Human Exceptionalism

Killing for Organs Push in The Atlantic

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs.

The assault on the “dead donor rule” has now filtered down to the popular media. The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying:”

A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”

If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.

Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs.

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

Moreover, some who are expected to die under such situations, actually don’t. The unconscious Karen Ann Quinlan is one example. She was expected to die when her respirator was removed. She actually lived another ten years.

The authors bring up an objection worth pondering:

Some may argue that such a model could compromise doctors’ care of critically ill patients. People who distrust the health-care system sometimes make similar arguments, accusing physicians of providing lesser care to those who have signed up to become organ donors.

In practice, though, a donor’s doctors have little connection to those involved with organ recovery, precisely so as to avoid any conflict of interest. We can’t imagine a scenario in which doctors would give a patient inferior care so that her organs could be procured.

I can. In fact, it happens already with medical futility and the push toward health care rationing.

Allowing doctors to kill patients during organ harvesting would be an acute threat, particularly in a medical milieu growing increasingly utilitarian in outlook, cost cutting in approach, and devaluing of the equal worth of all human life.

Knowing that doctors would kill for organs? I can’t think of a better way to sow distrust for the healthcare system generally, and organ transplant medicine specifically.

#verybadidea

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