The idea of organ donation euthanasia (ODE) is slowly garnering support in academic bioethics. In 2012, Oxford bioethicists Dominic Wilkinson and Julian Savulescu argued that chronic organ shortages provided good utilitarian justification for permitting ODE. More recently, Harvard bioethicist Robert Truog and two doctors from Western University argued in the New England Journal of Medicine that Canadian euthanasia legislation should be amended to allow for ODE.
Now a group of transplant surgeons have written an article defending ODE in one of the world’s leading transplantation journals, The Journal of Heart and Lung Transplantation.
The authors -- several doctors and ethicists from universities and hospitals in the Benelux region -- discuss both the ethics and legality of ODE. They focus in particular on Belgium and the Netherlands, where euthanasia has been legal for several years.
Currently ODE is not explicitly legal in either of these countries, though the authors suggest that there may be potential loopholes in the law.
While ODE may violate the dead donor rule, the authors argue that it is still compatible with respect for persons:
"...it is our belief that a physician should always inform a patient who is medically suitable about the possibility of organ donation, even if this could disrupt the trust relationship, as many patients may choose not to ask about donation because they assume it is not possible in this context”.
They authors claim that organ donation euthanasia does not amount to an instrumentalisation of patients:
“[One] ethical objection to living donation and euthanasia is that people are instrumentalized to obtain organs; people could be pressured to undergo euthanasia in order to donate, whereas the public may believe euthanasia was only granted to make organ donation possible. The topic of organ donation is therefore only to be discussed after a positive decision on euthanasia has been made".
The authors also suggest that the benefits of ODE -- in terms of lives saved -- may potentially outweigh any negative impacts that the procedure may have on public trust.
Bioethicist Wesley Smith said the article was a confirmation of his concerns about a ‘euthanasia slippery slope’. In a blog post, he warned against accepting ODE:
"May the public never be ready to accept doctors’ taking a living patient — who may not even be physically ill — into a surgical suite, anesthetizing him, and then harvesting his beating heart".
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