Using organs from euthanased patients seem to
have become a well established procedure in Belgium, only nine years after it was
legalized. A press release
from a team at a hospital in Leuven announced last week that it had successfully
transplanted lungs from four euthanased patients between 2007 and 2009.
In an article in the journal Applied Cardiopulmonary
Pathophysiology, the authors observe that the quality of the lungs from
euthanased patients is superior to those obtained from brain dead donors and donations
after cardiac death.
“In contrast to these
donors, euthanasia donors do not experience an agonal phase before circulatory arrest
as seen in donors dying from hypoxemia or from cardiogenic or hypovolemic shock.”
A number of patients who request euthanasia
want to donate their organs. However, since they often have cancer, the organs are
not suitable. Three of the euthanased patients who did donate suffered from “a debilitating
benign disease such as a neurological or muscular disorder”. The other was not ill
at all, but had an “unbearable mental disorder”.
The authors were at pains to stress that they
acted strictly within the guidelines for euthanasia in Belgium. All of the patients
gave their consent.
Organ donation after euthanasia in Belgium is
well organized. The ethics committee of Eurotransplant, a coordination
network for transplants in Austria, Belgium, Croatia, Germany, Luxembourg, the Netherlands
and Slovenia, has already developed elaborate protocols for “organ donation and
transplantation after euthanasia”. These include:
- Euthanasia must be legal in the donor country.
The way euthanasia
is done and how death is determined have to be legal.
The euthanasia procedure
and the explantation should follow a clear protocol.
retrieval and organ allocation should be kept as separate as possible.
Organs should only
be allocated to a patients on a Eurotransplant waiting list in countries which accept
organs from euthanased patients.
Although exploiting patients’ wish to die for
the sake of organ transplants may horrify many readers, this business has not been
taking place in a dark basement. The Belgian team has not been shy about publicising
their work. They described it at the 2006 World Transplant
Congress and last December at a conference organised by the Belgian Royal
Medical Academy. The journal article seems to be the first time, however, that information
about their work is readily accessible. Criteria for accepting organs from patients
were published in Eurotransplant’s
2008 annual report.
A host of probing questions need to be asked.
We only know about transplants from euthanased patients at one hospital in Belgium.
But euthanasia is legal in the Netherlands and Luxembourg as well. At how many hospitals
is this going on? It is illegal to tell recipients where their new organs came from.
Wouldn’t many recipients object to that?
A document on the Eurotransplant website, “Current ethical
considerations in organ transplantation”, fails to include transplants
from euthanased patients amongst the ethical problems. Does that mean that it is
not an ethical problem? Eurotransplant declares that “transparency” is a key corporate
value. Yet its 2010 annual
report omits the word “euthanasia”.
Eurotransplant has condemned the Chinese practice
of using organs from executed prisoners.
“The commercial exploitation
of organs from executed prisoners is considered a breach of human rights and is
an unacceptable practice… any act that risks calling the practice of transplantation
into disrepute is to be regretted.”
Doesn’t using organs from a mentally ill person
who thinks that life is not worth living call the practice of transplantation into
disrepute as well?