Bioethicist: Let Doctors Kill the Healthy by Harvesting Organs

We have entered the era of what I call “do harm medicine,” in which the concept of what constitutes harming the patient has become entirely malleable and subjective. I even wrote a book covering that subject.

Here’s an example: When organ transplant medicine began, the “dead donor rule” was instituted to assure a wary public that people’s vital organs would only be procured after the person was dead. A corollary to that rule assures the public that people will not be killed for their body parts.

The dead-donor rule has been under attack for some time within the utilitarian bioethics movement. (I am not writing about the brain-death controversy, which is a separate discussion.) Many bioethicists are now pushing to allow doctors to kill via organ harvest, sometimes called “organ donation euthanasia” (ODE).

At first, this proposed killing license was supposed to be limited to patients on the verge of death or the permanently unconscious. Now, a prominent bioethics journal has published a piece urging that healthy people be allowed to die by removal of vital organs.

The author claims that because people can instruct life-sustaining treatment to be withdrawn (LST), and can donate their organs after death, that ODE is also OK because it will result in death, too, and result in more usable organs procured and more lives saved. From, “May I Give My Heart Away?:On the Permissibility of Living Vital Organ Donation:”

In this situation, according to proponents of ODE, the doctor should respect the decision, even when this will cause the death of the patient. It seems commonly accepted that patient autonomy allows patients to refuse any medical intervention initiated on one’s body and life, and therefore, doctors are morally obligated to withdraw LST when this is what the patient wants. If we should uphold the DDR in such situations, the doctor should wait until the patient is declared dead to procure the patient’s organs.

Proponents of ODE argue that if the patient consents, it would be permissible to procure the patient’s organs before death. This will of course mean that the patient will die from donating his or her vital organs instead of dying from having his or her treatment withdrawn. However, this seems ethically immaterial in this situation since the outcome for the patient will be the same.

But that’s not true. Not everyone dies after having life-sustaining treatment withdrawn. Indeed, under current organ-donation protocols, if the patient doesn’t die, he is taken back to the ward and usually disqualified as an organ donor thereafter.

Once death ceases to be the necessary predicate for donating vital organs — and is replaced with “consent” — there would be no natural limiting principle. And so it is here. Rather than being a form of euthanasia to end suffering, the idea is to permit someone to have themselves killed for the altruistic purpose of saving other people’s lives, called living vital organ donation…