatomical integrity is involved. For the most part, the transplant of a cornea from living persons is no longer a problem because transplanting corneas from dead persons has been perfected.

This distinction between anatomical and functional integrity that we have incorporated in our formulation of the principle of totality and integrity (2.4) explains why blood transfusions and skin grafts are acceptable and why theologians have approved elective appendectomy if the abdominal cavity is open for another legitimate reason. In these situations loss of anatomical integrity may occur through loss of blood, skin tissue, or an internal organ, but no loss of functional integrity occurs.

Thus the concept of functional integrity is the key factor in addressing the morality of transplants between living persons. Certainly, a risk is involved if a donor surrenders an organ to another person, even if the donor has two of them. Aside from the risk involved in the surgical procedure, such donors take the risk of serious illness themselves if the one remaining organ becomes damaged or diseased. The risk, however, although serious, is deemed to be justified by the fact that donors share in the common good of the community to which they contribute by helping another, that is, by love (Ramsey, 1970).

Clearly, organ donation is not an obligation; rather, it is something chosen in the freedom of charity. Motivated by the same charity, one could decide not to offer an organ. Such a decision would not be unethical. For this reason, it is imperative that a donor's free and informed consent be obtained. Given the fact that the more successful transplants are between members of the same family, familial or social pressure to offer oneself as a donor may at times be severe but the courts (rightly, we believe) refuse to compel such donations (Hartman, 1993). Because of the motivation that should underlie the donation of an organ by a living person, it is clear that selling organs is unethical. The federal government has prohibited the sale of all organs in the United States, but sale of organs by living donors in some countries is a common practice (Barnett and Kaserman, 1993).

Kelly was certainly right in holding that organ transplants between two living persons are licit if the donor's functional integrity is maintained, but we would caution that great care should be taken in weighing the merely potential benefit against the actual risks. Consent should not be given unless the prognosis for both the donor and the recipient is good. In some cases it is necessary to weigh the value of a brief prolongation of life for the recipient against the lifelong risk to the donor.

In addition to the rationale put forward by Kelly and others to justify transplants between living persons, some theologians go a step further and seek to justify these procedures either by expanding the principle of totality and integrity or by treating the whole process as a curative action, even though two people are involved and one will be injured (Nolan, 1968). In so doing, they destroy the limits so carefully delineated by Kelly and others to protect human integrity. According to these theories, the human unity predicated on body and soul is destroyed, and the body becomes something merely used by the person, part of which, at least, is at the disposal or "over against" the person and thus may be sacrificed by the person for any higher good. Falling heir to Cartesian dualism that renders appreciation of the body-soul unity of human nature impossible, one author even concludes that both eyes may be donated "for the good of another person." Section 2.4 lists the reasons why we believe such views do not do justice to the Christian view of the integrity of the human person (Ramsey, 1970).

The development in the past 40 years of the moral teaching of theologians concerning organ transplants between the living is of more than antiquarian interest. First, it shows clearly that the opinion of theologians can evolve. Second, it shows that by refining accepted principles, and not denying them, new conclusions can be drawn from long-established principles. Third, it demonstrates that many ethical problems are solved by starting with intuitive judgments and then examining the principles in light of the solution proposed in the intuitive judgment.

In summary, the transplanting of organs or tissues from a dead person to a living person does not offer any intrinsic ethical problem. Transplanting organs from one living person to another is also ethically acceptable, provided that the following criteria are met:

1. There is a serious need on the part of the recipient that cannot be fulfilled in any other way.

2. The functional integrity of the donor as a human person will not be impaired, even though anatomical integrity may suffer.

3. The risk taken by the donor as an act of charity is proportionate to the good resulting for the recipient.

4. The donor's consent is free and informed.

 

If some serious question arises concerning transplant from a dead person to a living person, it stems from factors other than the transplant itself. For example, concern was expressed at first about the worth of heart transplants, most of it arising either from the great expense of money and personnel involved in a medical procedure that brings little substantive value to human society in general (Ramsey, 1970; Thorup et al., 1985) or from fear that in some cases the organ donor had not actually expired (P. Williams et al., 1973). These concerns are no longer prominent, however, because of better survival rates in recipients of heart transplants and from greater ability to ascertain the criteria for total brain death (Black, 1984).

I found this quote very disturbing, since by 1997, it was already known that a living heart, that is: a heart from a living donor, was essential for a successful transplant. Also the criteria for what constitutes death, is malleable in the transplant industry. This has been discussed on previous threads, which could be dug up.

On doing a search for "Gerald Kelly transplants", I came up with a book, The Ethics of Organ Donation by Steven J Jensen, with a chapter on Bioethics and the Ordinary Magisterium. On p283 he refers to (but does not quote) "Pius XII's 1952 speech to histopathologists in which he explicitly speaks against organ transplants". It would be worth checking.

Pius XII was clear that one person's bodily integrity could not be sacrificed for another. Surgery particularly cornea transplants were wide spread at the time and experimentation had been done for some time. the teaching was clear and majority opinion of theologians concured as well. If the thing was replaceable ie: Blood, skin, marrow etc. it could be transplanted. If non replaceable the answer was no. no  no no no no. The object of medicine had already moved. no longer was it there to aid us to live as healthy as we could but to try to make us live as long as possible.

p.s.
1869—First skin transplant performed.

1906—First transplant of a cornea performed.

1954—First successful kidney transplant performed. A living donor gave a kidney to his identical twin.

The object of medicine had already moved. no longer was it there to aid us to live as healthy as we could but to try to make us live as long as possible.

Yes, that's my impression of the John Paul II quote from Evangelium Vitæ above when he says organ transplant is laudable for "the sick who sometimes have no other hope". Really? They have no other hope? This smells of naturalism.

On doing a search for "Gerald Kelly transplants", I came up with a book, The Ethics of Organ Donation by Steven J Jensen, with a chapter on Bioethics and the Ordinary Magisterium. On p283 he refers to (but does not quote) "Pius XII's 1952 speech to histopathologists in which he explicitly speaks against organ transplants". It would be worth checking.

Fr. Benedict Ashley, O.P., mentions Pope Pius XII's "Allocution to a Group of Eye Specialists" (May 14), The Human Body: Papal Teachings, Boston: St. Paul Editions, 1979 [1960], n. 637-649. I cannot find the full text, but this has a quote from it:

The public must be educated. It must be explained with intelligence and respect that to consent explicitly or tacitly to serious damage to the integrity of the corpse in the interest of those who are suffering, is no violation of the reverence due to the dead.

This excellent LifeIssues.net article says the "13th September 1952" "allocution to the Italian Society of Histopathologists" is where Pope Pius XII "first named" "the principle of totality". It's AAS 44 (1952) 779-789. It's in French.

Yes indeed, thank you for that information, confederate catholic.

There are some medical transplants that do not cause intrinsic harm to a living person and we call them living donors.  One could give a kidney, a portion of one's liver, a lobe of one's lung, or bone marrow to another person.  Morally, I think this might fall under the category of self-sacrifice to help a sick child or other relative.  I do not believe, however, we should be forced to do so or condemned because we do not.   There is great reward in suffering, so I would think these types of donations would have to be well thought about and prayed about.  

As a former health care worker (in a lab sometimes with pathology), there are very few things that can be donated after one's death.  I have helped on several occasions with the harvest of such things.  You can use skin, bones, and eyes.  Corneas are removed shortly after death and may be kept up to 5 days before they cannot be used.  You probably could put in this category teeth as well.  This is done quite frequently and it seems Pope Pius XII deemed this would not be desecrating the body.

However, what we are dealing with today is heart harvesting.  When a person dies, the organs die as well.  Once they are dead, they can not be "restarted."  It is impossible.  This whole living organ donor issued is due entirely to heart harvesting.  As I mentioned above, there was absolutely nothing stopping a person from donating organs after a patient was dead.  But death meant absence of a heart beat and respiration.  (that is still death).  Many, many attempts were made to transplant hearts moments after patients died.  They were all unsuccessful because once an organ is dead it cannot be restarted.  In 1964, Dr. James Hardy transplanted a chimp heart into a human in Mississippi.  The patient lived for just over an hour.  In 1967 Dr. Christian Bernard got permission from a man who daughter had been severely injured in a car accident.  He told the man that his daughter would forever be in a coma, but that with his permission they could let her "die" and transplant her heart into another man.  To get around the laws of removing living organs from patients, Dr. Bernard injected her heart with potassium which sent into into shock.  Then he cut it out of her.  Mind you, her heart was not dead.  If it were, it would not have been restarted.  It was just shocked.

Following his limited success, Harvard established a committee to push-ahead with the concept of brain-death by using the idea of "irreversible coma."  This unleashed a series of experiments in medicine throughout the 60s and into the 70s.  Currently, brain death is the standard for determining death---and it has everything to do with the harvesting of organs.  Morally, this is unacceptable because a living person, who is unconscious, would never give consent to have their vital organs removed.  Ever.  Thus, they manipulate the definition of death and the emotions of the families.  The post conciliar Church went along with this atrocity by accepting the myth that brain death is actually death.  Couple that with the concept of "irreversible coma" and we have people "coming back to life" rather frequently when they weren't even dead.

It's a whole big deception and the only people profiting are the doctors.....