By Wesley J. Smith
My first anti-euthanasia column (Newsweek, 1993) worried that once euthanasia became normalized, it would lead to conjoined organ harvesting “as a plum to society.”
I was screamed at and labeled an alarmist. Oh Wesley, people assured me, that will never happen!
Yeah, right. The world’s most respected bioethicists have published serious articles in influential medical journals urging that doctors be allowed to harvest cognitively disabled patients while they are alive — known as ODE, e.g., “organ donation euthanasia” — as a means of cutting transplant waiting times.
That is not yet being done. But as I predicted all those years ago, organ harvesting after euthanasia is allowed in Netherlands and Belgium, and has been performed at least once in Canada.
Now, the Journal of Heart and Lung Transplantation — a respectable transplant medical journal, not a nut fringe Internet blog — has published an article proposing beating–heart harvesting as a form of euthanasia where medicalized homicide is legal.
First, the authors propose that doctors bring up organ transplantation to euthanasia seekers. From “Euthanasia Through Living Organ Donation”:
Current guidelines [in the Netherlands] state that only the patient should pose the question of organ donation, and only after a positive response to the euthanasia question, thus keeping both procedures strictly separated. However, it is our belief that a physician should always inform a patient who is medically suitable about the possibility of organ donation, even if this could disrupt the trust relationship, as many patients may choose not to ask about donation because they assume it is not possible in this context. Consent of the patient’s relatives for organ donation after euthanasia is not required.
Realize that the people who are harvested after euthanasia today are sometimes mentally ill, with no other underlying medical condition. Why? Because they have good organs. Others are disabled by neuromuscular conditions, who may also be harvested for the same reasons.
But why wait until the patients are dead? Let’s permit ODE, including live heart harvesting! First, they admit the obvious:
Because the proposed procedure does not involve patients who are brain dead, “living donation” is the correct term to use, even though this is normally used for people who donate their kidney, and do not die as a result of donation.
Yes, indeed: Taking out a beating heart will be 100 percent fatal.
The authors engage in the usual bioethical hand-wringing discussing objections, only to — voila! — conclude that heart harvesting would be peachy keen where euthanasia is legal. They even invoke the Hippocratic Oath!
Living donation in combination with euthanasia does not harm the patient more than organ donation after euthanasia does, or euthanasia without organ donation for that matter.
Making ODE possible, compared with neglecting the patient’s wish and not facilitating this procedure, respects the Hippocratic Oath, which mandates taking care of the organ donor and the recipient in the best possible way.
The Hippocratic Oath explicitly forbids euthanasia, but never mind.
The authors conclude:
The right of self-determination of the patient who meets the due diligence requirements for euthanasia should ideally give such a patient the possibility of also donating his heart, so that others can be helped and/or saved by as many donated organs as possible. Implementing ODE into practice should be approached with caution, however, as public perception may not yet be ready for this combination of procedures.
May the public never be ready to accept doctors’ taking a living patient — who may not even be physically ill — into a surgical suite, anesthetizing him, and then harvesting his beating heart.
Oh, Wesley, that will never happen! Yeah, right.
Those with eyes to see, let them see.
Editor’s note. Wesley’s great columns appear at National Review Online and are reposted with the author’s permission.