Death by Organ Donation - Euthanizing patients for organs.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Dr E Wesley Ely

E. Wesley Ely, who, among his other professional accolades, holds The Grant W. Liddle Chair in Medicine at Vanderbilt University Medical Center, wrote an insightful article that was published in the USA Today (today) titled: Death by organ donation: Euthanizing patients for their organs gains frightening traction.

Dr Ely has written his article from the point of view of a former co-director of Vanderbilt University’s lung transplant program and a practicing intensive care unit physician. His article is a response to presentations made at International medical conferences concerning organ donation and euthanasia and the ethical debate concerning euthanasia by organ donation. Ely writes:

At international medical conferences in 2018 and 2019, I listened as hundreds of transplant and critical care physicians discussed “donation after death.” This refers to the rapidly expanding scenario in Canada and some Western European countries whereby a person dies by euthanasia, with a legalized lethal injection that she or he requested, and the body is then operated on to retrieve organs for donation. 

At each meeting, the conversation unexpectedly shifted to an emerging question of “death by donation” — in other words, ending a people’s lives with their informed consent by taking them to the operating room and, under general anesthesia, opening their chest and abdomen surgically while they are still alive to remove vital organs for transplantation into other people. 

The big deal here is that death by donation would bypass the long-honored dead donor rule, which forbids removal of vital organs until the donor is declared dead. Death by donation would, at present, be considered homicide to end a life by taking organs.

Ely, who opposes euthanasia by organ donation, explains how euthanasia by organ donation would work.

The mechanics of obtaining organs after death from either euthanasia or natural cardiac death (both already legalized in Canada, Belgium and Netherlands) can be suboptimal for the person receiving the transplant, because damage occurs to organs by absence of blood flow during the 5 to 10 minutes-long dying process. This interval is called ischemia time. Death by donation purports to offer a novel solution. Instead of retrieving organs after death, organ removal would be done while organs are still being receiving blood. There would be no ischemia time and organ removal would be the direct and proximate cause of death.

If you think that euthanasia by organ donation is not a threat, Dr Ely explains:

Recently, the New England Journal of Medicine (NEJM) published an article by two Canadian physicians and an ethicist from Harvard Medical School, who contended it might be ethically preferable to ignore the dead donor rule if patients declare they want to die in order to donate their organs.

Dr Ely then argues that society should oppose euthanasia.

According to a 2015 article in the NEJM, of the 3,882 deaths due to physician-assisted suicide or euthanasia in Flanders, Belgium, in the year 2013 alone, 1,047 (27%) were due to medication dosages to hasten death without patients’ consent. Such patients are generally unconscious and may or may not have family members around.

In 2014, a statement on end-of-life decisions by the Belgian Society of Intensive Care Medicine asserts that "shortening the dying process" should be permissible "with use of medication ... even in absence of discomfort.” When discussing these facts, two prominent physicians, one from the Netherlands and another from Harvard, told me that where they come from, they call that murder. 

When physicians are participating in a procedure designed to take a person’s life, will patients feel 100% certain that their physician is firmly on the side of healing? What message does it send about the value of every human life when physicians endorse the exchange of one life for another? What affect has it already had on physicians complicit in such death-causing procedures?

Finally Dr Ely compares the discussion about euthanasia to the 1973 movie Soylent Green.

In the 1973 science fiction classic "Soylent Green," detective Frank Thorn searches for answers to dying oceans and a deteriorating human race on overcrowded Earth. He discovers the high-protein green food produced by the Soylent Corporation is recycled, euthanized humans. “Soylent Green is people!” he screams. 

"Soylent Green" was set in 2022. We are three years away.

Dr E. Wesley Ely is building awareness with the discussion and concerns with euthanasia by organ donation.

• Belgian doctor supports euthanasia by organ donation.

Sadly, once society accepts that killing can be an acceptable solution to certain human problems, then the only question is which human problems can killing be a solution for?

Once society accepts euthanasia, then it naturally follows that euthanasia by organ donation will be considered. If the issue is debated based on its efficacy, then euthanasia by organ donation will be become a reality because it is a very effective way to obtain healthy organs for transplanting.