Euthanasia, or Medical assistance in dying (MAID) as it is called in Canada, has been legal in Québec since December 2015 and elsewhere since July 2016. Since then, more than 60 people have donated their organs after euthanasia.
This is ethically contentious for many reasons: ensuring the autonomy of patients, possible pressure to choose euthanasia, information given to donors, the possibility of directed donations, and the option of death by donation.
A recent article in BMC Medical Ethics presented the results of an in-depth survey of 21 doctors, nurses and coordinators involved in this procedure to see what they thought about organ donation after euthanasia. It found that “Organ donation after MAID was widely accepted among the participants, based on the principle of respect for the donor’s autonomy.”
Below are a few comments made by the participants in the survey:
Respect for autonomy
If the MAID request is well founded and granted, and on top of it, clearly what the patient wants (…) then it should be even more straightforward, if the patient is truly free to make the decision, I don’t see why he should be refused.
Yes, I’m not uncomfortable because the MAID decision has been made and it’s nothing to do with me. It’s not that I’m washing my hands of it, but it’s, like, make your decisions among adults, you are adults, now you want to hear about organ donations and I can help you with that …
Informing patients requesting euthanasia about organ donation
… it’s garbage, it’s wrong to think like that because that’s like saying that it’s only the patients who know organs can be donated who can, who have access to that. You can’t … you can’t only be entitled to that when you know that it exists. How can you decide to give to this organization or the other when you don’t know such an organization exists?
Assessment of motivations for euthanasia
… the purpose of medical assistance for dying is to ease the suffering. Um … that is how it has to stay, it can’t become a way of giving my organs to my neighbour or a friend. It must … ease the suffering. Organ donation can be considered after that, if everything is in place.
It would be very sad if someone you knew or someone you wanted to benefit... could not benefit from your own donation. At that point, it’s also justice for the person who wants to donate.
Organ donation and euthanasia for people with mental illness
For her, to die this way and donate her organs, that’s probably the only way for her to die with dignity, that’s probably the only positive thing in her life and in her passing, both for herself and for her family.
This is difficult, because on the one hand the person will die anyway, and on the other we’re missing out on organs.
Death by donation
It’s the same thing, there’s no moral difference between killing a patient, then taking their organs, and killing a patient by taking their organs (laughs). No, there’s no difference, they’re dead either way.
Is there a big difference, morally speaking? Perhaps not so much, except for, once again, the image that it projects, that it’s the organ retrieval that’s killing him…honestly. (…) ultimately, this doesn’t change anything for the patient, because he won’t suffer, won’t feel anything.
Michael Cook is editor of BioEdge
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