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Slip Sliding Away: Death By Organ Donation

By David Stevens, MD, MA (Ethics) | September 22, 2016

by David Stevens, MD, MA (Ethics)

Proponents of physician-assisted suicide/euthanasia adamantly maintain the slippery slope does not exist. The U.S. is not like the Netherlands, Belgium, Switzerland and now Canada, they claim. They point out how well assisted suicide is working in states here.

Of course, no one knows really how it is working due to the shroud of secrecy that has been draped over the process. There is no effective penalty if doctors don’t report. By law, physicians’ voluntary reports must be destroyed after the data is tabulated. There is no way to go back to verify the accuracy of these reports. Doctors have to lie about the patient, who has taken their own life, and say the patient died of a terminal disease. Physicians are immune from malpractice liability, even if they missed the terminal diagnosis or botched the suicide.

Physician-assisted suicide is a “sacred cow,” even though the potential for abuse is high. We don’t treat any other new medical intervention like we treat physician-assisted suicide. Almost everyone has turned a blind eye.

And then there is the slippery slope.

Journal of Medical Ethics, which prides itself in being the “leading international journal that reflects the whole field of medical ethics,” recently published an article by Dr. Zoe B. Fritz of Warwick University’s Division of Health Sciences that argued euthanizing a persistent vegetative patient is more humane than deliberately dehydrating them to death. That is like arguing whether it is more humane to kill someone with a knife or strangulation. It sidesteps the main issue. Should anyone be allowed to deliberately kill a patient at all?

But Dr. Fritz didn’t stop there. The reason for euthanizing the patient was so their organs wouldn’t be damaged and could be harvested for organ donation.

I heard the same argument in the embryonic stem cell research debates more than 10 years ago. Proponents said, “These embryos are going to die anyway. Let’s just make it a little earlier so we can get some use out of their valuable biological parts.”  Making the best of a bad situation is a seductive argument. 

Remember this, there is a huge moral difference between someone expiring of a disease versus someone taking their life. Until recently, we called the first “dying of natural causes” and the second “murder.” Intent is everything. Dr. Fritz’s intent is to make the patient dead and dead sooner so their valuable organs can be harvested while they can still be used. If that reasoning is left unchallenged, “Why stop there?”

Through this short cut to death by euthanasia, patients with other diseases could benefit other patients who need organ donation. Stroke patients are ideal candidates. So are young people with severe trauma and those with severe mental illnesses.

It is already legal in the Netherlands to conjoin euthanasia with organ harvesting. More than 40 patients have had their organs harvested. But that is not enough. The Netherlands recently went to an “opt out” of organ donation system versus an “opt in” system. Unless you explicitly state you don’t want organ donation, your organs can be harvested at death without your or your family’s permission.

This latest decision may not seem to be a big deal unless you realize that “termination (euthanasia) without consent or permission” is not uncommon in the Netherlands and is rarely punished. A physician could easily get away with killing a patient in order to harvest their organs for the benefit of someone else.

There truly is a slippery slope, which already is looking more like a cliff than a slope. Once you say some lives are not worthy to live and the end justifies the means, there is no logical place to draw the line. That is why further legalization of physician-assisted suicide must be stopped.

It is simply too dangerous to head down this road.

Related Resources

Physician-Assisted Fact Sheet

CMDA Physician-Assisted
Suicide Ethics Statement

State Legislative Issues


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