We are a society of public policy promise breakers. Advocates for radical transformations in law and culture promise their proposed changes will be constrained and regulated by strict guidelines.
Then, when the policy becomes law, it is often Katy bar the door and the old promises are forgotten.
That pattern has not played out with organ transplant medicine. Yet.
Not for lack of trying. Many in bioethics and the transplant field want to break the important promise solemnly made that vital organs would only be taken from patients who are dead. This is known as the “dead donor rule.”
But with the backlog of organs growing due to fewer catastrophic brain injuries and improvements in transplant medicine, the utilitarians want to make the dead donor rule dead (as I have written about often over recent years).
The latest promise breaker pusher is Walter Glannon, a Canadian bioethicist, writing in the philosophical journal Aeon. First, Gannon says honoring patient choice to be killed and harvested is more important than that the patient actually be dead first.
Glannon has a whole list of people who could be killed for their organs. First sophistry, taking kidneys before death, and pretending it doesn’t actually cause death. From the piece:
In a protocol developed by the transplant surgeon Paul Morrissey at Brown University in Rhode Island, for instance, kidneys can be taken from patients while they are alive because doing this does not cause brain death or heart death. Death is declared after the kidneys, and then life-support, are removed. This scheme applies only to kidneys, though, and is thus limited.
I was unaware this is happening. If so, “scheme” is the right word since it is crass sophistry that pretends that the taking of the kidneys would not cause death. Ironically, kidneys don’t deteriorate as fast as other organs. So, this seems to me a gambit to destroy the DDR. It should be stopped.
Glannon next wants to kill and harvest those who are diagnosed as persistently unconscious like Aerial Sharon–and Terri Schiavo–mentioning that a few wake up, but omitting that about 40% of such diagnoses are later proven wrong.
From there, it is on to people with serious disabilities:
In some circumstances, when donation is a high priority for an individual, we could even remove organs from those with full capacity for consciousness whose lives might go on and on in deep suffering and pain. Among the candidates include those with locked-in syndrome and amyotrophic lateral sclerosis (ALS), or Lou Gehrig’s disease, where degenerating motor neurons render the person increasingly paralysed and unable to move.
Then, Glannon quotes me, favorably, which I appreciate:
In the National Review Online in 2013, the US attorney Wesley Smith, a senior fellow at the Discovery Institute in Seattle, wrote: ‘I can’t think of a better way to undermine public support for organ transplant medicine than to permit killing for organs. Not only is this kind of advocacy foolhardy, but it would have the transplant community break solemn public policy promises made to gain support from a public wary of the entire enterprise.’
He has a point. Abandoning the DDR could create public distrust in the transplant system and cause some people to opt out of organ donation for fear that they would be treated instrumentally as nothing more than a source of transplantable organs and killed for them. This could reduce the number of organs available for transplantation.
As a result, more potential transplant recipients would be harmed by poor quality of life and premature mortality from organ failure without transplantation. So there might be consequential reasons for defending the DDR and waiting until after a declaration of death before taking a patient’s organs.
Glannon pauses for about five seconds before, in effect, saying, “Nah:”
Nevertheless, abandoning the DDR would remove a huge obstacle to procurement of transplantable organs. Allowing procurement before a declaration of death would redefine harm and the practice of transplantation. It would also benefit many people who need organs by saving and improving the quality of their lives.
Killing for organs is wrong morally, not just as a matter of utilitarian balancing.
Think about the current upset over Planned Parenthood’s aborting fetuses in a less “crunchy” way in order to harvest organs. Now, multiply by one hundred. That is the impact such a change in policy would generate.
It would destroy transplant medicine and prove beyond any doubt that society should never believe “the experts” when they forge new–but limited!–public policies.