Solve the organ shortage with euthanasia, says leading bioethicist

It was only a matter of time before someone would construct a serious formal argument for solving the growing organ shortage by euthanasing brain-dead or unconscious. It has finally happened. The only surprise is that it has been made by an Oxford don who is on the editorial board of a leading journal, Bioethics.*

Professor Julian Savulescu and his associate Dominic Wilkinson, in an early on-line article, “Should we allow organ donation euthanasia? Alternatives for maximizing the number and quality of organs for transplantation”, contend that their proposal could supply as many as 2,200 more organs each year in the UK.

Savulescu and Wilkinson’s idea runs like this. It is indecent that 450 people die in Britain while waiting for an organ. People who are on life support or who are brain-dead are potentially a good source of organs, as each body can yield as many as nine of them. Organs taken from living patients are most suitable for transplant, because every second after the heart stops beating decreases the chances of transplant success. Patients would, of course, have to assent to the procedure before they became unconscious. And they envisage taking organs only from patients who would die soon anyway.

Adopting their proposal would be a revolution in medical ethics, they acknowledge, as doctors have always been forbidden to kill patients. And they also realise that the public would be unlikely to embrace the idea. “But if we can save even one life, that is something of great moral importance,” they write. “Many lives could be saved even if only a small percentage of people opted for [organ donation euthanasia].”

Their principal concern is to solve the organ shortage, but this idea also provides a strong argument for euthanasia: “although most arguments for euthanasia are distinguished from questions of organ donation, it may be that the benefits of donation, for the individual and for others, provide the strongest case for euthanasia.”

Savulescu and Wilkinson restrict their argument to patients who are on the verge of death in an intensive care ward. But organs taken from patients in a permanent vegetative state would be just as, if not more, useful. And, in fact, they argued this a couple of years ago:

“But there is another more radical way to increase the supply of organs. We could abandon the dead donor rule. We could for example, allow organs to be taken from people who are not brain dead, but who have suffered such severe injury that they would be permanently unconscious, like Terry Schiavo, who would be allowed to die anyway by removal of their medical treatment.”

* An earlier version of this misstated Professor Savulescu's relationship to the journal Bioethics. He is a member of its editorial board. 

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