I found the article about the Belgian euthanasia coupled with organ harvesting referenced in my critique yesterday of a bioethics journal article urging that very approach. The woman in question was not terminally ill, but in a “locked-in” state, that is, fully conscious and completely paralyzed. She wanted to die–a desire accommodated by her doctors. Just prior to being killed, she decided to donate her organs. From, “Organ donation after physician-assisted death,” (Letter to the Editor) published in the journal Transplantation (21 (2008) 915–no link):
The day before the euthanasia, the patient expressed her will of after-death organ donation. The ethical and legal possibility of combination of the two separate processes, physician-assisted suicide and after-death organ donation was then considered and agreed by the institutional ethical committee president. The intravenous euthanasia procedure was performed according to the regular protocol, in the presence of the patient’s husband, in a room adjacent to the operative room. The patient was in her regular hospital bed. No member of the transplant team was present during the euthanasia. When the patient’s death was declared by three independent physicians after 10 min of absence of cardiac activity, her cadaver was placed on the operative table. The liver and both kidneys were harvested and transplanted according to the regular Eurotransplant organ allocation rules for after-death organ donation. Currently, more than 1 year later, all three recipients are enjoying a normal graft function.
If this doesn’t set off alarm bells about how the sick and disabled are increasingly being looked upon not only as burdens (to themselves, families, and society), but potential objects for exploitation, what will? A disabled woman was killed, even though people with locked-in states often adjust over time to their disabilities and are happy to be alive. Indeed, the book The Diving Bell and the Butterfly-written by–Jean-Dominique Bauby–tells just such a story.
Moreover, agreeing to harvest organs from euthanasia/assisted suicides raises the very realistic prospect that despairing people with terminal illnesses or disabilities (or perhaps, just despair) could latch onto being killed for their organs as a way of bringing meaning to their lives. This is very dangerous territory, made all the more treacherous by doctors, spouses, and a respected medical journal validating the ideas that dead is better than disabled and that living patients can, essentially, be viewed as a natural resource to be killed and mined.
The authors don’t see it that way, of course. They have visions of organs dancing before their eyes:
This case of two separate requests, first euthanasia and second, organ donation after death, demonstrates that organ harvesting after euthanasia may be considered and accepted from ethical, legal and practical viewpoints in countries where euthanasia is legally accepted. This possibility may increase the number of transplantable organs and may also provide some comfort to the donor and his (her) family, considering that the termination of the patient’s life may somehow help other human beings in need for organ transplantation.
Taking the organs was the easy decision. Once you’ve pulled medicine into the forbidden zone of active killing, finding self-congratulatory justifications becomes a most desirable quest.
Some might defend the act by noting the patient’s decision to be euthanized was not made concurrent with her decision to be an organ donor. I don’t see the distinction. Besides, once society accepts that the two can be joined, saving others could easily become a frequent motivation for asking to be killed. Heck, given the number of non voluntary euthanasia deaths in the Netherlands–coupled with the push for “presumed consent” to harvest organs–”choice” itself could one day become moot.
May 8th, 2010 | 5:42 pm
[...] This post was mentioned on Twitter by Vince Humphreys. Vince Humphreys said: SHS: Belgian Doctors Euthanized Disabled Patient and Harvested Her Organs http://bit.ly/ap9ZwK #tcot [...]
May 8th, 2010 | 6:29 pm
[...] More details and analysis over at Secondhand Smoke. Comments (0) [...]
May 10th, 2010 | 2:42 am
The woman in the story wanted to die, but was without the means to commit suicide. Jean-Dominique Bauby in fact died of pneumonia shortly after his book was published. He apparently found his condition bearable (I haven’t read his book). Which of us can be sure that we would be the same? Not I.
Given that she was determined to end her life if possible, and given that this society is willing to cooperate, what is so vile about harvesting her organs so that others can live?
If anyone wants to stop this entire process, we need to address the spiritual and emotional conditions which caused this woman to desire death in the first place (assuming there’s nothing we can do medically). If Jean-Dominique Bauby’s experience is normative (and I suspect that it is) she was going to die in a relatively short period of time anyway, whatever she or anyone else did or didn’t do. What is wrong with taking this bad situation and making it a good thing for other people?
Wesley J. Smith Reply:
May 10th, 2010 at 9:15 am
Susan: Your last sentence provides the answer: It will encourage people in difficult circumstances to sacrifice themselves for the supposed greater good, rather than to find purpose and meaning in going on. It validates the notion that we can use people as objects–even with consent. It denigrates disability. Why can’t ANYONE who is suicidal do the same thing? She wasn’t terminal. And WHATEVER HAPPENED TO SUICIDE PREVENTION?
Self termination should not be made more easy and validated. She could have refused medical treatment. Beyond that, medicine should not go.
May 10th, 2010 | 12:11 pm
Wesley:
I disagree with your explanation to Susan of what’s “wrong” about the Belgian assisted suicide/organ donation matter.
You claim “It will encourage people in difficult circumstances to sacrifice themselves for the supposed greater good, rather than to find purpose and meaning in going on.” The very concepts of freedom and the integrity of the individual presuppose that certain decisions can be made by oneself, including what constitutes “the greater good,” what is “purpose and meaning in life” and, indeed, whether life is worth living under particular circumstances. Whence do you claim comes your right to prevent them from doing so?
You claim “it validates the notion that we can use people as objects–even with consent.” That’s ridiculous on its face, given that organ donation is widely-recognized as a legitimate activity. Rather, your objection appears based on the manner in which the donor died, not on “using people as objects” afterward.
“It denigrates disability.” I think what you meant to say was: “it denigrates disabled people.” After all, when did disability per se become venerable? That said, do you not think it presumptuous to expect a disabled person to accept your personal belief over their own respecting a conjectured nobility and purpose to be found in suffering?
“Why can’t ANYONE who is suicidal do the same thing?” Why not indeed?
“She wasn’t terminal. And WHATEVER HAPPENED TO SUICIDE PREVENTION?”
Whether she was terminal shouldn’t be an issue. She obviously made her mind up that she didn’t want to continue living with her present physical ailment. As for “whatever happened to suicide prevention,” who cares? Why not have squads of do-gooders posted in front of bars to dissuade people from drinking, or in front of XXX-rated theaters to dissuade them from exposure to obscene material?
“Self termination should not be made more easy and validated. She could have refused medical treatment. Beyond that, medicine should not go.”
Try a little candor. Your position with respect to assisted suicide is not “it shouldn’t be made easier” but, rather, that it shouldn’t be done at all.
May 10th, 2010 | 2:54 pm
Even in the setting of terminal disease, suicide is always a manifestation of depression, which is itself a clinical disorder. I find it interesting that in this case, so many commentators think that it is the physician’s responsibility to help the disease rather than the patient.
May 10th, 2010 | 7:55 pm
[...] Persons and then Taking Their Organs By nohiddenmagenta Wesley Smith, once again, is all over our slippery slope with regard to euthanasia: The woman in question was not terminally ill, but in a “locked-in” [...]
May 10th, 2010 | 10:14 pm
Susan – That you are bereft of any moral compass is evident. I nominate you for the next donor. [personal insult deleted]
May 11th, 2010 | 12:14 am
punditarian-good point.
May 11th, 2010 | 6:34 am
Punditarian, how did you know she was depressed. Nowhere in the article does it say she had been diagnosed with depression. There is no evidence for your claim. She could have had a clearly lucid mind when she made her decision. I got hit by a semi-truck and was incapacitated for almost a year. I can understand being in a situation where a person who is entirely lucid, can decide that living is just too painful. I saw a psychologist for a little while and found it totally useless. The only thing that helped me was to get physically better.
May 11th, 2010 | 7:41 am
[...] Belgian Doctors Euthanized Disabled Patient and Harvested Her Organs [...]
May 11th, 2010 | 8:51 am
Ragnan D.
What is your criterion for being “bereft of any moral compass”? Disagreeing with you? Disagreeing with the tenets of some religious organization? Disagreeing with Wesley Smith?
Enlighten us, please.
May 11th, 2010 | 2:30 pm
Some of you don’t really get what’s going on in places like Belgium and the Netherlands, or Switzerland. You seem to think it’s some sort of creepy “civil liberty” to be killed by a doctor. It really won’t be about freedom and choice as the state (wherever it is) goes broke, and has to “ration” more and more health care. Euthanasia already is not voluntary in many cases in the countries I mentioned above. When supposedly civilized countries in the 21st century hold life so cheaply, and encourage people to hold their own lives cheap by opting for sanctioned suicide, then a people is heading down the slippery slope to depravity.
May 11th, 2010 | 2:35 pm
“Bioethics” is one of those Orwellian terms meant to hide a monstrous philosophy. The chief architect of “Bioethics” and its accompanying ideology of Utilitarianism is a man named Peter Singer, who champions euthanasia of the “unfit.”
People who defend what happened as described in the above article are useful idiots and deluded fools. You are indeed “bereft of a moral compass,” and clueless about that fact.
May 11th, 2010 | 3:37 pm
I think it’s important for all to realize that, so-called locked in syndrome, is in principle, little different than quadroparalisis. That is, usually, but not always, the basilar artery in the pons, (part or the brain stem that’s continuous with the spinal cord), becomes obstructed, and the neurons that make up the pons, that are supplied by the basilar artery, are destroyed. These neurons include all the desending motor neurons that control the face, and everything below, with the exception of the nerons that control the muscles that allow one to look up and down. So, it’s essentially a worse kind of quadroplegia.
This would be a nightmarish condition to suffer from, and no one can blame this poor woman for wanting out. But her consciousness is intact, and her sensation is as well, and it’s possible, if she receives compassionate, expert care, to live a meaningful life. I’m curious, as to how much of her decision to die was based on, the misguided belief that she was doing her loved ones a “favor”, or her lack of a kind caregiver?
Finally, this condition can be confused with a persistent vegitative state. And, some doctors will, based on the belief that the patient has the latter, will recommend removal of feeding tubes. Both conditions are due to irreversible damage to the pons area of the brainstem, but the locked in syndrome affects “only” the motor tracts, thus sparing the sensory fibers, and the asending reticular formation, which is responsible for, simply put, “waking up”, the cerebral cortex, and allowing consciousness to occur. The persistent vegitative state does basically the reverse. Also, in the latter, the person’s eye’s sometimes will “follow”, a moving object, implying that this was voluntarily done, when in reality, it’s due to unconscious activity in what’s called the superior colliculus, a visual reflex area of the midbrain. As I mentioned, the locked in syndrome persom will also display eye movements, but, only up and down, movements.
I am not a physician, so maybe a physician, particularly a neurologist, can follow up, and provide more, and indeed better, insight into these horrible conditions.
May 13th, 2010 | 10:34 am
Don Rodrigo:
For your information the architect of Utilitarianism was John Stuart Mill, who expounded it in the mid-19th century. NOT Peter Singer.
May 14th, 2010 | 2:45 am
History Writer: Actually, Jeremy Bentham, was the originator of utilitarianism, a generation prior to John Stuart Mill, at the end of the eighteenth century. Bentham influenced James Mill, Joh’s father, who influenced John.
True, John took utilitarianism and elaborated it, and expanded it, but Bentham originated it.
Wesley J. Smith Reply:
May 14th, 2010 at 10:39 am
Bret: And Singer took it farther by including animals into utilitarian analyses, as deserving of equal consideration.
May 14th, 2010 | 12:57 pm
Singer certianly has taken utilitarianism to its logical,ghastly conclusion.
In my view, we should adopt a deontological basis for ethics. We have a duty, to respect the rights of all conscious, or potentially conscious beings, regardless of whether they’re human or animal.
May 16th, 2010 | 12:51 am
Susan’s comment warrants discussion. Her philosophy is cogent if “choice” – like birth or death – is a condition that does not vary. I do not agree with her analysis because “choice” has no an independent, stable meaning person from person, situation to situation. Choice is wildly subjective and temporally variable – though progressives tend to rely on moments of certainty-of-choice experienced by highly educated persons seemingly above influence by ignoble factors. Yet, experience warns humanity, there are always ignoble factors – a reality progressives delusionally deny and conservatives fret over. Being a conservative, I read these “choice” cases and immediately wonder, what’s not been reported here? Was money or benefit received for the organs – were insurance benefits favorably affected by the organ donation? Did any of the organs go to a relative? etc … I have found that, with time, the ignoble factors tend to emerge as predominant factors and the progressives often express … shock and surprise and remorse for the individual. It is not a slippery slope we are concerned with here – it’s the fraud called “choice” which is often nothing more than a calculation of how to best suit and please the persons closest to our care.
May 19th, 2010 | 12:31 pm
Here’s a question for you. How can you tell the difference between a depressed, suicidal person and someone who is non-depressed and wants to die. Do you rely on the person telling you s/he’s depressed? Given the stigma in today’s society, not everyone is open about their mental illness. (And being physically disabled is stigmatized as well. Even your own family can make such a person’s life pure misery.)
One would want to protect depressed people from making a mistake in killing themselves. As a depressed person with cerebral palsy and severe pain, I’ve had days when I wanted to die. I still have days like that and I sound very “lucid” It would take very little for me to track down a euthanasia organization and lobby for the “right” to kill myself. I suspect a lot of people would support that “right”, while not realizing that most of my other rights are violated constantly.
It’s easy to tell a person to be careful about what they say “on a bad day” I expend a lot of energy and strength doing just that. My depression is an on-going issue and if I get into trouble, it’s hard enough to not commit suicide without other people out there to help me to my death. Even if my depression is an on-going concern, I have to be open with my doctors and caregivers about how I feel. (Note: The government cutting my pension and cutting services to me when money is scarce doesn’t help me!)
It’s too simple to tell a depressed person to be quiet. Few people have any idea what severe pain can do to a soul. I shouldn’t have the “right to kill myself” when thoughts of loaded guns dance through my brain. A debate over life and death for me is pure torture. If I were to quietly decide to fight the depression without burdening others, then I would quickly die by my own hand. That’s how strong my depression now is. Just keeping quiet on a bad day takes much of my strength.
I am not still fighting because God or Wesley Smith wants me here but I thank God he and people like him are fighting for the right to life. I do not find anything they write to be sickening to the extent that Peter Singer’s writings are.
I never asked to be physically disabled. I’ve been made to suffer for it by the hand of man, hence the depression. I was never so badly suicidal until chronic pain entered my life and my depression crashed AFTER the pain was under better control. I never wanted any of my disabilities, mental or physical. That I should be forced to accept the tomb as the ultimate solution to my ills, it is both obscene and frightening
I’m still here because of the few friends I have, not because of what pro-lifers want or say, because they can’t take the physical pain away. Knowing that you’re wanted and loved can work wonders. Reading the writers like Singer or even watching society, I can see that I am very UNWANTED. I am also terrified of my friends getting sick of my depression.
You have no idea what abuse combined with severe physical and emotional pain can do to a person. The wheelchair doesn’t bug me as much as how people react to it. Don’t applaud my courage and resolve because there are days when I badly want to quit.
There is a huge difference between natural pain and human cruelty. I see far too much of the latter adding to my grief.
Wesley J. Smith Reply:
May 19th, 2010 at 12:52 pm
Thanks for your comments hamstergirl. We should treat the life of everyone who is suicidal with great care and loving. None should be abandoned to their despair. Hang in there. You are worth it.
May 19th, 2010 | 12:48 pm
It is very easy to want death when you are depressed. I can’t even understand why death is so appealing to me….or why the thoughts are persistent under stress, even on medication. (Others have told me that I had “valid” reasons for suicide, “unlike other people”…one more comment to make me sick.)
I would give all I possessed to be free of depression. If it were a choice between the wheelchair and the depression, I’d chose the wheelchair, because the depression affects my ability to deal with things. It’s not something that can be willed away.
Most able-bodied people would not understand why I am not distraught over not walking. I’ve had this all my life. I’ve known nothing else but the wheelchair, and the painful attempts to walk on crutches that destroyed me physically.
It’s not just one comment…but years and years of them, some from my own parents. I’d give anything to be able to support myself and it is just not possible. What should I do? Apologize? How?
May 19th, 2010 | 6:31 pm
hamstergirl: I’m sorry for what you have gone through. You’re obviously a very strong person. You have no reason to apologize. Please remember that your depression is only temporary.
Think about what you enjoy doing, and go for it. You’re a good writer, and I’m sure you have other talents as well.
I know you will have a great life. Please always seek help from a professional if you feel suicidal. There’s always help out there.
Please remember Wesley Smith’s kind words to you.
Of course, I don’t know you, but I care about you, and I’m sure many others do as well.
June 18th, 2010 | 5:01 am
[...] Moreover, agreeing to harvest organs from euthanasia/assisted suicides raises the very realistic prospect that despairing people with [...]
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