Human Exceptionalism

Legalize Murder for Organs?

The attacks on the dead donor rule–which requires death as a precondition of donating vital organs–are continuing in the world’s most prestigious medical and bioethical journals. 

Take the New England Journal of Medicine, which has just published opposing articles about the issue.

The pro-killing for organs article–by Robert D. Truog, M.D., Franklin G. Miller, Ph.D., and Scott D. Halpern M.D. Ph.D., contends that past assurances about donors being dead were, essentially, lies. (I disagree.) But rather than urge a return to ethical standards, the authors go all in for legalizing homicide for organs. From, “The Dead-Donor Rule and the Future of Organ Donation:”

Accordingly, patients should be permitted to donate vital organs except in circumstances in which doing so would harm them; and they would not be harmed when their death was imminent owing to a decision to stop life support. That patients be dead before their organs are recovered is not a foundational ethical requirement. Rather, by blocking reasonable requests from patients and families to donate, the DDR both infringes donor autonomy and unnecessarily limits the number and quality of transplantable organs.

Except: Not all patients who have life support removed, with the expectation that they will die, actually expire. And you can’t necessarily tell which-is-which ahead of time.

So, the authors would certainly seem to be arguing that we legalize murder for organs. Yup:

Although shifting the ethical foundation of organ donation from the DDR to the principles of autonomy and nonmaleficence would require creation of legal exceptions to our homicide laws, this would not be the first time we have struggled to reconcile laws with the desire of individual patients to die in the manner of their own choosing.

I would also point out that surrogates would be able to make the kill decision, just as they can agree now to donate after death even if the dead patient never agreed. Hello, Michael Schiavo?

This really gets me: We are told to trust the experts whenever there is a new and radical shift in bioethical public policy proffered. When society does, toward the end of going even farther down the road, we are later told the earlier assurances were really a charade.

But instead of advocating going back to a more ethical approach, these “experts” urge us to dive down the slope toward the moral cliff.

No thank you. If you want to destroy the people’s trust in organ transplant medicine, turn surgeons into killers.

The article in favor of maintaining the dead donor rule, by James Bernat, can be found here: I agree with Bernat. 

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