Wednesday, August 9, 2017

Is euthanasia corrupting transplant ethics?

This article was published by Wesley Smith on his blog on August 8, 2017.

Wesley Smith
By Wesley Smith

In my very first anti-euthanasia column, published by Newsweek in 1993, I worried that once medicalized killing became accepted, it would soon be joined by “organ harvesting as a plum to society.” 

“Alarmist!” I was called. “Slippery slope arguer!” It will never happen, I was assured. 

Until it did. 

Now in both Netherlands and Belgium, mentally ill and disabled patients are voluntarily euthanized and their organs harvested after being killed. Canada is discussing joining the infamous duo. 

I have waited for the organ transplant community to rise up and reject conjoining killing and organ donation. It has been a wait mostly in vain. 

Indeed, a letter in the current Journal of the American Medical Association merely warns against haste in widely instituting such a policy due to safety concerns: 
I urge caution before this practice is widely accepted. First, only short-term functional outcomes immediately after transplantation and at 6 months are available. Second, warm ischemia, an inevitable consequence of organ donation after cardiac death, results in greater risk for transplanted organs…  
There is a need to study long-term outcomes of transplanted organs resulting from euthanasia so that truly informed consent can be obtained. 
How starkly utilitarian can you get? 

If all that matters is consent–the clear implication of this letter–why would donors have to be suffering sufficiently to qualify for euthanasia? 

Indeed, why not let healthy people who simply want to die and believe others–who want to live–have a greater claim on their livers and hearts volunteer to be killed and harvested? 

The authors of the original article make in an equally bloodless, technocratic reply: 
Euthanasia is performed according to local protocol by injection of a drug to induce coma, followed by a muscle relaxant. After circulatory arrest, a waiting time of 5 minutes is respected before the patient is transferred to the operating room for organ removal.  
Compared with other donations after cardiac death, the process of dying is short (often less than 10-15 minutes), and death is not preceded by medical deterioration in the intensive care unit.  
Euthanasia donors are, on average, younger than other cardiac death donors. Better transplant results may therefore occur in organ donation after euthanasia compared with donation after other causes of cardiac death, but additional studies are required. 
Where are we as a society that killing and harvesting are respectfully discussed in one of the world’s most respected medical journals–and no one brings up crucial issues of right and wrong? 

As just one quick example: What could be more dangerous than letting despairing people believe that their deaths could have greater value than their lives? Becoming a donor could be the final factor that induces them to opt for euthanasia or assisted suicide. 

For that matter, how dangerous would it be if society ever came to accept that the hastened deaths of the despairing could offer a “plum?” 

Euthanasia corrupts everything it touches–including, it would seem, the ethics of organ transplant medicine.


Dr Trevor Stammers said...

I have a chapter on this very topic in "Euthanasia and Assisted Suicide: Lessons from Belgium" out later this month from Cambridge University Press. Even former supporters of assisted suicide are becoming concerned about the vulnerable being pressured to have their lives taken for their organs rather than offering their organs after taking their life or having it taken.


Here are four kinds of safeguards to prevent anything harmful from happening when we permit dying patients to donate their organs after death is officially declared and recorded:

BradleyMTaas said...

Meanwhile it is happening in the US. Noting the promoters of assisted suicide attempted to include prisoners in the California bill that legalized assisted suicide
there. Then I noticed on the C&C website of June 2016 they listed an event in July that would establish them in legal organ donor system. Studying all the existing legal assisted suicide laws in Oregon, WA, CA and CO reveals a covert nontransparent system after the sign up process that can allow organ trafficking to thrive since there is zero oversight. I suspect C&C preparing to gain a market share of lucrative organ trafficking by being involved in the legal system as indicated by their sponsoring an organ donation seminar in Coral Gables, FL in July 2016.
They have the same business plan, shares staff and chair people with their sister corporation, PP, who has already been revealed via the Daleiden undercover videos to be cutting lucrative side deals for tissues and organs.

Alex Schadenberg said...

The problem with James is that he thinks that the assisted suicide lobby cares about his, so called, "safeguards." The fact is that organ donation and euthanasia is a problem is based on a radical secular ideology that places efficacy above ethics.

Lamplighter said...

Where we are is where we always would be when we eliminate God from the equation, and, absent a Creator, we become chance products of evolution, of no ultimate or lasting value other that what we conceive of at any given time. All is arbitrary, and expedience trumps any notion of intrinsic value. Small wonder then that increasing numbers of people see their lives as having little or no value. They have no value in the womb and are aborted without conscience, and when they cease to or fail to have value as a means of production, they are put down like a lame horse. Often in fact lame horses are better treated! We have embraced a culture of death, and worship at the altar of Molech, where our unborn, infirm, and “useless” flotsam of humanity are laid, to be consumed in the fire. Like the Nazis though, we first remove anything that we deem might be of value, and with the Godless utilitarianism of our age, fill our organ banks with the grisly by-products of this holocaust!

Madellen said...

Having worked with vulnerable patients in the Canadian health care system together with many personal experiences, I submit to you that professional accountability/liability for the quality of terminal, chronic and palliative care is to start with, very slippery. When quality of care is substandard, ethics are already compromised.

As it stands now, for example, dying patients are given timelines and deadlines for their stay on palliative care wards, such as 4 weeks. That alone creates pressure both on patients and staff to hasten death. As it stands NOW, patient/family experience is really a non-factor in either terminal care or discharge planning. The grieving process, the anxiety of having to hastily find a hospice or nursing home bed in case your loved one lives for 6 weeks not 4, the need to say good-bye, the need for comfort and peace of mind aka 'dignity', is not factored into overall terminal care planning, at the present time. Most Canadian hospitals don't even have palliative care units. Where is the choice in this scenario? Where is the dignity? One can easily imagine how these conditions will affect organ donors.

With As/Eu layered onto already sketchy terminal care protocols, a new 'ethic' is promoted, where efficiency is the priority, self determination is a platitude without real options, where 'dignity' means death, not compassionate care.

To me, every argument for hastening death - for the disabled, for terminal care patients, for chronic care, for deformed newborns, for elderly patients, for chronic psychiatric patients - argues for death in despair, not mercy, nor compassion nor dignity.