Human Exceptionalism

Killing for Organs: More Analysis

I have written from time to time about the drive within some in the organ transplantation and bioethics communities to do away with the dead donor rule in order to permit patients to be killed for their organs. I expand on that in this article published in the Center for Bioethics newsletter. From the column:

This isn’t a fringe movement. Indeed, an article urging the extinction of the dead donor rule just appeared in the New England Journal of Medicine , probably the most prestigious medical journal in the world. (“The Dead Donor Rule and Organ Transplantation” NEJM (359:7, August 14, 2008), The authors, Robert D. Troug, MD, a physician at Harvard Medical School, and Franklin D. Miller, a bioethicist at the NIH, claim that patients brain dead may not really be dead, since, as one example, some patients declared dead by neurological criteria secrete certain hormones. Nor, they argue, should patients whose organs are procured under protocols that permit harvesting two-to- five minutes after full cardiac arrest be considered deceased because some of these patients might be resuscitated with vigorous CPR.

But if they are right—and be clear, I don’t accept their premise—then surely the ethical answer isn’t to broaden the categories of living patients who are harvested! Rather it is just the opposite; to tighten the rules to ensure that organs are taken from only truly dead patients. Otherwise, medical ethics will be mutated into mere medical expediency

I think this drive can be held back. But doing so requires that every time would-be harvesters of non-paired vital organs from living patients try to move the ball forward, we turn on the klieg lights. The public will never accept this (he said hopefully). Thus the only way it will ever come to pass is if the agenda is passed in the dark–or is somehow imposed by the courts.