The Corner

Culture

Is Euthanasia Corrupting Transplant Medical Ethics?

In my very first anti-euthanasia column, published by Newsweek in 1993, I worried that once medicalized killing became accepted, it would soon be joined by “organ harvesting as a plum to society.”

“Alarmist!” I was called. “Slippery slope arguer!” It will never happen, I was assured.

Until it did.

Now in both Netherlands and Belgium, mentally ill and disabled patients are voluntarily euthanized and their organs harvested after being killed. Canada is discussing joining the infamous duo.

I have waited for the organ transplant community to rise up and reject conjoining killing and organ donation. It has been a wait mostly in vain.

Indeed, a letter in the current Journal of the American Medical Association merely warns against haste in widely instituting such a policy due to safety concerns:

I urge caution before this practice is widely accepted. First, only short-term functional outcomes immediately after transplantation and at 6 months are available. Second, warm ischemia, an inevitable consequence of organ donation after cardiac death, results in greater risk for transplanted organs…

There is a need to study long-term outcomes of transplanted organs resulting from euthanasia so that truly informed consent can be obtained.

How starkly utilitarian can you get? 

If all that matters is consent–the clear implication of this letter–why would donors have to be suffering sufficiently to qualify for euthanasia?

Indeed, why not let healthy people who simply want to die and believe others–who want to live–have a greater claim on their livers and hearts volunteer to be killed and harvested?

The authors of the original article make in an equally bloodless, technocratic reply:

Euthanasia is performed according to local protocol by injection of a drug to induce coma, followed by a muscle relaxant. After circulatory arrest, a waiting time of 5 minutes is respected before the patient is transferred to the operating room for organ removal.

Compared with other donations after cardiac death, the process of dying is short (often less than10-15 minutes), and death is not preceded by medical deterioration in the intensive care unit.

Euthanasia donors are, on average, younger than other cardiac death donors. Better transplant results may therefore occur in organ donation after euthanasia compared with donation after other causes of cardiac death, but additional studies are required.

Where are we as a society that killing and harvesting are respectfully discussed in one of the world’s most respected medical journals–and no one brings up crucial issues of right and wrong?

As just one quick example: What could be more dangerous than letting despairing people believe that their deaths could have greater value than their lives? Becoming a donor could be the final factor that induces them to opt for euthanasia or assisted suicide.

For for that matter, how dangerous would it be if society ever came to accept that the hastened deaths of the despairing could offer a “plum?”

Euthanasia corrupts everything it touches–including, it would seem, the ethics of organ transplant medicine.

 

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