European doctors have proposed legal reforms to increase the popularity of combining euthanasia and organ donation in the Netherlands and Belgium.
The researchers reported the unpublished information about the prevalence of the procedure in the Journal of Medical Ethics
. The procedure has been performed only about 40 times in the two countries.
‘People with mental illness could be persuaded to see organ donation euthanasia as a way they could end their suffering and give the gift of life to someone.
"There is a persisting discrepancy between the number of organ donors and the number of patients on the waiting lists for transplantation which euthanasia patients could help to balance."
Euthanasia is not a cure-all for organ shortage, said the authors. Most of the euthanasia patients suffer from cancer, which is a contraindication for organ transplantation. However, 25 to 30% of them do not, so there is a real possibility of expanding the supply, said the researchers.
They also added that the public perception about euthanasia is increasing positively. "Transplant coordinators in Belgium and the Netherlands notice a contemporary trend towards an increasing willingness and motivation to undergo euthanasia and to subsequently donate organs as well, supported by the increasing number of publications in popular media on this topic."
"In the context of organ donation after euthanasia, the right to self-determination is a paramount ethical and legal aspect. It is the patient's wish and right to die in a dignified way, and likewise, his wish to donate his organs is expressed. Organ donation after euthanasia enables those who do not wish to remain alive to prolong the lives of those who do, and also—compared with 'classical' donation after circulatory death—allows many more people to fulfill their wish to donate organs after death."
There are some legal barriers in both countries. In the Netherlands, euthanasia is regarded as an "unnatural death" which has to be reported to the public prosecutor. This could delay donations. If the law were changed to allow the cause of death to be reported as the underlying condition, the procedure would be more expeditious.
In Belgium, the current policy of determination of death by three independent physicians could be a hindrance to facilitate the procedure.
However, it is necessary to maintain a strict separation between the request for euthanasia and the need for the organ. This is also a need to ensure that the donor is not being pressured.
"Since a patient undergoing euthanasia has chosen to die, it is worth arguing that the no-touch time (depending on the protocol) could be skipped, limiting the warm ischemia time and contributing to the quality of the transplanted organs. It is even possible to extend this argument to a 'heart-beating organ donation euthanasia' where a patient is sedated, after which his organs are being removed, causing death."
Tory MP Fiona Bruce said, "The paper confirms the worst fears expressed by Parliament when the House of Commons conclusively voted to stop the legalization of assisted suicide in this country. The possibility of euthanasia achieved through live organ donation, such as by removing a patient's beating heart, as posited in this paper is shocking and chilling."
Lord Carlile of Berriew, a Liberal Democrat peer who is a leading lawyer, said, "I have extreme concerns about the ghoulish nature of the combined euthanasia and organ donation systems in the Netherlands and Belgium. Both can result in unbearable and irresistible pressure on an individual to die, and on a doctor to encourage death."