Smith: Euthanasia by Organ Donation

Wesley Smith

Wesley Smith

This article was first published by National Review on March 25, 2016.

By Wesley Smith

In 1993, my first anti-euthanasia article published in Newsweek, warned that if society ever embraced assisted suicide, we would eventually couple medicalized killing with organ harvesting “as a plum to society.” 

That is now happening in Netherlands and Belgium, where doctors are on the lookout for mentally ill and people with neuromuscular disabilities who want to be killed and harvested.

An article written by a gaggle of Netherlander doctors and medical professors in the Journal of Medical Ethics, now suggests taking the next step of directly harvesting-to-death sick, disabled, and mentally ill suicidal people (all eligible for euthanasia in both countries) without bothering with the lethal injection beforehand.

Link to the full article

Belgium - Organ donation, presumed consent, euthanasia

Wesley Smith

Wesley Smith

This article was published by Wesley Smith on his blog on March 25, 2016

By Wesley Smith

A just published article in the Journal of Medical Ethics argues for allowing killing by organ removal as a form of euthanasia and organ donation. More, over at The Corner

The authors mention that Belgium has “presumed consent” for organ donation. From the piece

When a patient is determined dead on the basis of either circulatory or neurological criteria, the treating physician is legally allowed to remove his organs for transplantation. 
In case of donation, three non-treating physicians, who are not involved in the transplantation procedure, should independently determine death.  
The law explicitly states that relatives should be enabled to say farewell to the deceased as soon as possible after the donation procedure.

In the immoral utilitarian milieu that now reigns in Belgium, this means that that doctors could look upon all “suffering” patients as potential organ suppliers. 

That could easily influence how they discuss treatment options, and lead to subtle persuasion for euthanasia–without discussing the organ issue. 

The authors also suggest that doctors should be able to recommend organ donation to euthanasia requesters, and all doubts about pressure or emotional coercion can be remedied simply by assuring the public all is honorable: 

One, however, needs to avoid the public having the perception that anyone who is ill and willing to donate his organs will be able to undergo euthanasia, or that a physician would motivate a patient to undergo euthanasia because of organ donation possibility.  
The public needs to have confidence in the ability of a physician to judge objectively and acknowledge that strict legal criteria and boundaries regarding euthanasia and organ donation exist. 

Here’s the problem: Once doctors and society accepts the killing-is-an-acceptable-answer-to-suffering premise of euthanasia, eventually it won’t matter if those deemed to have a life not worth living are herded toward euthanasia–particularly if their organs are harvestable. After all, there are people who could have better lives who need those livers and hearts! 

If you believe euthanasia and organ harvesting can be conjoined without adverse impacting society’s adherence to the intrinsic equal dignity of human life, I have a beautiful orange bridge that links San Francisco to Marin County to sell at a bargain rate. Interested?

A 4-year-old girl in coma recovers

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

The story of Gemma Botelho, a 4-year-old girl who is recovering after being in coma, is a story of hope and a story of caution.

According to an article in CNN:

Shortly after arriving at the emergency room on December 17, Gemma went into cardiac arrest. For 45 minutes doctors and nurses performed CPR, but her heart wouldn't start. Doctors and nurses filled the room, asking her parents to wait outside the door. 
"We heard beeping, and then no beeping," said her mother, Lejla Szabo, a model in Miami. "She was just flatlining. We really felt that we had lost her." 
Her husband, Alexander Botelho, who works in the hospitality industry, turned to her. "He told me we just had to look back and appreciate those 4½ years we had with her," she remembered. 
On Friday (Dec 18) ... Gemma flew to All Children's Hospital Johns Hopkins Medicine, 250 miles away in St. Petersburg. 
Friday and Saturday Gemma's heart quivered uselessly. Doctors prepared to put her on a list for a new heart but there were no guarantees it would arrive in time to save Gemma's life. 
On the Sunday before Christmas, as their daughter lay in intensive care, Szabo, who is from Hungary, and Botelho, who's from Brazil, organized friends to say prayers for Gemma at Catholic Masses in their home countries as well as in Argentina, Italy, Miami and Boston. 
That night, Szabo and Botelho finally heard good news: Gemma's heart was beginning to beat again. 
Two days later, her heart was working well enough that her pediatric heart surgeon, Dr. Jeffrey Jacobs, and his team at All Children's Hospital removed her from life support. 
The heart surgeon said he can't explain what caused her heart to start again. 
"Sometimes we don't understand everything that happens in medicine," said Jacobs, director of the Johns Hopkins All Children's Heart Institute.

According to the article, Gemma was given a 1% chance of recovery.

Often families and medical professionals will give up on a person who is in coma too quickly and agree to withdraw all treatment and care, including food and water causing death by dehydration rather than a natural death caused by the medical condition.

Killing for Organs

This article was published on Wesley Smith's blog on July 28, 2015.

By Wesley Smith

Wesley smith

Wesley smith

We are a society of public policy promise breakers. Advocates for radical transformations in law and culture promise their proposed changes will be constrained and regulated by strict guidelines. 

Then, when the policy becomes law, it is often Katy bar the door and the old promises are forgotten. 

That pattern has not played out with organ transplant medicine. Yet. 

Not for lack of trying. Many in bioethics and the transplant field want to break the important promise solemnly made that vital organs would only be taken from patients who are dead. This is known as the “dead donor rule.” 

But with the backlog of organs growing due to fewer catastrophic brain injuries and improvements in transplant medicine, the utilitarians want to make the dead donor rule dead (as I have written about often over recent years). 

The latest promise breaker pusher is Walter Glannon, a Canadian bioethicist, writing in the philosophical journal Aeon. First, Gannon says honoring patient choice to be killed and harvested is more important than that the patient actually be dead first. 

Glannon has a whole list of people who could be killed for their organs. First sophistry, taking kidneys before death, and pretending it doesn’t actually cause death. From the piece

In a protocol developed by the transplant surgeon Paul Morrissey at Brown University in Rhode Island, for instance, kidneys can be taken from patients while they are alive because doing this does not cause brain death or heart death. Death is declared after the kidneys, and then life-support, are removed. This scheme applies only to kidneys, though, and is thus limited. 

I was unaware this is happening. If so, “scheme” is the right word since it is crass sophistry that pretends that the taking of the kidneys would not cause death. Ironically, kidneys don’t deteriorate as fast as other organs. So, this seems to me a gambit to destroy the DDR. It should be stopped. 

Glannon next wants to kill and harvest those who are diagnosed as persistently unconscious like Aerial Sharon–and Terri Schiavo–mentioning that a few wake up, but omitting that about 40% of such diagnoses are later proven wrong.

Link to the full article

The Atlantic - Pushing Killing for Organs

Wesley Smith

Wesley Smith

This article was published on Wesley Smith's blog on March 24, 2015.

By Wesley Smith

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs. 

The assault on the “dead donor rule” has now filtered down to the popular media. The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying":

"A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”  
If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.  
Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs."

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

I have repeatedly warned about articles published in medical and bioethics journals advocating killing the profoundly disabled or dying for their organs. 

The assault on the “dead donor rule” has now filtered down to the popular media. The Atlantic has an article advocating that dying patients be killed for their organs rather than having to actually, you know, die first. From, “As They Lay Dying:” 
A more useful ethical standard could involve the idea of “imminent death.” Once a person with a terminal disease reaches a point when only extraordinary measures will delay death; when use (or continued use) of these measures is incompatible with what he considers a reasonable quality of life; and when he therefore decides to stop aggressive care, knowing that this will, in relatively short order, mean the end of his life, we might say that death is “imminent.”  
If medical guidelines could be revised to let people facing imminent death donate vital organs under general anesthesia, we could provide patients and families a middle ground—a way of avoiding futile medical care, while also honoring life by preventing the deaths of other critically ill people.  
Moreover, healthy people could incorporate this imminent-death standard into advance directives for their end-of-life care. They could determine the conditions under which they would want care withdrawn, and whether they were willing to have it withdrawn in an operating room, under anesthesia, with subsequent removal of their organs.

There’s a name for that: Homicide. Doctors should never be killers, even for a “beneficial” purpose.

Link to the full article

Organ donation, euthanasia and assisted suicide

By Alex Schadenberg, Executive Director - Euthanasia Prevention Coalition

Several days ago I received a phone call from Sharon Kirkey who was writing an article concerning the practice of organ donation after assisted death, an article that was published in the National Post. Kirkey asked me my thoughts on whether organ donation would occur after assisted death? It is interesting that she didn't include any of my quotes in the article. I said:

Sharon, you are asking the wrong question. Any person who signs their organ donor card and who dies by assisted death would be eligible for organ donation.

I then said to her:

The real question is whether or not, in the future, organ donation and assisted death will be coupled.

There was some silence on the other end of the phone. I continued.

If a person has signed their organ donor card and if they have been approved for assisted death, why wouldn't the organs be donated? Once assisted death becomes more common, why wouldn't they remove the organs before lethal injection? Death by lethal injection and death by removal of vital organs is the same thing, simply done in a different way.

Sharon questioned me further and I said:

My concern is that in the future euthanasia will be sold to the public as "good for society."
By coupling organ donation with assisted death, new social pressure will be created for people with healthy organs who are living with disabilities, depression or chronic conditions. They will be subtly encouraged to "voluntarily" die by "assisted death" for the "common good."

Whether I like it or not, if "assisted death" becomes legal, organ donation will soon be subtly promoted as a "good outcome" of assisted death and later become overtly promoted especially for people who are living with disabilities, depression, or chronic illnesses. The healthiest organs make for the best transplants.

Organ donation after assisted suicide in Switzerland

By Alex Schadenberg, Executive Director/International chair - Euthanasia Prevention Coalition

For the past few years doctors in Belgium have linked organ donation to euthanasia. Recently the Dutch Minister of Public Health, Edith Schippersproposed guidelines for euthanasia/organ donation.

Yesterday, Swissinfo.ch published an interview with ethicist, David Shaw, concerning organ donation / assisted suicide. Shaw specialises in the ethics of organ donation and transplantation in the Institute for Biomedical Ethics at the University of Basel. He is also a member of Britain’s Donation Ethics Committee, which advises the Department of Health on organ policy.

In the interview, Shaw questions why Switzerland doesn't have a national donor registry. Shaw believes that donor cards alone aren't enough.

Link to the full article