A new paper on voluntary euthanasia and organ transplants is causing quite a stir. The authors, Julian Savulescu and Dominic Wilkinson, suggest that being able to donate one’s organs while requesting euthanasia could give an added sense of meaning to a dignified death. Critics have immediately thrown up their hands in horror, than that people will be ‘killed off’ for the sake of their organs. Is there any justification for such a fear?
One of the first people to prominently suggest the idea was Dr Jack Kevorkian in his book Prescription: Medicide. Working outside the ‘system’, he could reasonably be accused of not having formal checks in place – to say nothing of the technical difficulties. But in a properly regulated and lawful situation, would it be possible to avoid the dreaded ‘slippery slope?’
Not according to the pro-life ‘bioethicists’ who seize on the paper to paint nightmarish scenarios. But in reality, the dilemma is already tackled in everyday hospital situations. UK law dictates that a team responsible for transplants cannot be the same doctors that are responsible for the patient’s terminal care. It means any potential conflict of interest is basically nullified.
Professor Savulescu is not advocating some lightweight euthanasia booth, in spite of the eye-catching title. It is more about when the patient’s primary care team are reaching a decision to withdraw life support anyway.
“There are not enough solid organs available to meet the needs of patients with organ failure. Thousands of patients every year die on the waiting lists for transplantation. Yet there is one currently available, underutilized, potential source of organs. Many patients die in intensive care following withdrawal of life-sustaining treatment whose organs could be used to save the lives of others. At present the majority of these organs go to waste. In this paper we consider and evaluate a range of ways to improve the number and quality of organs available from this group of patients. Changes to consent arrangements (for example conscription of organs after death) or changes to organ donation practice could dramatically increase the numbers of organs available, though they would conflict with currently accepted norms governing transplantation. We argue that one alternative, Organ Donation Euthanasia, would be a rational improvement over current practice regarding withdrawal of life support. It would give individuals the greatest chance of being able to help others with their organs after death. It would increase patient autonomy. It would reduce the chance of suffering during the dying process. We argue that patients should be given the choice of whether and how they would like to donate their organs in the event of withdrawal of life support in intensive care. Continuing current transplantation practice comes at the cost of death and prolonged organ failure. We should seriously consider all of the alternatives.”
How to donate your organs after death
How to donate your body for medical research
Royal College Guidance on Organ Donation
More suggestions on addressing organ shortage, from Prof. Savulescu’s blog
Extract from Professor Savulescu’s book on DNR and living wills
Organ donation euthanasia in Belgium